retention in a ngo supported antiretroviral program in the democratic republic of congo保留在一个非政府组织支持刚果民主共和国的抗逆转录病毒程序.pdfVIP

Retention in a NGO Supported Antiretroviral Program in the Democratic Republic of Congo 1 2,3 3 1 4 Olivier Koole *, Lucien Kalenga , Modeste Kiumbu , Joris Menten , Robert W. Ryder , Henri Mukumbi2,3, Robert Colebunders1,5 1 Institute of Tropical Medicine, Antwerp, Belgium, 2 AmoCongo, Lubumbashi, Democratic Republic of Congo, 3 School of Public Health, Kinshasa, Democratic Republic of Congo, 4 Division of Hospital Medicine, University of California San Diego, San Diego, California, United States of America, 5 University of Antwerp, Antwerp, Belgium Abstract Background: Retention of patients in ART care is a major challenge in sub-Saharan programs. Retention is also one of the key indicators to evaluate the success of ART programs. Methods and Findings: A retrospective review of 1500 randomly selected medical charts of adult ART patients from a local non-governmental (NGO) supported ART program in the Democratic Republic of Congo (DRC). Retention was defined as any visit to the clinic in the 4 months prior to the abstraction date. Retention over time and across different sites was described. The relationship between patient characteristics and retention rates at 1 year was also examined. 1450 patients were included in the analysis. The overall retention rates were 81.4% (95% CI: 79.3–83.4), 75.2% (95% CI: 72.8–77.3), 65.0% (95% CI: 62.3–67.6) and 57.2% (95% CI: 54.0–60.3) at 6 months, 1 year, 2 years and 3 years respectively. The retention rates between sites varied between 62.1% and 90.6% at 6 months and between 55.5% and 86.2% at 1 year. During multivariable analysis weight below 50 kg (aHR: 1.33, 95%CI: 1.05–1.69), higher WHO stage at initiation (aHR: 1.22, 95%CI 0.85–1.76 for stage 3 and aHR: 2.98, 95%CI: 1.93–4.59 for