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Self-transfers, Hospital Admissions and Mortality Among Children and Adolescents Lost to Follow-up From Antiretroviral Therapy Programs in the Western Cape, South Africa Between 2004 and 2019: Linkage to Provincial Records.
Nyakato, Patience; Boulle, Andrew; Wood, Robin; Eley, Brian; Rabie, Helena; Egger, Matthias; Yiannoutsos, Constantin T; Davies, Mary-Ann; Cornell, Morna.
Afiliación
  • Nyakato P; From the Centre for Infectious Disease Epidemiology and Research, School of Public Health, Faculty of Health Sciences, University of Cape Town.
  • Boulle A; Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine.
  • Wood R; From the Centre for Infectious Disease Epidemiology and Research, School of Public Health, Faculty of Health Sciences, University of Cape Town.
  • Eley B; Department of Health, Khayelitsha ART Programme.
  • Rabie H; Department of Health, Western Cape Government: Health.
  • Egger M; Gugulethu HIV Programme and Desmond Tutu HIV Centre, University of Cape Town.
  • Yiannoutsos CT; Red Cross War Memorial Children's Hospital and Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
  • Davies MA; Department of Paediatrics and Child Health, Tygerberg Academic Hospital, University of Stellenbosch, Stellenbosch, South Africa.
  • Cornell M; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Pediatr Infect Dis J ; 43(5): 430-436, 2024 May 01.
Article en En | MEDLINE | ID: mdl-38451913
ABSTRACT

BACKGROUND:

Pediatric programs face a high rate of loss to follow-up (LTFU) among children and adolescents living with HIV (CAHIV). We assessed true outcomes and predictors of these among CAHIV who were LTFU using linkage to the Western Cape Provincial Health Data Centre at Western Cape sites of the International epidemiology Databases to Evaluate AIDS-Southern Africa collaboration.

METHODS:

We examined factors associated with self-transfer, hospital admission and mortality using competing risks regression in a retrospective cohort of CAHIV initiating antiretroviral therapy <15 years old between 2004 and 2019 and deemed LTFU (no recorded visit at the original facility for ≥180 days from the last visit date before database closure and not known to have officially transferred out or deceased).

RESULTS:

Of the 1720 CAHIV deemed LTFU, 802 (46.6%) had self-transferred and were receiving care elsewhere within the Western Cape, 463 (26.9%) had been hospitalized and 45 (2.6%) CAHIV had died. The overall rates of self-transfer, hospitalization, mortality and LTFU were 9.4 [95% confidence interval (CI) 8.8-10.1], 5.4 (95% CI 5.0-6.0), 0.5 (95% CI 0.4-0.7) and 4.8 (95% CI 4.4-5.3) per 100 person-years respectively. Increasing duration on antiretroviral therapy before LTFU was associated with self-transfers while male sex, older age at last visit (≥10 years vs. younger) were associated with hospital admission and immune suppression at last visit was associated with 5 times higher mortality.

CONCLUSIONS:

Nearly half of CAHIV classified as LTFU had self-transferred to another health facility, a quarter had been hospitalized and a small proportion had died.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Fármacos Anti-VIH Límite: Adolescent / Child / Humans / Male País/Región como asunto: Africa Idioma: En Revista: Pediatr Infect Dis J Asunto de la revista: DOENCAS TRANSMISSIVEIS / PEDIATRIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Fármacos Anti-VIH Límite: Adolescent / Child / Humans / Male País/Región como asunto: Africa Idioma: En Revista: Pediatr Infect Dis J Asunto de la revista: DOENCAS TRANSMISSIVEIS / PEDIATRIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos