Anglaret Xavier, Toure Siaka, Gourvellec Gwénola, Tchehy Amah, Zio Lambert, Zaho Marcel, Kassi Marie-Cécile, Lehou Jean, Coulibaly Hélène, Seyler Catherine, N'Dri-Yoman Thérèse, Salamon Roger, Chêne Geneviève
INSERM U.593, Université Victor Segalen, Bordeaux, France.
J Acquir Immune Defic Syndr. 2004 Mar 1;35(3):320-3. doi: 10.1097/00126334-200403010-00015.
In HIV cohorts in sub-Saharan Africa, documenting vital status of patients lost to follow-up is a major challenge. The effect of specific vital status investigation procedures (VSIPs) on the number of known deaths has never been shown. We assessed the effects of VSIP on survival estimates in a 4-year prospective cohort study in Abidjan, Côte d'Ivoire. As of June 2000, 545 HIV-infected adults had been followed for 1186 person-years, of whom 233 were documented as deceased. Forty-eight percent of deaths were known through scheduled VSIPs, including reading of the newspaper obituaries (2%), telephone calls to relatives (10%), and home visits (36%). Survival probability at 1, 2, and 3 years was estimated to be 0.79, 0.65, and 0.56, respectively. Without VSIP, survival at 1, 2, and 3 years would have been estimated to be 11, 23, and 30% higher, respectively. In this large African capital city, survival estimates closely depended on VSIPs, mainly home visits. We suggest that the percentage of deaths known through VSIPs would be a useful indicator to be added when reporting survival data from urban HIV cohort studies in sub-Saharan Africa.
在撒哈拉以南非洲地区的艾滋病毒队列研究中，记录失访患者的生命状态是一项重大挑战。特定生命状态调查程序（VSIP）对已知死亡人数的影响尚未得到证实。我们在科特迪瓦阿比让进行了一项为期4年的前瞻性队列研究，评估了VSIP对生存估计的影响。截至2000年6月，545名感染艾滋病毒的成年人接受了1186人年的随访，其中233人被记录为死亡。48%的死亡是通过定期VSIP得知的，包括阅读报纸讣告（2%）、给亲属打电话（10%）和家访（36%）。1年、2年和3年的生存概率估计分别为0.79、0.65和0.56。如果没有VSIP，1年、2年和3年的生存率估计分别会高出11%、23%和30%。在这个非洲大城市，生存估计很大程度上依赖于VSIP，主要是家访。我们建议，在报告撒哈拉以南非洲城市艾滋病毒队列研究的生存数据时，通过VSIP得知的死亡百分比将是一个有用的补充指标。
