Retention and loss to follow-up in antiretroviral treatment programmes in southeast NiRetention and loss to follow-up in antiretroviral treatment programmes in southeast Nigeria

This study generated new information about the outcomes of patients enrolled in antiretroviral
treatment programmes, as well as the true outcomes of those lost to follow-up (LTF).
Methods: Anonymized data were collected for patients enrolled over a 12-month period from two
programmes (public and private) in southeast Nigeria. Estimates of retention, LTF, mortality and transfers
were computed. All LTF enrollees (defined as patients who had missed three scheduled visits) whose
contact information met pre-defined criteria were traced.
Results: A total of 481 (public) and 553 (private) records were included. Median duration of follow-up was
about 14 months. Cumulative retention and LTF proportions were 66.5 and 32.8% (public), and 82.6 and
11.0% (private) respectively. LTF rates at third, sixth, ninth and twelfth months were 7.5, 19.3, 25.4 and
29.6% respectively (public), and 4.1, 7.1, 9.0 and 10.0% (private). LTF was higher among males, patients
with CD4z cell count(200 and public programme enrollees. For the public facility, 56.7% of 104 traceable
patients were dead and 38.8% were alive; the figures were 34.2 and 60.5% of 46 patients respectively for
the private. Most deaths had occurred by the third month.
Conclusion: Not all patients enrolled for treatment were retained. Though some died, many were LTF, lived
within the community, and could develop and transmit resistant viral stains. Most traced patients were dead
by the third month and poor contact information limited the effectiveness of tracing. Antiretroviral treatment
programmes need to improve documentation processes and develop and implement tracing strategiesThis study generated new information about the outcomes of patients enrolled in antiretroviral
treatment programmes, as well as the true outcomes of those lost to follow-up (LTF).
Methods: Anonymized data were collected for patients enrolled over a 12-month period from two
programmes (public and private) in southeast Nigeria. Estimates of retention, LTF, mortality and transfers
were computed. All LTF enrollees (defined as patients who had missed three scheduled visits) whose
contact information met pre-defined criteria were traced.
Results: A total of 481 (public) and 553 (private) records were included. Median duration of follow-up was
about 14 months. Cumulative retention and LTF proportions were 66.5 and 32.8% (public), and 82.6 and
11.0% (private) respectively. LTF rates at third, sixth, ninth and twelfth months were 7.5, 19.3, 25.4 and
29.6% respectively (public), and 4.1, 7.1, 9.0 and 10.0% (private). LTF was higher among males, patients
with CD4z cell count(200 and public programme enrollees. For the public facility, 56.7% of 104 traceable
patients were dead and 38.8% were alive; the figures were 34.2 and 60.5% of 46 patients respectively for
the private. Most deaths had occurred by the third month.
Conclusion: Not all patients enrolled for treatment were retained. Though some died, many were LTF, lived
within the community, and could develop and transmit resistant viral stains. Most traced patients were dead
by the third month and poor contact information limited the effectiveness of tracing. Antiretroviral treatment
programmes need to improve documentation processes and develop and implement tracing strategies.