scholarly journals Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort study

2019 ◽  
Author(s):  
Catrina Mugglin ◽  
Andreas Haas ◽  
Joep van Oosterhout ◽  
Malango Msukwa ◽  
Lyson Tenthani ◽  
...  
Keyword(s):  
Young Adults ◽  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Early Years ◽  
First Year ◽  
Term Retention ◽  
Number Of Patients ◽  
Long Term Retention

Objectives: We examine long-term retention of adults, adolescents and children on antiretroviral therapy under different HIV treatment guidelines in Malawi. Design: Prospective cohort study. Setting and participants: Adults and children starting ART between 2005 and 2015 in 21 health facilities in southern Malawi. Methods: We used survival analysis to assess retention at clinic level, Cox regression to examine risk factors for loss to follow up, and competing risk analysis to assess long-term outcomes of people on antiretroviral therapy (ART). Results: We included 132,274 individuals in our analysis, totalling 270,256 person years of follow up (PYFU; median per patient 1.3, interquartile range (IQR) 0.26-3.1), 62% were female and the median age was 32 years. Retention on ART was lower in the first year on ART compared to subsequent years for all guideline periods and age groups. Infants (0-3 years), adolescents and young adults (15-24 years) were at highest risk of LTFU. Comparing the different calendar periods of ART initiation we found that retention improved initially, but remained stable thereafter. Conclusion: Even though the number of patients and the burden on health care system increased substantially during the study period of rapid ART expansion, retention on ART improved in the early years of ART provision, but gains in retention were not maintained over 5 years on ART. Reducing high attrition in the first year of ART should remain a priority for ART programs, and so should addressing poor retention among adolescents, young adults and men.

scholarly journals Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort study

PLoS ONE ◽  
2019 ◽  
Vol 14 (11) ◽  
pp. e0224837 ◽  
Author(s):  
Catrina Mugglin ◽  
Andreas D. Haas ◽  
Joep J. van Oosterhout ◽  
Malango Msukwa ◽  
Lyson Tenthani ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Term Retention ◽  
Adolescents And Adults ◽  
Long Term Retention

scholarly journals Efficacy of implementing intermittent STOP THE BLEED® reviews on long term retention of hemorrhage control skills of first year medical students

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Enkhtsogt Sainbayar ◽  
Nathan Holt ◽  
Amber Jacobson ◽  
Shalini Bhatia ◽  
Christina Weaver
Keyword(s):  
Medical Students ◽  
Intervention Group ◽  
Training Session ◽  
Likert Scale ◽  
Control Group ◽  
First Year ◽  
Hemorrhage Control ◽  
Term Retention ◽  
Long Term Retention

Abstract Context Some medical schools integrate STOP THE BLEED® training into their curricula to teach students how to identify and stop life threatening bleeds; these classes that are taught as single day didactic and hands-on training sessions without posttraining reviews. To improve retention and confidence in hemorrhage control, additional review opportunities are necessary. Objectives To investigate whether intermittent STOP THE BLEED® reviews were effective for long term retention of hemorrhage control skills and improving perceived confidence. Methods First year osteopathic medical students were asked to complete an eight item survey (five Likert scale and three quiz format questions) before (pretraining) and after (posttraining) completing a STOP THE BLEED® training session. After the surveys were collected, students were randomly assigned to one of two study groups. Over a 12 week intervention period, each group watched a 4 min STOP THE BLEED® review video (intervention group) or a “distractor” video (control group) at 4 week intervals. After the 12 weeks, the students were asked to complete an 11 item survey. Results Scores on the posttraining survey were higher than the pretraining survey. The median score on the five Likert scale items was 23 points for the posttraining survey and 14 points for the pretraining survey. Two of the three knowledge based quiz format questions significantly improved from pretraining to posttraining (both p<0.001). On the 11 item postintervention survey, both groups performed similarly on the three quiz questions (all p>0.18), but the intervention group had much higher scores on the Likert scale items than the control group regarding their confidence in their ability to identify and control bleeding (intervention group median = 21.4 points vs. control group median = 16.8 points). Conclusions Intermittent review videos for STOP THE BLEED® training improved medical students’ confidence in their hemorrhage control skills, but the videos did not improve their ability to correctly answer quiz-format questions compared with the control group.

