Trends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho

dc.contributor.authorBygrave, Helenen_ZA
dc.contributor.authorKranzer, Katharinaen_ZA
dc.contributor.authorHilderbrand, Katherineen_ZA
dc.contributor.authorWhittall, Jonathanen_ZA
dc.contributor.authorJouquet, Guillaumeen_ZA
dc.contributor.authorGoemaere, Ericen_ZA
dc.contributor.authorVlahakis, Nathalieen_ZA
dc.contributor.authorTriviño, Lauraen_ZA
dc.contributor.authorMakakole, Lipontsoen_ZA
dc.contributor.authorFord, Nathanen_ZA
dc.date.accessioned2015-11-16T04:08:02Z
dc.date.available2015-11-16T04:08:02Z
dc.date.issued2010en_ZA
dc.description.abstractBACKGROUND: 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.en_ZA
dc.identifier.apacitationBygrave, H., Kranzer, K., Hilderbrand, K., Whittall, J., Jouquet, G., Goemaere, E., ... Ford, N. (2010). Trends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho. <i>PLoS One</i>, http://hdl.handle.net/11427/14984en_ZA
dc.identifier.chicagocitationBygrave, Helen, Katharina Kranzer, Katherine Hilderbrand, Jonathan Whittall, Guillaume Jouquet, Eric Goemaere, Nathalie Vlahakis, Laura Triviño, Lipontso Makakole, and Nathan Ford "Trends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho." <i>PLoS One</i> (2010) http://hdl.handle.net/11427/14984en_ZA
dc.identifier.citationBygrave, H., Kranzer, K., Hilderbrand, K., Whittall, J., Jouquet, G., Goemaere, E., ... & Ford, N. (2010). Trends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho. PLoS One, 5(10), e13198. doi:10.1371/journal.pone.0013198en_ZA
dc.identifier.ris TY - Journal Article AU - Bygrave, Helen AU - Kranzer, Katharina AU - Hilderbrand, Katherine AU - Whittall, Jonathan AU - Jouquet, Guillaume AU - Goemaere, Eric AU - Vlahakis, Nathalie AU - Triviño, Laura AU - Makakole, Lipontso AU - Ford, Nathan AB - 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. DA - 2010 DB - OpenUCT DO - 10.1371/journal.pone.0013198 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - Trends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho TI - Trends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho UR - http://hdl.handle.net/11427/14984 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14984
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0013198
dc.identifier.vancouvercitationBygrave H, Kranzer K, Hilderbrand K, Whittall J, Jouquet G, Goemaere E, et al. Trends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesotho. PLoS One. 2010; http://hdl.handle.net/11427/14984.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2010 Bygrave et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherLabor mobilityen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherLesothoen_ZA
dc.subject.otherSouth Africaen_ZA
dc.subject.otherAIDSen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherAdultsen_ZA
dc.subject.otherAntiretroviralsen_ZA
dc.titleTrends in loss to follow-up among migrant workers on antiretroviral therapy in a community cohort in Lesothoen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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