scholarly journals Attrition and Loss to Follow-up Among Children and Adolescents in a Community Home-Based Care HIV Programme in Uganda

2013 ◽  
Vol 03 (05) ◽  
Author(s):  
Massavon William
Keyword(s):  
Children And Adolescents ◽  
Loss To Follow Up ◽  
Home Based ◽  
Home Based Care

scholarly journals Factors Determining Survival and Retention among HIV-Infected Children and Adolescents in a Community Home-Based Care and a Facility-Based Family-Centred Approach in Kampala, Uganda: A Cohort Study

ISRN AIDS ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
W. Massavon ◽  
L. Barlow-Mosha ◽  
L. Mugenyi ◽  
W. McFarland ◽  
G. Gray ◽  
...  
Keyword(s):  
Cohort Study ◽  
Children And Adolescents ◽  
Care Delivery ◽  
Rank Test ◽  
Term Survival ◽  
Log Rank Test ◽  
Home Based ◽  
Significant Difference ◽  
Home Based Care

We describe factors determining retention and survival among HIV-infected children and adolescents engaged in two health care delivery models in Kampala, Uganda: one is a community home-based care (CHBC) and the other is a facility-based family-centred approach (FBFCA). This retrospective cohort study reviewed records from children aged from 0 to 18 years engaged in the two models from 2003 to 2010 focussing on retention/loss to follow-up, mortality, use of antiretroviral therapy (ART), and clinical characteristics. Kaplan Meier survival curves with log rank tests were used to describe and compare retention and survival. Overall, 1,623 children were included, 90.0% (1460/1623) from the CHBC. Children completed an average of 4.2 years of follow-up (maximum 7.7 years). Median age was 53 (IQR: 11–109) months at enrolment. In the CHBC, retention differed significantly between patients on ART and those not (log-rank test, adjusted, P<0.001). Comparing ART patients in both models, there was no significant difference in long-term survival (log-rank test, P=0.308, adjusted, P=0.489), while retention was higher in the CHBC: 94.8% versus 84.7% in the FBFCA (log-rank test, P<0.001, adjusted P=0.006). Irrespective of model of care, children receiving ART had better retention in care and survival.

Home-Based Versus Hospital-Based Care for People with Serious Mental Illness

1994 ◽  
Vol 165 (2) ◽  
pp. 179-194 ◽  
Author(s):  
I. M. Marks ◽  
J. Connolly ◽  
M. Muijen ◽  
B. Audini ◽  
G. McNamee ◽  
...  
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Social Adjustment ◽  
Daily Living ◽  
Emergency Admission ◽  
Controlled Study ◽  
Patient Admissions ◽  
Home Based ◽  
Home Based Care

Background.A controlled study tested whether the superior outcome of community care for serious mental illness (SMI) in Madison and in Sydney would also be found in inner London.Method.Patients from an inner London catchment area who faced emergency admission for SMI (many were violent or suicidal) were randomised to 20 months or more of either home-based care (Daily Living Programme, DLP; n = 92), or standard in-patient and later out-patient care (controls, n = 97). Most DLP patients had brief in-patient stays at some time. Measures included number and duration of in-patient admissions, independent ratings of clinical and social function, and patients' and relatives' satisfaction.Results.Outcome was superior with home-based care. Until month 20, DLP care improved symptoms and social adjustment slightly more, and enhanced patients' and relatives' satisfaction. From 3 to 18 months DLP care greatly reduced the number of in-patient bed days as long as the DLP team was responsible for any in-patient phase its patients had. Cost was less. DLP care did not reduce the number of admissions, nor of deaths from self-harm (3 DLP, 2 control). One DLP patient killed a child. Even at 20 months many DLP and control patients still had severe symptoms, poor social adjustment, no job, and need for assertive follow-up and heavy staff input. (Beyond 20 months most gains were lost apart from satisfaction.)Conclusions.It is unclear how much the gain until 20 months from home-based care was due to its site of care, its being problem-centred, its teaching of daily living skills, its assertive follow-up, the home care team's keeping responsibility for any in-patient phase, its coordination of total care (case management), or to other care components. Home-based care is hard to organise and vulnerable to many factors, and needs careful training and clinical audit if gains are to be sustained.

