PLoS ONE
Volume 5, Issue 10, 2010

Trends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho (Article) (Open Access)

Bygrave H.* , Kranzer K. , Hilderbrand K. , Whittall J. , Jouquet G. , Goemaere E. , Vlahakis N. , Triviño L. , Makakole L. , Ford N.
  • a Médecins Sans Frontières, Morija, Lesotho
  • b London School of Hygiene and Tropical Medicine, London, United Kingdom
  • c Médecins Sans Frontières, Cape Town, South Africa, Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa
  • d Médecins Sans Frontières, Cape Town, South Africa
  • e Médecins Sans Frontières, Morija, Lesotho
  • f Médecins Sans Frontières, Cape Town, South Africa
  • g Médecins Sans Frontières, Morija, Lesotho
  • h Médecins Sans Frontières, Morija, Lesotho
  • i Scott Hospital, Morija, Lesotho
  • j Médecins Sans Frontières, Cape Town, South Africa, Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa

Abstract

Background: The provision of antiretroviral therapy (ART) to migrant populations raises particular challenges with respect to ensuring adequate treatment support, adherence, and retention in care. We assessed rates of loss to follow-up for migrant workers compared with non-migrant workers in a routine treatment programme in Morjia, Lesotho. Design: All adult patients (≥ 18 years) initiating ART between January 1, 2008, and December 31, 2008, and followed up until the end of 2009, were included in the study. We described rates of loss to follow-up according to migrant status by Kaplan-Meier estimates, and used Poisson regression to model associations between migrant status and loss to follow-up controlling for potential confounders identified a priori. Results: Our cohort comprised 1185 people, among whom 12% (148) were migrant workers. Among the migrant workers, median age was 36.1 (29.6-45.9) and the majority (55%) were male. We found no statistically significant differences between baseline characteristics and migrant status. Rates of lost to follow up were similar between migrants and non-migrants in the first 3 months but differences increased thereafter. Between 3 and 6 months after initiating antiretroviral therapy, migrants had a 2.78-fold increased rate of defaulting (95%CI 1.15-6.73); between 6 and 12 months the rate was 2.36 times greater (95%CI 1.18-4.73), whereas after 1 year the rate was 6.69 times greater (95%CI 3.18-14.09). Conclusions: Our study highlights the need for programme implementers to take into account the specific challenges that may influence continuity of antiretroviral treatment and care for migrant populations. © 2010 Bygrave et al.

Author Keywords

[No Keywords available]

Index Keywords

patient care HIV Infections Human immunodeficiency virus infection follow up human highly active antiretroviral therapy Health Behavior middle aged Cohort Studies Lesotho trend study health service controlled study migrant worker Humans treatment duration male CD4 lymphocyte count female tuberculosis Article patient compliance major clinical study adult migration health care access cohort analysis Transients and Migrants anti human immunodeficiency virus agent Anti-HIV Agents
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-78149444352&doi=10.1371%2fjournal.pone.0013198&partnerID=40&md5=77eacb7388608ce4043c15b376479926
DOI: 10.1371/journal.pone.0013198
ISSN: 19326203
Cited by: 29
Original Language: English