ArticlePloS one2014
Patient retention, clinical outcomes and attrition-associated factors of HIV-infected patients enrolled in Zimbabwe's National Antiretroviral Therapy Programme, 2007-2010.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 3 of them syntheses that pooled it.
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Who cites it
57 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Predictors of Adult Retention in HIV Care: A Systematic Review.AIDS and behavior · 2018Pooled it
- Pooled it
- Retention of Adult Patients on Antiretroviral Therapy in Low- and Middle-Income Countries: Systematic Review and Meta-analysis 2008-2013.Journal of acquired immune deficiency syndromes (1999) · 2015Pooled it
- Trial
- Sex Differences in HIV Prevalence Persist over Time: Evidence from 18 Countries in Sub-Saharan Africa.PloS one · 2016Trial
- Trial
- Trial
- Retention in HIV care before and after implementation of a case management program in Malawi.BMC public health · 2026Article
- The loss to follow-up of participants excluded from the NAMSAL trial: a retrospective cohort study.Scientific reports · 2025Article
- Effect of antiretroviral therapy on retention of people living with HIV in India (2012-2017): a retrospective, cohort study.The Lancet regional health. Southeast Asia · 2025Article
- Article
- Using adult care visits to diagnose HIV infection in children, Burkina Faso.Bulletin of the World Health Organization · 2024Article
- Article
- Loss to Follow-Up Risk among HIV Patients on ART in Zimbabwe, 2009-2016: Hierarchical Bayesian Spatio-Temporal Modeling.International journal of environmental research and public health · 2022Article
- Survival probability and factors associated with time to loss to follow-up and mortality among patients on antiretroviral treatment in central Kenya.BMC infectious diseases · 2022Article
- Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem.BMC infectious diseases · 2022Observational
- The cascade of care of HIV after one year of follow-up in a cohort of HIV-positive adult patients in three health settings of Morrumbene in rural Mozambique.Tropical medicine & international health : TM & IH · 2021Observational
- Markov modelling of viral load adjusting for CD4 orthogonal variable and multivariate conditional autoregressive mapping of the HIV immunological outcomes among ART patients in Zimbabwe.Theoretical biology & medical modelling · 2021Article
- A review of multistate modelling approaches in monitoring disease progression: Bayesian estimation using the Kolmogorov-Chapman forward equations.Statistical methods in medical research · 2021Review
- Ten-year attrition and antiretroviral therapy response among HIV-positive adults: a sex-based cohort analysis from eight West African countries.Journal of the International AIDS Society · 2021Article
Corrections and comments
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8 authors.
Funding
Abstract
backgroundSince establishment of Zimbabwe's National Antiretroviral Therapy (ART) Programme in 2004, ART provision has expanded from <5,000 to 369,431 adults by 2011. However, patient outcomes are unexplored.
objectiveTo determine improvement in health status, retention and factors associated with attrition among HIV-infected patients on ART.
methodsA 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. Cox proportional hazards models were used to determine factors associated with attrition.
resultsOf 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/µL 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).
conclusionsOur 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. These findings suggest the need to strengthen earlier diagnosis and treatment to further improve treatment outcomes. Whilst decentralisation improves ART coverage it should be coupled with strategies aimed at improving patient retention.
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