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Mortality and loss to follow-up among HAART initiators in rural South Africa.

Publication ,  Journal Article
MacPherson, P; Moshabela, M; Martinson, N; Pronyk, P
Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene
June 2009

A retrospective cohort study of mortality rates and potential predictors of death was conducted in public-sector patients initiating highly active antiretroviral therapy (HAART) between October 2005 and September 2007 in a rural, under-resourced region of South Africa. The aims were to determine the relative contribution of death to cohort exit and the causes and predictors of mortality among HAART initiators. A community outreach programme traced non-attenders. Patients categorised as dying at home underwent a verbal autopsy (by interviewing family members) and case-file review, and those dying in hospital a case-file review, to determine the probable cause of death. At 24 months 1131 (83.6%) patients were retained on treatment in the programme, 124 (9.2%) had died, 63 (4.7%) had transferred out, and 35 (2.6%) were lost to follow-up. The most common causes of death were tuberculosis (44.3%) and diarrhoeal diseases (24.5%). Death was the major reason for cohort exit. As experience is gained with rural HAART programmes mortality rates may decrease. These results draw attention to the need for early HIV diagnosis, increased access to HAART services with earlier treatment initiation, and routine screening and aggressive management of opportunistic infections, particularly tuberculosis.

Duke Scholars

Published In

Transactions of the Royal Society of Tropical Medicine and Hygiene

DOI

EISSN

1878-3503

ISSN

0035-9203

Publication Date

June 2009

Volume

103

Issue

6

Start / End Page

588 / 593

Related Subject Headings

  • Young Adult
  • Tropical Medicine
  • Treatment Outcome
  • South Africa
  • Rural Health
  • Retrospective Studies
  • Patient Acceptance of Health Care
  • Male
  • Humans
  • Health Services Accessibility
 

Citation

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Chicago
ICMJE
MLA
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MacPherson, P., Moshabela, M., Martinson, N., & Pronyk, P. (2009). Mortality and loss to follow-up among HAART initiators in rural South Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene, 103(6), 588–593. https://doi.org/10.1016/j.trstmh.2008.10.001
MacPherson, Peter, Mosa Moshabela, Neil Martinson, and Paul Pronyk. “Mortality and loss to follow-up among HAART initiators in rural South Africa.Transactions of the Royal Society of Tropical Medicine and Hygiene 103, no. 6 (June 2009): 588–93. https://doi.org/10.1016/j.trstmh.2008.10.001.
MacPherson P, Moshabela M, Martinson N, Pronyk P. Mortality and loss to follow-up among HAART initiators in rural South Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jun;103(6):588–93.
MacPherson, Peter, et al. “Mortality and loss to follow-up among HAART initiators in rural South Africa.Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 103, no. 6, June 2009, pp. 588–93. Epmc, doi:10.1016/j.trstmh.2008.10.001.
MacPherson P, Moshabela M, Martinson N, Pronyk P. Mortality and loss to follow-up among HAART initiators in rural South Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jun;103(6):588–593.
Journal cover image

Published In

Transactions of the Royal Society of Tropical Medicine and Hygiene

DOI

EISSN

1878-3503

ISSN

0035-9203

Publication Date

June 2009

Volume

103

Issue

6

Start / End Page

588 / 593

Related Subject Headings

  • Young Adult
  • Tropical Medicine
  • Treatment Outcome
  • South Africa
  • Rural Health
  • Retrospective Studies
  • Patient Acceptance of Health Care
  • Male
  • Humans
  • Health Services Accessibility