scholarly journals Nsambya Community Home-Based Care Complements National HIV and TB Management Efforts and Contributes to Health Systems Strengthening in Uganda: An Observational Study

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
William Massavon ◽  
Levi Mugenyi ◽  
Martin Nsubuga ◽  
Rebecca Lundin ◽  
Martina Penazzato ◽  
...  
Keyword(s):  
Observational Study ◽  
Health Systems Strengthening ◽  
People Living With Hiv ◽  
Chi Square ◽  
Loss To Follow Up ◽  
Resource Limited ◽  
Home Based ◽  
Chi Square Test ◽  
Adults And Children ◽  
Home Based Care

Community Home-Based Care (CHBC) has evolved in resource-limited settings to fill the unmet needs of people living with HIV/AIDS (PLHA). We compare HIV and tuberculosis (TB) outcomes from the Nsambya CHBC with national averages in Kampala, Uganda. This retrospective observational study compared HIV and TB outcomes from adults and children in the Nsambya CHBC to national averages from 2007 to 2011. Outcomes included numbers of HIV and TB patients enrolled into care, retention, loss to follow-up (LTFU), and mortality among patients on antiretroviral therapy (ART) at 12 months from initiation; new smear-positive TB cure and defaulter rates; and proportion of TB patients tested for HIV. Chi-square test and trends analyses were used to compare outcomes from Nsambya CHBC with national averages. By 2011, approximately 14,000 PLHA had been enrolled in the Nsambya CHBC, and about 4,000 new cases of TB were detected and managed over the study period. Overall, retention and LTFU of ART patients 12 months after initiation, proportion of TB patients tested for HIV, and cure rates for new smear-positive TB scored higher in the Nsambya CHBC compared to national averages. The findings show that Nsambya CHBC complements national HIV and TB management and results in more positive outcomes.

scholarly journals Loss to follow-up among children and adolescents growing up with HIV infection: age really matters

2017 ◽  
Vol 20 (1) ◽  
pp. 21737 ◽  
Author(s):  
Katharina Kranzer ◽  
John Bradley ◽  
Joseph Musaazi ◽  
Mary Nyathi ◽  
Hilary Gunguwo ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Children And Adolescents ◽  
Growing Up ◽  
Loss To Follow Up ◽  
Infection Age

THE IMPACT OF ACUTE INPATIENT REHABILITATION ON SUBSEQUENT QUALITY OF LIFE IN CHRONIC SCI

2021 ◽  
pp. 26-28
Author(s):  
Ravi Sankaran ◽  
Sreethu P Joy ◽  
Greeshma Varun ◽  
Paul T Francis ◽  
Minu Maria Mathew
Keyword(s):  
Quality Of Life ◽  
Inpatient Rehabilitation ◽  
Developed Countries ◽  
Medical Rehabilitation ◽  
Home Based ◽  
Cord Injury ◽  
Home Based Care ◽  
The Impact

There are 15,000 new cases of spinal cord injury per year in India. The majority of persons survive due to improved quality of acute care compared to the past. Survival impacts Quality of Life. In developed countries quadriplegia is associated with a poor QOL on average. South Asian QOL on average is lower than in developed countries so those with diseases are worse off. A large part of expenditure is on early surgery and subsequent home based therapy. Most are managed at centers without medical rehabilitation units. Once stabilized the patient is discharged for home based care. The net impact leads to lost follow-up or succumbing to associated life-threatening complications. It is established that multidisciplinary rehabilitation improves outcomes in this population. Interventions to improve function thereby QOL may prove cost-effective in the long run. There is no Indian data on the impact on QOL comparing acute inpatient rehabilitation to early home based care in tetraplegia. In this study we report the long-term impact of acute medical rehabilitation with follow-up on Quality of Life in Chronic SCI. We specically report this in Chronic SCI patients greater than 1 year from injury using the EQ5DL3, and VAS.

