Makerere University School of Public Health, Kampala, Uganda.
Trans R Soc Trop Med Hyg. 2012 Feb;106(2):84-9. doi: 10.1016/j.trstmh.2011.10.015. Epub 2011 Dec 10.
Among HIV-infected adults attending non-governmental organization voluntary counseling and testing (VCT) sites in Uganda that provide a nine-month course of isoniazid preventive treatment (IPT), we report on loss to follow-up (LTFU) and its associated risk factors. The design was a retrospective cohort study of program data spanning a three year period (2006-2008). A total of 586 IPT patients were enrolled of whom 335 (57.1%) were females with a mean age of 34 years. Of those starting IPT, 341 (58.1%) were lost to follow-up, 197 (33.6%) completed IPT, 29 (4.9%) were discontinued and 19 (3.2%) died. The return rates at one, three, five and seven months were 78.0% (457), 62.1% (364), 52.9% (310) and 33.6% (197) respectively. Being less than 30 years of age, widowed, separated, or divorced were found to be associated with a higher risk of loss to follow-up. Sudden improvement in retention on IPT was observed between the years 2006 and 2007, although causes of the improvement are poorly understood hence the need for more research. At non-governmental VCT sites in Uganda, six out of ten individuals enrolled on IPT are lost to follow-up and efforts to reduce this attrition including systems strengthening might play a critical role in the success of IPT programs.
在乌干达的非政府组织自愿咨询和检测(VCT)点,为感染艾滋病毒的成年人提供为期九个月的异烟肼预防治疗(IPT),我们报告了失访(LTFU)及其相关的危险因素。该设计是一项为期三年(2006-2008 年)的方案数据回顾性队列研究。共纳入 586 名 IPT 患者,其中 335 名(57.1%)为女性,平均年龄为 34 岁。在开始 IPT 的患者中,有 341 名(58.1%)失访,197 名(33.6%)完成了 IPT,29 名(4.9%)停止了治疗,19 名(3.2%)死亡。一个月、三个月、五个月和七个月的回归率分别为 78.0%(457)、62.1%(364)、52.9%(310)和 33.6%(197)。年龄小于 30 岁、丧偶、分居或离婚与更高的失访风险相关。尽管不太清楚导致这种改善的原因,但在 2006 年至 2007 年期间,IPT 保留率突然提高,因此需要进行更多的研究。在乌干达的非政府 VCT 点,登记参加 IPT 的十个人中有六个失访,包括加强系统在内的减少这种流失的努力可能对 IPT 项目的成功起着至关重要的作用。