Patient retention, clinical outcomes and attrition-associated factors of HIV-Infected patients enrolled in Zimbabwe’s national antiretroviral therapy programme, 2007 – 2010.
To determine improvement in health status, retention and attrition among HIV-infected patients on ART
Abstract
Background
Since establishment of Zimbabwe’s National Antiretroviral Therapy (ART) Programme in 2004, ART provision has expanded from,5,000 to 369,431 adults by 2011.
Objective
To determine improvement in health status, retention and factors associated with attrition among HIV-infected patients on ART.
Methods
A retrospective review of abstracted patient records of adults $15 years who initiated ART from 2007 to 2009 was done. Frequencies and medians were calculated for rates of retention in care and changes in key health status outcomes at 6, 12, 24 and 36 months respectively.
Results
Of the 3,919 patients, 64% were female, 86% were either WHO clinical stage III or IV. Rates of patient retention at 6, 12, 24 and 36 months were 90.7%, 78.1%, 68.8% and 64.4%, respectively. After ART initiation, median weight gains at 6, 12, and 24 months were 3, 4.5, and 5.0 kgs whilst median CD4+ cell count gains at 6, 12 and 24 months were 122, 157 and 279 cells/mL respectively. Factors associated with an increased risk of attrition included male gender (AHR 1.2; 95% CI, 1.1–1.4), baseline WHO stage IV (AHR 1.7; 95% CI, 1.1–2.6), lower baseline body weight (AHR 2.0; 95% CI, 1.4–2. 8) and accessing care from higher level healthcare facilities (AHR 3.5; 95% 1.1–11.2).
Conclusions
Findings with regard to retention as well as clinical and immunological improvements following uptake of ART, are similar to what has been found in other settings. Factors influencing attrition also mirror those found in other parts of sub-Saharan Africa.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Citation
Mutasa-Apollo T, Shiraishi RW, Takarinda KC, Dzangare J, Mugurungi O, et al. (2014) Patient Retention, Clinical Outcomes and Attrition-Associated Factors of HIV-Infected Patients Enrolled in Zimbabwe’s National Antiretroviral Therapy Programme, 2007–2010. PLoS ONE 9(1): doi:10.1371/journal.pone.0086305