Retention in a NGO supported antiretroviral program in the Democratic Republic of Congo
Retention of patients in ART care is a major challenge in sub-Saharan programs. Retention is also one of the key indicators to evaluate the success of ART programs. A retrospective review of 1500 randomly selected medical charts of adult ART patients from a local non-governmental (NGO) supported ART...
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| creator | Koole, Olivier Kalenga, Lucien Kiumbu, Modeste Menten, Joris Ryder, Robert W Mukumbi, Henri Colebunders, Robert |
| description | Retention of patients in ART care is a major challenge in sub-Saharan programs. Retention is also one of the key indicators to evaluate the success of ART programs.
A retrospective review of 1500 randomly selected medical charts of adult ART patients from a local non-governmental (NGO) supported ART program in the Democratic Republic of Congo (DRC). Retention was defined as any visit to the clinic in the 4 months prior to the abstraction date. Retention over time and across different sites was described. The relationship between patient characteristics and retention rates at 1 year was also examined. 1450 patients were included in the analysis. The overall retention rates were 81.4% (95% CI: 79.3-83.4), 75.2% (95% CI: 72.8-77.3), 65.0% (95% CI: 62.3-67.6) and 57.2% (95% CI: 54.0-60.3) at 6 months, 1 year, 2 years and 3 years respectively. The retention rates between sites varied between 62.1% and 90.6% at 6 months and between 55.5% and 86.2% at 1 year. During multivariable analysis weight below 50 kg (aHR: 1.33, 95%CI: 1.05-1.69), higher WHO stage at initiation (aHR: 1.22, 95%CI 0.85-1.76 for stage 3 and aHR: 2.98, 95%CI: 1.93-4.59 for stage 4), and male sex (aHR: 1.32, 95%CI: 1.05-1.65) remained as significant risk factors for attrition during the first year after ART initiation. Other independent risk factors were year of initiation (aHR: 1.73, 95%CI: 1.26-2.38 for the year 2007 and aHR: 3.06, 95%CI: 2.26-4.14 for the period 2008-2009), and site.
Retention is a major problem in DRC, while coverage of patients on ART is still very low. With the flattening of funding for HIV care and treatment in sub-Saharan Africa, and with decreasing funding worldwide, maximizing retention during the much needed scaling-up will even be more important. |
| doi_str_mv | 10.1371/journal.pone.0040971 |
| format | Article |
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A retrospective review of 1500 randomly selected medical charts of adult ART patients from a local non-governmental (NGO) supported ART program in the Democratic Republic of Congo (DRC). Retention was defined as any visit to the clinic in the 4 months prior to the abstraction date. Retention over time and across different sites was described. The relationship between patient characteristics and retention rates at 1 year was also examined. 1450 patients were included in the analysis. The overall retention rates were 81.4% (95% CI: 79.3-83.4), 75.2% (95% CI: 72.8-77.3), 65.0% (95% CI: 62.3-67.6) and 57.2% (95% CI: 54.0-60.3) at 6 months, 1 year, 2 years and 3 years respectively. The retention rates between sites varied between 62.1% and 90.6% at 6 months and between 55.5% and 86.2% at 1 year. During multivariable analysis weight below 50 kg (aHR: 1.33, 95%CI: 1.05-1.69), higher WHO stage at initiation (aHR: 1.22, 95%CI 0.85-1.76 for stage 3 and aHR: 2.98, 95%CI: 1.93-4.59 for stage 4), and male sex (aHR: 1.32, 95%CI: 1.05-1.65) remained as significant risk factors for attrition during the first year after ART initiation. Other independent risk factors were year of initiation (aHR: 1.73, 95%CI: 1.26-2.38 for the year 2007 and aHR: 3.06, 95%CI: 2.26-4.14 for the period 2008-2009), and site.
