Effective coverage for antiretroviral therapy in a Ugandan district with a decentralized model of care

Bibliografische gegevens
Hoofdauteurs:	Scheibe, Florian J. B., Waiswa, Peter, Kadobera, Daniel, Müller, Olaf, Ekström, Anna M., Sarker, Malabika, Neuhann, H. W. Florian
Andere auteurs:	James P Grant School of Public Health, BRAC University
Formaat:	Artikel
Taal:	English
Gepubliceerd in:	© 2013 PLoS ONE 2017
Onderwerpen:	Antiretroviral therapy (ART) Uganda HIV patients Young adult
Online toegang:	http://hdl.handle.net/10361/7661 http://doi.org/10.1371/journal.pone.0069433

id	10361-7661
record_format	dspace
spelling	10361-76612017-01-24T09:29:56Z Effective coverage for antiretroviral therapy in a Ugandan district with a decentralized model of care Scheibe, Florian J. B. Waiswa, Peter Kadobera, Daniel Müller, Olaf Ekström, Anna M. Sarker, Malabika Neuhann, H. W. Florian James P Grant School of Public Health, BRAC University Antiretroviral therapy (ART) Uganda HIV patients Young adult This article was published in the PLoS ONE [© 2013 PLoS ONE] and The Journal's website is at: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0069433 Introduction:While increasing access to antiretroviral therapy (ART) is reported from many African countries, data on effective coverage particular from settings without external support or research remains scarce. We examined and report effective coverage data from a public ART program in rural Uganda.Methods:We conducted a retrospective cohort study at all ART-providing governmental health facilities in Iganga District, Eastern Uganda. Based on all HIV patients registered between April 2004 and September 2009 (n = 4775), we assessed indicators of program performance and determined rates of retention and Cox proportional hazards for attrition. Effective ART coverage was calculated using projections (SPECTRUM software) adapted to the district demographic structure and number of people receiving ART.Results:By September 2009, district public sector effective ART coverage was 10.3% for adults and 1.9% for children. After a median follow-up of 26.9 months, overall ART retention was 54.7%. The probability of retention was 0.72 (95% confidence interval (CI) 0.69-0.75) at 12 and 0.58 (CI 0.54-0.62) at 36 months after ART initiation. Individual health facilities differed considerably regarding performance indicators and retention. Overall, 198 (16.9%) individual files of 1171 registered ART patients were lost. Young adult age (15-24 years) had a higher risk of attrition (HR 2.1, CI 1.4-3.2) as well as WHO stage I (HR 4.8, CI 1.9-11.8) and WHO stage IV (HR 2.5, CI 1.3-4.7). An interval ≥6 weeks between HIV testing and ART initiation was associated with a reduced risk (HR 0.6, CI 0.47-0.78).Conclusion:Compared to reported national data effective ART coverage in Iganga District was low. Intensified efforts to improve access, retention in care, and quality of documentation are urgently needed. Children and young adults require special attention in the program. Published 2017-01-24T09:27:46Z 2017-01-24T09:27:46Z 2013 Article Scheibe, F. J. B., Waiswa, P., Kadobera, D., Müller, O., Ekström, A. M., Sarker, M., & Neuhann, H. W. F. (2013). Effective coverage for antiretroviral therapy in a ugandan district with a decentralized model of care. PLoS ONE, 8(7) doi:10.1371/journal.pone.0069433 19326203 http://hdl.handle.net/10361/7661 http://doi.org/10.1371/journal.pone.0069433 en http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0069433 © 2013 PLoS ONE
institution	Brac University
collection	Institutional Repository
language	English
topic	Antiretroviral therapy (ART) Uganda HIV patients Young adult
spellingShingle	Antiretroviral therapy (ART) Uganda HIV patients Young adult Scheibe, Florian J. B. Waiswa, Peter Kadobera, Daniel Müller, Olaf Ekström, Anna M. Sarker, Malabika Neuhann, H. W. Florian Effective coverage for antiretroviral therapy in a Ugandan district with a decentralized model of care
description	This article was published in the PLoS ONE [© 2013 PLoS ONE] and The Journal's website is at: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0069433
author2	James P Grant School of Public Health, BRAC University
author_facet	James P Grant School of Public Health, BRAC University Scheibe, Florian J. B. Waiswa, Peter Kadobera, Daniel Müller, Olaf Ekström, Anna M. Sarker, Malabika Neuhann, H. W. Florian
format	Article
author	Scheibe, Florian J. B. Waiswa, Peter Kadobera, Daniel Müller, Olaf Ekström, Anna M. Sarker, Malabika Neuhann, H. W. Florian
author_sort	Scheibe, Florian J. B.
title	Effective coverage for antiretroviral therapy in a Ugandan district with a decentralized model of care
title_short	Effective coverage for antiretroviral therapy in a Ugandan district with a decentralized model of care
title_full	Effective coverage for antiretroviral therapy in a Ugandan district with a decentralized model of care
title_fullStr	Effective coverage for antiretroviral therapy in a Ugandan district with a decentralized model of care
title_full_unstemmed	Effective coverage for antiretroviral therapy in a Ugandan district with a decentralized model of care
title_sort	effective coverage for antiretroviral therapy in a ugandan district with a decentralized model of care
publisher	© 2013 PLoS ONE
publishDate	2017
url	http://hdl.handle.net/10361/7661 http://doi.org/10.1371/journal.pone.0069433
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Effective coverage for antiretroviral therapy in a Ugandan district with a decentralized model of care

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