Factors Affecting Loss to Follow-Up in Children and Adolescents with Chronic Endocrine Conditions

2019 ◽  
Vol 92 (4) ◽  
pp. 254-261
Author(s):  
Laura Atger-Lallier ◽  
Sophie Guilmin-Crepon ◽  
Priscilla Boizeau ◽  
Delphine Zenaty ◽  
Dominique Simon ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Factors Affecting ◽  
Loss To Follow Up

scholarly journals Resistant dermatomyositis in a rural indigenous Maya woman

2019 ◽  
Vol 12 (2) ◽  
pp. e223886 ◽  
Author(s):  
Katia Cnop ◽  
Boris Martinez ◽  
Kirsten E Austad
Keyword(s):  
Care Delivery ◽  
Cultural Barriers ◽  
The Public ◽  
Home Based ◽  
Pulse Dose ◽  
Oral Steroids ◽  
Lost To Follow Up ◽  
Home Based Care ◽  
Free Government

A 28-year-old indigenous Guatemalan woman presented with 7 months of progressive weakness and numerous dermatological findings. She initially sought care within the free government-run health system and was treated with oral steroids for presumed dermatomyositis. Her symptoms progressed, including severe dysphagia, hypophonia and weakness preventing sitting. She was lost to follow-up in the public system due to financial and cultural barriers. A non-governmental organisation tailored to the needs of Maya patients provided home intravenous pulse dose methylprednisolone in the absence of first-line biologicals. With longitudinal home-based care, she achieved symptom free recovery. The rising burden of chronic non-communicable diseases highlights shortcomings in health systems evident in this case, including lack of provider capacity, limited infrastructure to test for and treat rare diseases and poor continuity of care. We provide potential solutions to help care delivery in low-resource settings adapt to the demans of chronic disease control with particular attention to social determinants of health.

scholarly journals COVID-19 Home Based Management in Poor Resources Settings: A Case of Rwanda

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Uwera S ◽  
◽  
Nikwigize S ◽  
Bagwaneza T ◽  
Rutayisire E ◽  
...  
Keyword(s):  
Health Workers ◽  
Economic Status ◽  
World Health ◽  
Home Based ◽  
Access To Water ◽  
The Government ◽  
Health Organization ◽  
And Control ◽  
Home Based Care

COVID-19 is an infectious disease and can be transmitted from humans to humans through infected air droplets during coughing and sneezing or though contact with contaminated hands or surfaces. By March 01st 2021, World Health Organization (WHO) reported 113,820,168 confirmed cases globally, among them 2,851,062 are from the continent of Africa. Rwanda reported 18,850 confirmed cases, and 261 deaths. Healthcare systems have been burdened by the huge number of COVID-19 cases. Home-Based Care (HBC) was introduced as an alternative option to control the pandemic specifically in poor resource countries. Since December 2020, the number of COVID-19 case and death continued to rise in Rwanda. To handle this issue, the government of Rwanda started promoting the home-based care for asymptomatic people or patients with mild symptoms and they would be followed up by trained Community Health Workers (CHW). The increased number of positive cases is attributed to inadequate compliance to COVID-19 Infectious Prevention and Control (IPC) measures, low socio-economic status, inability to self-isolate due to having small and shared living rooms, food insecurity, lack of familiarity to disinfection procedures for home sanitation, inadequate access to water, weak policy regulating HBC, insufficient PPEs for CHWs, CHW fear of getting infected through HBC, low level of community awareness and perception, comorbidities, poor communication during follow up of HBC patients. Overall, we concluded that HBC has been very crucial in management of COVID-19 as it relieved the burden on health facilities, but more improvement on HBC is needed to be properly applicable in poor resource settings.

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