Retention is a major problem in DRC, while coverage of patients on ART is still very low. With the flattening of funding for HIV care and treatment in sub-Saharan Africa, and with decreasing funding worldwide, maximizing retention during the much needed scaling-up will even be more important.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0040971</identifier><identifier>PMID: 22815883</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adolescent ; Adult ; Aged ; AIDS ; Anti-Retroviral Agents - therapeutic use ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral Therapy, Highly Active - methods ; Biology ; Charts ; Democratic Republic of the Congo ; Economic indicators ; Female ; Funding ; Geography ; Health Services Accessibility ; HIV ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Male ; Medicine ; Middle Aged ; NGOs ; Nongovernmental organizations ; Organizations, Nonprofit ; Patient Compliance ; Patients ; Proportional Hazards Models ; Retention ; Risk analysis ; Risk Factors ; Scaling ; Sexually transmitted diseases ; STD ; Time Factors ; Treatment Outcome ; Websites</subject><ispartof>PloS one, 2012-07, Vol.7 (7), p.e40971-e40971</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>2012 Koole et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Koole et al. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-16917bb5bb884a87e09bdc312a6b20ba230ed59603a6039189e804435e157e413</citedby><cites>FETCH-LOGICAL-c692t-16917bb5bb884a87e09bdc312a6b20ba230ed59603a6039189e804435e157e413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398868/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398868/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22815883$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koole, Olivier</creatorcontrib><creatorcontrib>Kalenga, Lucien</creatorcontrib><creatorcontrib>Kiumbu, Modeste</creatorcontrib><creatorcontrib>Menten, Joris</creatorcontrib><creatorcontrib>Ryder, Robert W</creatorcontrib><creatorcontrib>Mukumbi, Henri</creatorcontrib><creatorcontrib>Colebunders, Robert</creatorcontrib><title>Retention in a NGO supported antiretroviral program in the Democratic Republic of Congo</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Retention of patients in ART care is a major challenge in sub-Saharan programs. Retention is also one of the key indicators to evaluate the success of ART programs.
A retrospective review of 1500 randomly selected medical charts of adult ART patients from a local non-governmental (NGO) supported ART program in the Democratic Republic of Congo (DRC). Retention was defined as any visit to the clinic in the 4 months prior to the abstraction date. Retention over time and across different sites was described. The relationship between patient characteristics and retention rates at 1 year was also examined. 1450 patients were included in the analysis. The overall retention rates were 81.4% (95% CI: 79.3-83.4), 75.2% (95% CI: 72.8-77.3), 65.0% (95% CI: 62.3-67.6) and 57.2% (95% CI: 54.0-60.3) at 6 months, 1 year, 2 years and 3 years respectively. The retention rates between sites varied between 62.1% and 90.6% at 6 months and between 55.5% and 86.2% at 1 year. During multivariable analysis weight below 50 kg (aHR: 1.33, 95%CI: 1.05-1.69), higher WHO stage at initiation (aHR: 1.22, 95%CI 0.85-1.76 for stage 3 and aHR: 2.98, 95%CI: 1.93-4.59 for stage 4), and male sex (aHR: 1.32, 95%CI: 1.05-1.65) remained as significant risk factors for attrition during the first year after ART initiation. Other independent risk factors were year of initiation (aHR: 1.73, 95%CI: 1.26-2.38 for the year 2007 and aHR: 3.06, 95%CI: 2.26-4.14 for the period 2008-2009), and site.
