Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort study Article Swipe
Catrina Mugglin
,
Andreas D. Haas
,
Joep van Oosterhout
,
Malango Msukwa
,
Lyson Tenthani
,
Janne Estill
,
Matthias Egger
,
Olivia Keiser
·
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1101/19010322
YOU?
·
· 2019
· Open Access
·
· DOI: https://doi.org/10.1101/19010322
Objectives: We examine long-term retention of adults, adolescents and children on antiretroviral therapy under different HIV treatment guidelines in Malawi. Design: Prospective cohort study. Setting and participants: Adults and children starting ART between 2005 and 2015 in 21 health facilities in southern Malawi. Methods: We used survival analysis to assess retention at clinic level, Cox regression to examine risk factors for loss to follow up, and competing risk analysis to assess long-term outcomes of people on antiretroviral therapy (ART). Results: We included 132,274 individuals in our analysis, totalling 270,256 person years of follow up (PYFU; median per patient 1.3, interquartile range (IQR) 0.26-3.1), 62% were female and the median age was 32 years. Retention on ART was lower in the first year on ART compared to subsequent years for all guideline periods and age groups. Infants (0-3 years), adolescents and young adults (15-24 years) were at highest risk of LTFU. Comparing the different calendar periods of ART initiation we found that retention improved initially, but remained stable thereafter. Conclusion: Even though the number of patients and the burden on health care system increased substantially during the study period of rapid ART expansion, retention on ART improved in the early years of ART provision, but gains in retention were not maintained over 5 years on ART. Reducing high attrition in the first year of ART should remain a priority for ART programs, and so should addressing poor retention among adolescents, young adults and men.
Related Topics
Concepts
Medicine
Interquartile range
Pediatrics
Antiretroviral therapy
Retention rate
Proportional hazards model
Cohort
Young adult
Attrition
Cohort study
Human immunodeficiency virus (HIV)
Prospective cohort study
Demography
Gerontology
Family medicine
Viral load
Surgery
Dentistry
Internal medicine
Sociology
Computer science
Computer security
Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/19010322
- https://www.medrxiv.org/content/medrxiv/early/2019/11/02/19010322.full.pdf
- OA Status
- green
- Cited By
- 2
- References
- 41
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W2983138172
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W2983138172Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1101/19010322Digital Object Identifier
- Title
-
Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort studyWork title
- Type
-
preprintOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2019Year of publication
- Publication date
-
2019-11-02Full publication date if available
- Authors
-
Catrina Mugglin, Andreas D. Haas, Joep van Oosterhout, Malango Msukwa, Lyson Tenthani, Janne Estill, Matthias Egger, Olivia KeiserList of authors in order
- Landing page
-
https://doi.org/10.1101/19010322Publisher landing page
- PDF URL
-
https://www.medrxiv.org/content/medrxiv/early/2019/11/02/19010322.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
-
https://www.medrxiv.org/content/medrxiv/early/2019/11/02/19010322.full.pdfDirect OA link when available
- Concepts
-
Medicine, Interquartile range, Pediatrics, Antiretroviral therapy, Retention rate, Proportional hazards model, Cohort, Young adult, Attrition, Cohort study, Human immunodeficiency virus (HIV), Prospective cohort study, Demography, Gerontology, Family medicine, Viral load, Surgery, Dentistry, Internal medicine, Sociology, Computer science, Computer securityTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
2Total citation count in OpenAlex
- Citations by year (recent)
-
2024: 1, 2023: 1Per-year citation counts (last 5 years)
- References (count)
-
41Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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