Trends in and Determinants of Loss to Follow Up and Early Mortality in a Rapid Expansion of the Antiretroviral Treatment Program in Vietnam: Findings from 13 Outpatient Clinics

Dam Anh Tran; Anh Duc Ngo; Anthony Shakeshaft; David P. Wilson; Christopher Doran; Lei Zhang

doi:10.1371/journal.pone.0073181

Back

Trends in and Determinants of Loss to Follow Up and Early Mortality in a Rapid Expansion of the Antiretroviral Treatment Program in Vietnam: Findings from 13 Outpatient Clinics

Journal article

Open access

Peer reviewed

Trends in and Determinants of Loss to Follow Up and Early Mortality in a Rapid Expansion of the Antiretroviral Treatment Program in Vietnam: Findings from 13 Outpatient Clinics

Dam Anh Tran, Anh Duc Ngo, Anthony Shakeshaft, David P. Wilson, Christopher Doran and Lei Zhang

PLoS One, Vol.8(9), pp.1-8

2013

DOI: https://doi.org/10.1371/journal.pone.0073181

PMID: 24066035

Files and links (1)

pdf

file193.04 kBDownload View

Published Version Open Access CC BY V4.0

Abstract

Background This study aims to describe the trends in and determinants of six month mortality and loss to follow up (LTFU) during 2005–2009 in 13 outpatient clinics in Vietnam. Method Data were obtained from clinical records of 3,449 Vietnamese HIV/AIDS patients aged 18 years or older who initiated ART between 1 January 2005 and 31 December 2009. Mantel-Haenszel chi-square test, log rank test were conducted to examine the trends of baseline characteristics, six month mortality and LTFU. Cox proportional hazards regression models were performed to compute hazard ratio (HR) and 95% Confidence Interval (CI). Results Though there was a declining trend, the incidence of six month mortality and LTFU remained as high as 6% and 15%, respectively. Characteristics associated with six month mortality were gender (HR females versus males 0.54, 95%CI: 0.34–0.85), years of initiation (HR 2009 versus 2005 0.54, 95%CI: 0.41–0.80), low baseline CD4 (HR 350–500 cells/mm3 versus <50 cells/mm3 0.26, 95%CI: 0.18–0.52), low baseline BMI (one unit increase: HR 0.96, 95%CI: 0.94–0.97), co-infection with TB (HR 1.61, 95%CI: 1.46–1.95), history of injecting drugs (HR 1.58, 95%CI: 1.31–1.78). Characteristics associated with LTFU were younger age (one year younger: HR 0.97, 95%CI: 0.95–0.98), males (HR females versus males 0.82, 95%CI: 0.63–0.95), and poor adherence (HR 0.55, 95%CI: 0.13–0.87). Conclusions To reduce early mortality, special attention is required to ensure timely access to ART services, particularly for patients at higher risk. Patients at risk for LTFU after ART initiation should be targeted through enhancing treatment counselling and improving patient tracing system at ART clinics.

Details

Title: Trends in and Determinants of Loss to Follow Up and Early Mortality in a Rapid Expansion of the Antiretroviral Treatment Program in Vietnam: Findings from 13 Outpatient Clinics
Authors: Dam Anh Tran (Corresponding Author) - UNSW Sydney
Anh Duc Ngo - University of South Australia
Anthony Shakeshaft - UNSW Sydney
David P. Wilson - UNSW Sydney
Christopher Doran - Hunter Medical Research Institute
Lei Zhang - UNSW Sydney
Publication details: PLoS One, Vol.8(9), pp.1-8
Publisher: Public Library of Science
Date published: 2013
DOI: 10.1371/journal.pone.0073181
ISSN: 1932-6203
PMID: 24066035
Copyright note: © 2013 Tran et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Organisation Unit: School of Health - Psychology
Language: English
Record Identifier: 991242156002621
Output Type: Journal article

Metrics

1 Record Views

29 Times Cited - Web of Science

See more details