1. Treatment Initiation, Program Attrition and Patient Treatment Outcomes Associated with Scale-Up and Decentralization of HIV Care in Rural Malawi
- Author
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Annette Heinzelmann, Elisabeth Szumilin, Simon D Makombe, Loretxu Pinoges, Mar Pujades-Rodriguez, Rupa Kanapathipillai, Martha Huckabee, Megan McGuire, and Tamika Munyenyembe
- Subjects
Male ,Rural Population ,Pediatrics ,Malawi ,Non-Clinical Medicine ,Epidemiology ,lcsh:Medicine ,HIV Infections ,Logistic regression ,Global Health ,Risk Factors ,Health care ,Clinical Epidemiology ,Longitudinal Studies ,lcsh:Science ,Health Systems Strengthening ,education.field_of_study ,Multidisciplinary ,Mortality rate ,HIV diagnosis and management ,Middle Aged ,AIDS ,Treatment Outcome ,HIV epidemiology ,Medicine ,Infectious diseases ,Female ,Public Health ,Viral load ,Research Article ,Cart ,Adult ,medicine.medical_specialty ,Patient Dropouts ,Clinical Research Design ,Anti-HIV Agents ,Population ,Sexually Transmitted Diseases ,Viral diseases ,Infectious Disease Epidemiology ,medicine ,Humans ,education ,Retrospective Studies ,Health Care Policy ,business.industry ,lcsh:R ,HIV ,Retrospective cohort study ,Confidence interval ,CD4 Lymphocyte Count ,Cross-Sectional Studies ,lcsh:Q ,Rural Health Services ,business - Abstract
Objective To describe patient antiretroviral therapy (cART) outcomes associated with intensive decentralization of services in a rural HIV program in Malawi. Methods Longitudinal analysis of data from HIV-infected patients starting cART between August 2001 and December 2008 and of a cross-sectional immunovirological assessment conducted 12 (±2) months after therapy start. One-year mortality, lost to follow-up, and attrition (deaths and lost to follow-up) rates were estimated with exact Poisson 95% confidence intervals (CI) by type of care delivery and year of initiation. Association of virological suppression (
- Published
- 2012