A retrospective cohort analysis of people living with HIV/Aids enrolled in HIV care at a reference center in Antananarivo, Madagascar
Bibliographic Data
| ID | 22088230 |
|---|---|
| Authors | Mihaja Raberahona (0000-0001-8857-5834, University of Antananarivo, corresponding author), Rado Rakotomalala (University of Antananarivo), Volatiana Andriananja (University of Antananarivo), Johary Andriamamonjisoa (0000-0002-5736-8514, University of Antananarivo), Etienne Rakotomijoro (0000-0001-8613-7929, University of Antananarivo), Radonirina Lazasoa Andrianasolo (University of Antananarivo), Rivonirina Andry Rakotoarivelo (Université de Fianarantsoa), Mamy Jean de Dieu Randria (University of Antananarivo) |
| Year | 2024 |
| Volume | 11 |
| Pages | 1329194-1329194 |
| Publication date | 2024-01-15 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2023.1329194 |
| PMID | 38288430 |
| OpenAlex | W4390884499 |
| Language | EN |
| References cited | 29 |
Background The impact of the “Treat all” policy on the individual and in terms of public health is closely related to early diagnosis and retention in care. Patient-level data are scarce in Madagascar. In this study, we aimed to describe the profile of a cohort of newly diagnosed people living with HIV/AIDS (PLHIV), identify their outcomes, and assess factors associated with attrition from care and advanced HIV disease (AHD) at presentation. Methods We conducted a retrospective cohort study of PLHIV aged ≥15 years newly diagnosed at the University Hospital Joseph Raseta Befelatanana Antananarivo from 1 January 2010 to 31 December 2016. Results A total of 490 PLHIV were included in the cohort analysis. In total, 67.1% were male. The median age (interquartile range) at enrollment in care was 29 years (24-38). Overall, 36.1% of PLHIV were diagnosed with AHD at baseline. The proportion of patients with WHO stage IV at baseline increased significantly from 3.3% in 2010 to 31% in 2016 ( p = 0.001 for trend). The probability of retention in care after the diagnosis at 12 months, 24 months, and 36 months was 71.8%, 65.5%, and 61.3%, respectively. Age ≥ 40 years (aHR: 1.55; 95% CI: 1.05–2.29; p = 0.026), low level of education (aHR:1.62; 95% CI: 1.11–2.36; p = 0,013), unspecified level of education (aHR:2.18; 95% CI: 1.37–3.47; p = 0.001) and unemployment (aHR:1.52; 95% CI: 1.07–2.16; p = 0.019) were independently associated with attrition from care. Factors associated with AHD at baseline were age ≥ 40 (aOR: 2.77; 95% CI: 1.38–5.57, p = 0.004), unspecified level of education (aOR: 3.80; 95% CI: 1.58–9.16, p = 0.003) and presence of clinical symptoms at baseline (aOR: 23.81; 95% CI: 10.7–52.98; p < 0.001). Sex workers were independently less likely to have an AHD at presentation (aOR: 0.23; 95% CI: 0.05–0.96, p = 0.044). Conclusion Sociodemographic determinants influenced retention in care more than clinical factors. The presence of clinical symptoms and sociodemographic determinants were the main factors associated with AHD at baseline
Cohort · Cohort study · Interquartile range · Public health · Retrospective cohort study · HIV/AIDS oral health manifestations · HIV/AIDS Research and Interventions · Medicine · Pneumocystis jirovecii pneumonia detection and treatment · Internal Medicine · Pediatrics
| Highly cited | No |
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