Interruptions in treatment among adults on anti-retroviral therapy before and after test-and-treat policy in Tanzania.
<h4>Introduction</h4>The World Health Organization recommended the initiation of antiretroviral therapy (ART) for people living with HIV (PLHIV) regardless of CD4 cell counts. Tanzania adopted this recommendation known as test-and-treat policy in 2016. However, programmatic implementatio...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0292740&type=printable |
| _version_ | 1797315885144211456 |
|---|---|
| author | Redempta J Mbatia Expeditho L Mtisi Abbas Ismail Christopher V Henjewele Sisty J Moshi Alexander K Christopher Noela W Nsanzugwanko Appolinary G Bukuku Rehema A Msimbe Agnes R Kirato Francis S Nyabukene Eunice J Mmari Anath A Rwebembera Benedicta N Masanja Alexander Kailembo Eva J Matiko |
| author_facet | Redempta J Mbatia Expeditho L Mtisi Abbas Ismail Christopher V Henjewele Sisty J Moshi Alexander K Christopher Noela W Nsanzugwanko Appolinary G Bukuku Rehema A Msimbe Agnes R Kirato Francis S Nyabukene Eunice J Mmari Anath A Rwebembera Benedicta N Masanja Alexander Kailembo Eva J Matiko |
| author_sort | Redempta J Mbatia |
| collection | DOAJ |
| description | <h4>Introduction</h4>The World Health Organization recommended the initiation of antiretroviral therapy (ART) for people living with HIV (PLHIV) regardless of CD4 cell counts. Tanzania adopted this recommendation known as test-and-treat policy in 2016. However, programmatic implementation of this policy has not been assessed since its initiation. The objective of the study was to assess the impact of this policy in Tanzania.<h4>Methods</h4>This was a cross-sectional study among PLHIV aged 15 years and older using routinely collected program data. The dependent variable was interruption in treatment (IIT), defined as no clinical contact for at least 90 days after the last clinical appointment. The main independent variable was test-and-treat policy status which categorized PLHIV into the before and after groups. Co-variates were age, sex, facility type, clinical stage, CD4 count, ART duration, and body mass index. The associations were assessed using the generalized estimating equation with inverse probability weighting.<h4>Results</h4>The study involved 33,979 PLHIV-14,442 (42.5%) and 19,537 (57.5%) were in the before and after the policy groups, respectively. Among those who experienced IIT, 4,219 (29%) and 7,322 (38%) were in the before and after the policy groups respectively. Multivariable analysis showed PLHIV after the policy was instated had twice [AOR 2.03; 95%CI 1.74-2.38] the odds of experiencing IIT than those before the policy was adopted. Additionally, higher odds of experiencing IIT were observed among younger adults, males, and those with advanced HIV disease.<h4>Conclusion</h4>Demographic and clinical status variables were associated with IIT, as well as the test-and-treat policy. To achieve epidemic control, programmatic adjustments on continuity of treatment may are needed to complement the programmatic implementation of the policy. |
| first_indexed | 2024-03-08T03:10:20Z |
| format | Article |
| id | doaj.art-e638663413de45e59bd76bc86a9fafb8 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-08T03:10:20Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-e638663413de45e59bd76bc86a9fafb82024-02-13T05:34:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011811e029274010.1371/journal.pone.0292740Interruptions in treatment among adults on anti-retroviral therapy before and after test-and-treat policy in Tanzania.Redempta J MbatiaExpeditho L MtisiAbbas IsmailChristopher V HenjeweleSisty J MoshiAlexander K ChristopherNoela W NsanzugwankoAppolinary G BukukuRehema A MsimbeAgnes R KiratoFrancis S NyabukeneEunice J MmariAnath A RwebemberaBenedicta N MasanjaAlexander KailemboEva J Matiko<h4>Introduction</h4>The World Health Organization recommended the initiation of antiretroviral therapy (ART) for people living with HIV (PLHIV) regardless of CD4 cell counts. Tanzania adopted this recommendation known as test-and-treat policy in 2016. However, programmatic implementation of this policy has not been assessed since its initiation. The objective of the study was to assess the impact of this policy in Tanzania.<h4>Methods</h4>This was a cross-sectional study among PLHIV aged 15 years and older using routinely collected program data. The dependent variable was interruption in treatment (IIT), defined as no clinical contact for at least 90 days after the last clinical appointment. The main independent variable was test-and-treat policy status which categorized PLHIV into the before and after groups. Co-variates were age, sex, facility type, clinical stage, CD4 count, ART duration, and body mass index. The associations were assessed using the generalized estimating equation with inverse probability weighting.<h4>Results</h4>The study involved 33,979 PLHIV-14,442 (42.5%) and 19,537 (57.5%) were in the before and after the policy groups, respectively. Among those who experienced IIT, 4,219 (29%) and 7,322 (38%) were in the before and after the policy groups respectively. Multivariable analysis showed PLHIV after the policy was instated had twice [AOR 2.03; 95%CI 1.74-2.38] the odds of experiencing IIT than those before the policy was adopted. Additionally, higher odds of experiencing IIT were observed among younger adults, males, and those with advanced HIV disease.<h4>Conclusion</h4>Demographic and clinical status variables were associated with IIT, as well as the test-and-treat policy. To achieve epidemic control, programmatic adjustments on continuity of treatment may are needed to complement the programmatic implementation of the policy.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0292740&type=printable |
| spellingShingle | Redempta J Mbatia Expeditho L Mtisi Abbas Ismail Christopher V Henjewele Sisty J Moshi Alexander K Christopher Noela W Nsanzugwanko Appolinary G Bukuku Rehema A Msimbe Agnes R Kirato Francis S Nyabukene Eunice J Mmari Anath A Rwebembera Benedicta N Masanja Alexander Kailembo Eva J Matiko Interruptions in treatment among adults on anti-retroviral therapy before and after test-and-treat policy in Tanzania. PLoS ONE |
| title | Interruptions in treatment among adults on anti-retroviral therapy before and after test-and-treat policy in Tanzania. |
| title_full | Interruptions in treatment among adults on anti-retroviral therapy before and after test-and-treat policy in Tanzania. |
| title_fullStr | Interruptions in treatment among adults on anti-retroviral therapy before and after test-and-treat policy in Tanzania. |
| title_full_unstemmed | Interruptions in treatment among adults on anti-retroviral therapy before and after test-and-treat policy in Tanzania. |
| title_short | Interruptions in treatment among adults on anti-retroviral therapy before and after test-and-treat policy in Tanzania. |
| title_sort | interruptions in treatment among adults on anti retroviral therapy before and after test and treat policy in tanzania |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0292740&type=printable |
| work_keys_str_mv | AT redemptajmbatia interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT expeditholmtisi interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT abbasismail interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT christophervhenjewele interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT sistyjmoshi interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT alexanderkchristopher interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT noelawnsanzugwanko interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT appolinarygbukuku interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT rehemaamsimbe interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT agnesrkirato interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT francissnyabukene interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT eunicejmmari interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT anatharwebembera interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT benedictanmasanja interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT alexanderkailembo interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania AT evajmatiko interruptionsintreatmentamongadultsonantiretroviraltherapybeforeandaftertestandtreatpolicyintanzania |