Gilles Wandeler|Olivia Keiser|Karolin Pfeiffer|Sabrina Pestilli|Christiane Fritz|Niklaus Daniel Labhardt|Franzisco Mbofana|Robert F Mudyiradima|Jan Emmel|Matthias Egger|Jochen Ehmer
Outcomes of Antiretroviral Treatment Programs in Rural Southern Africa
University Hospital of Bern|Institute of Social and Preventive Medicine|University of Bern|University of Bern|Institute of Social and Preventive Medicine|Ministry of Health|Ministry of Health and Child Welfare|University of Bern|Institute of Social and Preventive Medicine
data outcomes antiretroviral treatment art programs rural subsaharan african scarce describe early losses longterm outcomes 6 rural programs southern africa limited access viral load monitoring secondline artpatients aged 16 years starting art 2 programs zimbabwe mozambique lesotho included evaluated risk factors followup starting art mortality loss followup ltfu 3 years art using logistic regression competing risk models odds ratios subdistribution hazard ratios adjusted gender age category cd4 category world health organization stage start art reportedamong 7725 patients 449 58 return initiation art 9575 personyears 698 96 least 1 followup visit died 1319 181 ltfu 3 years cumulative incidence death ltfu 125 115135 254 240269 respectively important differences countries follows zimbabwe 751 728773 alive art 3 years compared 554 528580 lesotho 516 480552 mozambique settings young age male gender predicted ltfu whereas advanced clinical stage low baseline cd4 counts predicted deathin african art programs limited access secondline treatment mortality ltfu high first 3 years art low retention care major threat sustainability art delivery southern africa particularly rural sites