ArticlePloS one2012
The pattern of attrition from an antiretroviral treatment program in Nigeria.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Retention in Care Among People Living with HIV in Nigeria: A Systematic Review and Meta-analysis.Journal of research in health sciences · 2024Pooled it
- Specification of implementation interventions to address the cascade of HIV care and treatment in resource-limited settings: a systematic review.Implementation science : IS · 2017Pooled it
- Decentralising HIV treatment in lower- and middle-income countries.The Cochrane database of systematic reviews · 2013Pooled it
- Rates and predictors of adherence and retention for antiretroviral therapy among HIV-positive adults in Enugu, Nigeria.Malawi medical journal : the journal of Medical Association of Malawi · 2019Article
- Programmatic outcomes and impact of rapid public sector antiretroviral therapy expansion in adults prior to introduction of the WHO treat-all approach in rural Eswatini.Tropical medicine & international health : TM & IH · 2019Article
- Observational Study of the Effect of Patient Outreach on Return to Care: The Earlier the Better.Journal of acquired immune deficiency syndromes (1999) · 2017Observational
- Social and clinical attributes of patients who restart antiretroviral therapy in central and Copperbelt provinces, Zambia: a retrospective longitudinal study.BMC public health · 2016Article
- Treatment Buddies Improve Clinic Attendance among Women but Not Men on Antiretroviral Therapy in the Nyanza Region of Kenya.AIDS research and treatment · 2016Article
- Outcomes of Nigeria's HIV/AIDS Treatment Program for Patients Initiated on Antiretroviral Treatment between 2004-2012.PloS one · 2016Article
- Pregnant women with HIV in rural Nigeria have higher rates of antiretroviral treatment initiation, but similar loss to follow-up as non-pregnant women and men.International health · 2015Article
- Article
- Enhancing linkage and retention in HIV care: a review of interventions for highly resourced and resource-poor settings.Current HIV/AIDS reports · 2014Review
- Time-Dependent Predictors of Loss to Follow-Up in a Large HIV Treatment Cohort in Nigeria.Open forum infectious diseases · 2014Article
- Risk factors for delayed initiation of combination antiretroviral therapy in rural north central Nigeria.Journal of acquired immune deficiency syndromes (1999) · 2014Article
- Long Term Exposure to Tenofovir Disoproxil Fumarate-Containing Antiretroviral Therapy Is Associated with Renal Impairment in an African Cohort of HIV-Infected Adults.Journal of the International Association of Providers of AIDS CareArticle
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Authors and funding
10 authors.
Funding
Abstract
objectiveTo evaluate the rate and factors associated with attrition of patients receiving ART in tertiary and secondary hospitals in Nigeria. METHODS AND
findingsWe reviewed patient level data collected between 2007 and 2010 from 11 hospitals across Nigeria. Kaplan-Meier product-limit and Cox regression were used to determine probability of retention in care and risk factors for attrition respectively. Of 6,408 patients in the cohort, 3,839 (59.9%) were females, median age of study population was 33years (IQR: 27-40) and 4,415 (69%) were from secondary health facilities. The NRTI backbone was Stavudine (D4T) in 3708 (57.9%) and Zidovudine (ZDV) in 2613 (40.8%) of patients. Patients lost to follow up accounted for 62.7% of all attrition followed by treatment stops (25.3%) and deaths (12.0%). Attrition was 14.1 (N = 624) and 15.1% (N = 300) in secondary and tertiary hospitals respectively (p = 0.169) in the first 12 months on follow up. During the 13 to 24 months follow up period, attrition was 10.7% (N = 407) and 19.6% (N = 332) in secondary and tertiary facilities respectively (p<0.001). Median time to lost to follow up was 11.1 (IQR: 6.1 to 18.5) months in secondary compared with 13.6 (IQR: 9.9 to 17.0) months in tertiary sites (p = 0.002). At 24 months follow up, male gender [AHR 1.18, 95% CI: 1.01-1.37, P = 0.038]; WHO clinical stage III [AHR 1.30, 95%CI: 1.03-1.66, P = 0.03] and clinical stage IV [AHR 1.90, 95%CI: 1.20-3.02, p = 0.007] and care in a tertiary hospital [AHR 2.21, 95% CI: 1.83-2.67, p<0.001], were associated with attrition.
conclusionAttrition could potentially be reduced by decentralizing patients on ART after the first 12 months on therapy to lower level facilities, earlier initiation on treatment and strengthening adherence counseling amongst males.
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