correcting for mortality among patients lost to follow up on antiretroviral therapy in south africa a cohort analysis校正死亡率患者失去跟进抗逆转录病毒疗法在南非一群分析.pdfVIP

Correcting for Mortality Among Patients Lost to Follow Up on Antiretroviral Therapy in South Africa: A Cohort Analysis 1,2 1,2 1,2 1 3 Gilles Van Cutsem *, Nathan Ford , Katherine Hildebrand , Eric Goemaere , Shaheed Mathee , 1 2 2 Musaed Abrahams , David Coetzee , Andrew Boulle ´ ` 1 Medecins Sans Frontieres, Cape Town, South Africa, 2 Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa, 3 Department of Health, Provincial Government of the Western Cape, Cape Town, South Africa Abstract Background: Loss to follow-up (LTF) challenges the reporting of antiretroviral treatment (ART) programmes, since it encompasses patients alive but lost to programme and deaths misclassified as LTF. We describe LTF before and after correction for mortality in a primary care ART programme with linkages to the national vital registration system. Methods and Findings: We included 6411 patients enrolled on ART between March 2001 and June 2007. Patients LTF with available civil identification numbers were matched with the national vital registration system to ascertain vital status. Corrected mortality and true LTF were determined by weighting these patients to represent all patients LTF. We used Kaplan-Meier estimates and Cox regression to describe LTF, mortality among those LTF, and true LTF. Of 627 patients LTF, 85 (28.8%) had died within 3 months after their last clinic visits. Respective estimates of LTF before and after correction for mortality were 6.9% (95% co