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Leno NN, Guilavogui F, Camara A, Kadio KJJO, Guilavogui T, Diallo TS, Diallo MA, Leno DWA, Ricarte B, Koita Y, Kaba L, Ahiatsi A, Touré N, Traoré P, Chaloub S, Kamano A, Vicente CA, Delamou A, Cissé M. Retention and Predictors of Attrition Among People Living With HIV on Antiretroviral Therapy in Guinea: A 13-Year Historical Cohort Study in Nine Large-Volume Sites. Int J Public Health 2023; 68:1605929. [PMID: 37519433 PMCID: PMC10372218 DOI: 10.3389/ijph.2023.1605929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 05/22/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives: The objective of this study was to estimate the retention rate of patients in an ART program and identify the predictors of attrition. Methods: This was a historical cohort study of HIV patients who started ART between September 2007 and April 2020, and were followed up on for at least 6 months in nine large-volume sites. Kaplan Meier techniques were used to estimate cumulative retention and attrition probabilities. Cox proportional hazards models were used to identify predictors of attrition. Results: The cumulative probability of retention at 12 and 24 months was 76.2% and 70.2%, respectively. The attrition rate after a median follow-up time of 3.1 years was 35.2%, or an incidence of 11.4 per 100 person-years. Having initiated ART between 2012 and 2015; unmarried status; having initiated ART with CD4 count <100 cells/μL; and having initiated ART at an advanced clinical stage were factors significantly associated with attrition. Conclusion: The retention rate in our study is much lower than the proposed national target (90%). Studies to understand the reasons for loss to follow-up are needed.
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Affiliation(s)
- Niouma Nestor Leno
- African Center of Excellence for Prevention and Control of Communicable Diseases (CEA-PCMT), Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Guinea
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University Conakry, Conakry, Guinea
- Ministry of Health, Conakry, Guinea
| | - Foromo Guilavogui
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University Conakry, Conakry, Guinea
- Ministry of Health, Conakry, Guinea
- National AIDS and Hepatitis Control Program, Conakry, Guinea
| | - Alioune Camara
- African Center of Excellence for Prevention and Control of Communicable Diseases (CEA-PCMT), Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Guinea
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University Conakry, Conakry, Guinea
- National Malaria Control Program, Conakry, Guinea
| | | | - Timothé Guilavogui
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University Conakry, Conakry, Guinea
- Ministry of Health, Conakry, Guinea
| | | | | | | | | | - Youssouf Koita
- National AIDS and Hepatitis Control Program, Conakry, Guinea
| | - Laye Kaba
- National AIDS and Hepatitis Control Program, Conakry, Guinea
| | - Arnold Ahiatsi
- National AIDS and Hepatitis Control Program, Conakry, Guinea
| | - Nagnouman Touré
- National AIDS and Hepatitis Control Program, Conakry, Guinea
| | - Pascal Traoré
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University Conakry, Conakry, Guinea
| | | | - André Kamano
- NGO “Doctors Without Borders Belgium”, Conakry, Guinea
| | | | - Alexandre Delamou
- African Center of Excellence for Prevention and Control of Communicable Diseases (CEA-PCMT), Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Guinea
- Department of Public Health, Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University Conakry, Conakry, Guinea
- National Center for Education and Research in Rural Health Maférinyah, Forécariah, Guinea
| | - Mohamed Cissé
- Department of Dermatology and Sexually Transmitted Infections, Gamal Abdel Nasser University of Conakry Faculty of Health Sciences and Techniques, Conakry, Guinea
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TITOU H, BOUI M, HJIRA N. [Cost and factors associated with the prescription of non-antiretroviral drugs among HIV-infected patients under antiretroviral therapy in a reference hospital in Morocco]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2022; 2:mtsi.2022.199. [PMID: 35685838 PMCID: PMC9128496 DOI: 10.48327/mtsi.2022.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/04/2022] [Indexed: 11/24/2022]
Abstract
Objective To determine the costs of non-antiretroviral drugs and to identify the factors associated with their prescription in HIV-1 patients on antiretroviral therapy in Morocco. Methods Retrospective study of a cohort of 264 patients living with HIV-1 who were given antiretroviral therapy in the Venerology Dermatology Department at the Mohamed V Military Training Hospital of Rabat during the period from January 1st, 2014, December 31st, 2018. The costs retained were those of the hospital pharmacy for essential drugs, otherwise they were the costs in the private pharmacies. The logistic regression model was used to analyze the factors associated with prescription. Results Of the 264 patients included, the male predominance was 75%. The median age of patients was 49 [41-57]. At the onset, 21.2% of patients were already in the AIDS stage. After a mean duration of 11.1 ± 6.8 months of antiretroviral therapy, 71.6% of patients received at least one prescription for a non-antiretroviral drug. Over the entire follow-up period, the mean cost per patient was 24.2 €, and the mean cost supported per patient was 22.1 €. After cotrimoxazole (30.7% of patients), the most frequently prescribed drugs were iron (29.2% of patients), antibiotics (20.8% of patients), hypolipemics (20.1% of patients) and general antimycosics (16.3% of patients). Age (RR: 1.01; 95% CI: 1.00-1.07), AIDS stage (RR: 2.15; 95% CI: 1.61-4.19), anemia (RR: 2.02; 95% CI: 2.10-5.41) and number of comorbidities (RR: 2.45; 95% CI: 2.10-5.41) were significantly associated with the prescription of non-antiretroviral drugs. Conclusion Our work highlights the high frequency of prescription of non-antiretroviral drugs in patients living with HIV in Morocco; especially those who are older, anemic at the onset and those who are already at the AIDS stage.
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