Retention is a major problem in DRC, while coverage of patients on ART is still very low. With the flattening of funding for HIV care and treatment in sub-Saharan Africa, and with decreasing funding worldwide, maximizing retention during the much needed scaling-up will even be more important.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>AIDS</subject><subject>Anti-Retroviral Agents - therapeutic use</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral Therapy, Highly Active - methods</subject><subject>Biology</subject><subject>Charts</subject><subject>Democratic Republic of the Congo</subject><subject>Economic indicators</subject><subject>Female</subject><subject>Funding</subject><subject>Geography</subject><subject>Health Services Accessibility</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>NGOs</subject><subject>Nongovernmental organizations</subject><subject>Organizations, Nonprofit</subject><subject>Patient Compliance</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Retention</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Scaling</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>Time Factors</subject><subject>Treatment 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koole, Olivier</au><au>Kalenga, Lucien</au><au>Kiumbu, Modeste</au><au>Menten, Joris</au><au>Ryder, Robert W</au><au>Mukumbi, Henri</au><au>Colebunders, Robert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Retention in a NGO supported antiretroviral program in the Democratic Republic of Congo</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2012-07-17</date><risdate>2012</risdate><volume>7</volume><issue>7</issue><spage>e40971</spage><epage>e40971</epage><pages>e40971-e40971</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Retention of patients in ART care is a major challenge in sub-Saharan programs. Retention is also one of the key indicators to evaluate the success of ART programs.
A retrospective review of 1500 randomly selected medical charts of adult ART patients from a local non-governmental (NGO) supported ART program in the Democratic Republic of Congo (DRC). Retention was defined as any visit to the clinic in the 4 months prior to the abstraction date. Retention over time and across different sites was described. The relationship between patient characteristics and retention rates at 1 year was also examined. 1450 patients were included in the analysis. The overall retention rates were 81.4% (95% CI: 79.3-83.4), 75.2% (95% CI: 72.8-77.3), 65.0% (95% CI: 62.3-67.6) and 57.2% (95% CI: 54.0-60.3) at 6 months, 1 year, 2 years and 3 years respectively. The retention rates between sites varied between 62.1% and 90.6% at 6 months and between 55.5% and 86.2% at 1 year. During multivariable analysis weight below 50 kg (aHR: 1.33, 95%CI: 1.05-1.69), higher WHO stage at initiation (aHR: 1.22, 95%CI 0.85-1.76 for stage 3 and aHR: 2.98, 95%CI: 1.93-4.59 for stage 4), and male sex (aHR: 1.32, 95%CI: 1.05-1.65) remained as significant risk factors for attrition during the first year after ART initiation. Other independent risk factors were year of initiation (aHR: 1.73, 95%CI: 1.26-2.38 for the year 2007 and aHR: 3.06, 95%CI: 2.26-4.14 for the period 2008-2009), and site.
Retention is a major problem in DRC, while coverage of patients on ART is still very low. With the flattening of funding for HIV care and treatment in sub-Saharan Africa, and with decreasing funding worldwide, maximizing retention during the much needed scaling-up will even be more important.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22815883</pmid><doi>10.1371/journal.pone.0040971</doi><tpages>e40971</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Acquired immune deficiency syndrome Adolescent Adult Aged AIDS Anti-Retroviral Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral Therapy, Highly Active - methods Biology Charts Democratic Republic of the Congo Economic indicators Female Funding Geography Health Services Accessibility HIV HIV Infections - drug therapy Human immunodeficiency virus Humans Male Medicine Middle Aged NGOs Nongovernmental organizations Organizations, Nonprofit Patient Compliance Patients Proportional Hazards Models Retention Risk analysis Risk Factors Scaling Sexually transmitted diseases STD Time Factors Treatment Outcome Websites |
| title | Retention in a NGO supported antiretroviral program in the Democratic Republic of Congo |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T17%3A34%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Retention%20in%20a%20NGO%20supported%20antiretroviral%20program%20in%20the%20Democratic%20Republic%20of%20Congo&rft.jtitle=PloS%20one&rft.au=Koole,%20Olivier&rft.date=2012-07-17&rft.volume=7&rft.issue=7&rft.spage=e40971&rft.epage=e40971&rft.pages=e40971-e40971&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0040971&rft_dat=%3Cgale_plos_%3EA477074781%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1326223394&rft_id=info:pmid/22815883&rft_galeid=A477074781&rft_doaj_id=oai_doaj_org_article_5784a6d3bd66480ba15df09c579c3320&rfr_iscdi=true |