Long-term retention and detection of oxytetracycline marks applied to hatchery-reared larval striped bass, Morone saxatilis

1998 ◽  
Vol 55 (3) ◽  
pp. 539-543 ◽  
Author(s):  
Thomas R Reinert ◽  
Julie Wallin ◽  
Mary C Griffin ◽  
Michael J Conroy ◽  
Michael J Van Den Avyle
Keyword(s):  
Striped Bass ◽  
Retention Rate ◽  
Morone Saxatilis ◽  
First Year ◽  
Detectable Change ◽  
Savannah River ◽  
Term Retention ◽  
Long Term Retention ◽  
Coded Wire Tags

Hatchery-reared larval striped bass, Morone saxatilis, destined for stocking in the Savannah River, Georgia, were immersed in oxytetracycline (OTC) to mark bony structures for later identification. Approximately 170 000 of these fish were raised to larger sizes and tagged with micromagnetic coded-wire tags (CWT). Recaptures of OTC-marked (OTC only) and marked and tagged (OTC and CWT) fish allowed us to determine retention of the OTC mark in otoliths to 3 years of age and to evaluate reader ability to detect those marks. The estimated retention rate was 80.2% for the first year, with no detectable change in additional years. Detection of OTC was age independent and estimated at 72.6% when one otolith was examined versus 92.5% when both otoliths were examined. Only 74.2% (retention x detection) of recaptures in this study would have been correctly identified as stocked fish if OTC alone was used as the marking method.

scholarly journals Ill Effects of Smoking: Baseline Knowledge among School Children and Implementation of the “AntE Tobacco” Project

2011 ◽  
Vol 2011 ◽  
pp. 1-7
Author(s):  
Salim Surani ◽  
Raghu Reddy ◽  
Amy E. Houlihan ◽  
Brenda Parrish ◽  
Gina L. Evans-Hudnall ◽  
...  
Keyword(s):  
Educational Program ◽  
Short Term ◽  
Educational Objectives ◽  
Item Questionnaire ◽  
Term Retention ◽  
Baseline Knowledge ◽  
Long Term Retention ◽  
Tobacco Education

Introduction. Cigarette smoking contributes to the deaths of more than 400,000 Americans annually. Each day >3,000 children and adolescents become regular smokers. This paper details a new antitobacco educational program titled “AntE Tobacco”Method. Children in grades 1–3 were administered a 10-item questionnaire to ascertain their baseline knowledge about the ill effects of smoking, shown an educational cartoon video depicting the ill effects of tobacco, and given a story book based on the video. At the end of video, children were administered a questionnaire to determine short-term recall of the antitobacco educational objectives of the program. Four to 6 weeks later, the children were then administered a follow-up survey to determine long-term retention of the anti tobacco educational program.Result. Eighty two percent of the children answered the outcome questions correctly immediately following the video. At follow-up, 4–6 weeks later, 83% of children answered all questions correctly.Conclusion. The anti tobacco education program used in this study effectively conveyed most of the educational objectives. The results of this study indicate that a multimedia (i.e., video and book) educational program can be used to educate and reinforce anti tobacco messages. This program may be very useful as a part of a comprehensive anti tobacco curriculum in school systems.

scholarly journals Mortality in a cohort of 3.1 million children, adolescents and young adults

2020 ◽  
Vol 74 (3) ◽  
pp. 260-268 ◽  
Author(s):  
Joel G Ray ◽  
Astrid Guttmann ◽  
Jose Silveira ◽  
Alison L Park
Keyword(s):  
Young Adults ◽  
Cohort Study ◽  
Urban Areas ◽  
Demographic Variables ◽  
Adolescents And Young Adults ◽  
First Year ◽  
Preventive Strategies ◽  
Self Harm ◽  
First Year Of Life

BackgroundMany youth deaths occur in the first year of life, from prematurity and anomalies. Detailing mortality after age 1 year may differentially guide preventive strategies in children, adolescents and young adults.MethodsA cohort study in Ontario, Canada comprised 3 139 698 children born from 1990 to 2016. Adjusted HR (aHR) for death between 1 and 24 years were generated, comparing demographic variables and parity.ResultsAfter a median of 13.7 years of follow-up, 6930 deaths occurred between ages 1 and 24 years (incidence rate 17.0 per 100 000 person-years), peaking at age 23 years (43.7 per 100 000). The aHR for death was higher among males than females (1.44, 95% CI 1.37 to 1.51), rural versus urban areas (1.48, 95% CI 1.39 to 1.58), lowest versus highest income areas (1.39, 95% CI 1.29 to 1.51) and at parity 1 (1.16, 95% CI 1.10 to 1.23), parity 2 (1.34, 95% CI 1.23 to 1.45), parity 3+ (1.96, 95% CI 1.74 to 2.21), each relative to a child without an older sibling. Among males, the proportion of deaths due to injury jumped from 30% before age 15 years to 65% thereafter, and in females, from 28% to 51%. Intentional self-harm/assault explained 11% of injury-related deaths among males before age 15 years, and 20% thereafter, with respective figures of 18% and 17% for females. Deaths outside of hospital increased with age, from 35% at age 1 year, to 66% at age 22 years.ConclusionThere is a heightened susceptibility of dying starting at age 15 years, especially among males, from injury, and arising outside of hospital.

scholarly journals Comparative Effectiveness of Pneumococcal Vaccination With PPV23 and PCV13 in COPD Patients Over a 5-Year Follow-Up Cohort Study

