食物支持对喀麦隆东部地区医院儿童和青少年艾滋病毒抗逆转录病毒治疗随访失败的积极影响

IF 1.5 Q4 INFECTIOUS DISEASES HIV AIDS-Research and Palliative Care Pub Date : 2023-11-01 DOI:10.2147/hiv.s417852

Habakkuk Yumo, Jackson Jr Ndenkeh, Marcus Beissner

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引用次数: 0

摘要

喀麦隆的儿童艾滋病毒治疗覆盖率仍然很低，只有35%。高随访损失(LTFU)仍然是造成这种糟糕表现的主要因素，这与缺乏实施有效干预措施以提高护理留置率有关。本研究评估了食物支持(FS)对喀麦隆东部农村地区医院儿童和青少年LTFU的影响。方法:这是一项在喀麦隆东部地区阿隆姆邦地区医院(ADH)进行的回顾性前瞻性研究。在研究期间，我们向在该机构开始抗逆转录病毒治疗(ART)的儿童和青少年提供了食品包，并对他们进行了前瞻性随访(前瞻性阶段)。另一方面，利用医疗记录，我们收集了研究前在医院接受抗逆转录病毒治疗的儿童和青少年的回顾性数据(回顾性阶段)。然后，我们使用Fisher精确检验、logistic回归、Kaplan-Meier生存曲线和Cox比例风险模型在5%显著水平下比较研究前(无FS)和研究后(有FS)儿童和青少年LTFU的比例。结果:我们发现，接受FS的儿童和青少年LTFU的比例降低了11倍(2.4%对26.7%，p =0.014)，平均护理保留时间增加了30%(17个月对12个月，p < 0.001)，未接受FS的儿童和青少年LTFU的可能性增加了10倍[aHR=10.3 (4.0 - 26.2)， p < 0.001)]。结论:食物支持是减少接受抗逆转录病毒治疗的儿童和青少年LTFU的有效干预措施。这种干预应得到充分的资金，以便能够在实地大规模实施。这可能有助于改善资源有限地区儿科抗逆转录病毒治疗覆盖率的结果。关键词:艾滋病关爱，食物援助，食物支持，失访，滞留，儿童，青少年

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The Positive Impact of Foods Support on Loss to Follow Up Among Children and Adolescents on HIV Antiretroviral Therapy in a District Hospital in East Cameroon

Introduction: The pediatric HIV treatment coverage in Cameroon remains low at 35%. The high loss to follow up (LTFU) remains a major factor to this dismal performance which is related to the lack of implementation of effective interventions to improve retention in care. This study assessed the impact of foods support (FS) on LTFU among children and adolescents in a rural district hospital in eastern Cameroon. Methods: This was a retro-prospective study conducted in Abong Mbang District Hospital (ADH) in the East Region of Cameroon. We provided foods kits to children and adolescents initiated on antiretroviral therapy (ART) in this facility during the study and followed them up prospectively (prospective phase). On the other hand, using medical records, we collected retrospectively data for children and adolescents who enrolled on ART in the hospital prior to the study (retrospective phase). We then compared the proportions of children and adolescents LTFU before (no FS) and after (with FS) the study, using the Fisher’s exact test, logistic regression, Kaplan–Meier survival curves and Cox proportional-hazards model at 5% significant level. Results: We found that with FS, the proportion of children and adolescents LTFU was 11 times lower (2.4% vs 26.7%, p =0.014), the mean time of retention in care was 30% higher (17 months vs 12 months, p < 0.001) and children and adolescents who did not receive FS were 10 times more likely to be LTFU [aHR=10.3 (4.0– 26.2), p < 0.001)]. Conclusion: Foods support is an effective intervention in reducing LTFU among children and adolescents on ART. This intervention should be adequately funded to enable a large-scale implementation in the field. This could help to improve the outcome of pediatric ART coverage in resource-limited settings. Keywords: HIV care, foods assistance, foods support, loss to follow up, retention, children, adolescents

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来源期刊

HIV AIDS-Research and Palliative Care INFECTIOUS DISEASES-

CiteScore

3.00

自引率

6.70%

发文量

审稿时长

16 weeks

期刊介绍： About Dove Medical Press Dove Medical Press Ltd is part of Taylor & Francis Group, the Academic Publishing Division of Informa PLC. We specialize in the publication of Open Access peer-reviewed journals across the broad spectrum of science, technology and especially medicine. Dove Medical Press was founded in 2003 with the objective of combining the highest editorial standards with the ''best of breed'' new publishing technologies. We have offices in Manchester and London in the United Kingdom, representatives in Princeton, New Jersey in the United States, and our editorial offices are in Auckland, New Zealand. Dr Scott Fraser is our Medical Director based in the UK. He has been in full time clinical practice for over 20 years as well as having an active research interest.