2021 ◽  
Author(s):  
Galina L. Ignatova ◽  
Sergey N. Avdeev ◽  
Vladimir Nikolayevich Antonov
Keyword(s):  
Cohort Study ◽  
Pneumococcal Vaccination ◽  
Clinical Effectiveness ◽  
Chronic Obstructive ◽  
First Year ◽  
Clinical Effects ◽  
Copd Exacerbations ◽  
Bode Index

Abstract BackgroundVaccination against Streptococcus pneumoniae is among the most effective measures for preventing pneumonia and reducing the rate of chronic obstructive pulmonary disease (COPD) exacerbations. The objective of this work was to evaluate the long-term effectiveness of PCV13 and PPV23 for preventing pneumonia and COPD exacerbations.MethodsThe open-label, prospective, observational cohort study involved 302 male patients aged ≥45 years: PCV13 group (n=123); PPV23 group (n=32); and vaccine-naïve group (n=147). The primary endpoint included the frequency of pneumonia episodes and COPD exacerbations per year over a 5-year follow-up period. The secondary endpoints included the dynamics of dyspnea severity (MMRC), the BODE index, FEV1, the CAT index, the SGRQ score, and the results of 6-min walk test.ResultsVaccination with PCV13 and PPV23 significantly reduces the total rate of pneumonia during the first year after vaccination. Starting with the second year, clinical effectiveness in PPV23 group decreases compared with both PCV13 group and vaccine-naïve patients. Pneumonia by year 5 after vaccination were registered in versus 47% of patients in the PPV23 group 3.3% of patients in the PCV13 group (p<0.001); COPD exacerbations – in 81.3% versus 23.6%, respectively (p<0.001). Vaccination with PCV13 significantly reduced and maintained the BODE index over the 5-year follow-up period.ConclusionAlthough both vaccines have comparable clinical effects during the first year after vaccination, only PCV13 is characterized by persistent clinical effectiveness during the 5-year follow-up period. Patients older than 55 years on PPV23 have significantly higher risks of having pneumonia episodes more frequently during the long-term follow-up.

scholarly journals Long-term retention and predictors of attrition for key populations receiving antiretroviral treatment through community-based ART in Benue State Nigeria: A retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260557
Author(s):  
Olujuwon Ibiloye ◽  
Plang Jwanle ◽  
Caroline Masquillier ◽  
Sara Van Belle ◽  
Ekere Jaachi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Key Populations ◽  
Community Based ◽  
Term Retention ◽  
Community Based Art ◽  
Long Term Retention

Background Key populations (KP) are disproportionately infected with HIV and experience barriers to HIV care. KP include men who have sex with men (MSM), female sex workers (FSW), persons who inject drugs (PWID) and transgender people (TG). We implemented three different approaches to the delivery of community-based antiretroviral therapy for KP (KP-CBART) in Benue State Nigeria, including One Stop Shop clinics (OSS), community drop-in-centres (DIC), and outreach venues. OSS are community-based health facilities serving KP only. DIC are small facilities led by lay healthcare providers and supported by an outreach team. Outreach venues are places in the community served by the outreach team. We studied long-term attrition of KP and virological non-suppression. Method This is a retrospective cohort study of KP living with HIV (KPLHIV) starting ART between 2016 and 2019 in 3 0SS, 2 DIC and 8 outreach venues. Attrition included lost to follow-up (LTFU) and death. A viral load >1000 copies/mL showed viral non-suppression. Survival analysis was used to assess retention on ART. Cox regression and Firth logistic regression were used to assess risk factors for attrition and virological non-suppression respectively. Result Of 3495 KPLHIV initiated on ART in KP-CBART, 51.8% (n = 1812) were enrolled in OSS, 28.1% (n = 982) in DIC, and 20.1% (n = 701) through outreach venues. The majority of participants were FSW—54.2% (n = 1896), while 29.8% (n = 1040), 15.8% (n = 551) and 0.2% (n = 8) were MSM, PWID, and TG respectively. The overall retention in the programme was 63.5%, 55.4%, 51.2%, and 46.7% at 1 year, 2 years, 3 years, and 4 years on ART. Of 1650 with attrition, 2.5% (n = 41) died and others were LTFU. Once adjusted for other factors (age, sex, place of residence, year of ART enrollment, WHO clinical stage, type of KP group, and KP-CBART approach), KP-CBART approach did not predict attrition. MSM were at a higher risk of attrition (vs FSW; adjusted hazard ratio (aHR) 1.27; 95%CI: 1.14–1.42). Of 3495 patients, 48.4% (n = 1691) had a viral load test. Of those, 97.8% (n = 1654) were virally suppressed. Conclusion Although long-term retention in care is low, the virological suppression was optimal for KP on ART and retained in community-based ART care. However, viral load testing coverage was sub-optimal. Future research should explore the perspectives of clients on reasons for LTFU and how to adapt approach to CBART to meet individual client needs.

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