scholarly journals Lost to follow up and clinical outcomes of HIV adult patients on antiretroviral therapy in care and treatment centres in Tanga City, north-eastern Tanzania

2012 ◽  
Vol 14 (4) ◽  
Author(s):  
Williams H. Makunde ◽  
Filbert Francis ◽  
Bruno P. Mmbando ◽  
Mathias L. Kamugisha ◽  
Acleus M. Rutta ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Scaling Up ◽  
Regional Hospital ◽  
Crucial Aspect ◽  
Number Of Patients ◽  
North Eastern ◽  
Patient Documentation ◽  
Care And Treatment ◽  
Lost To Follow Up

Scaling up of Antiretroviral (ARV) drugs is crucial and should be a perpetual venture in developing countries in-order to increase the survival period of HIV/AIDS individuals. In Tanzania, information on the rate of patients considered as lost to follow up during treatment with ARVs is scarce. The objective of this study was to determine the rate of lost to follow up and treatment outcome among patients attending two care and treatment clinics (CTCs) in Tanga City in north-eastern Tanzania. A descriptive observational study was carried out on cohorts from Tanga AIDS Working Group and Bombo Regional Hospital. The total number of patients identified as “lost to follow up” were 89 of which 14 (15.7%) died. Among those who died, 3 (21.4%) died between the second week and 3 months after ARV initiation. Of those still alive (84.3%; 75/89), 25% (19/75) were still on ARVs, whereas 47 (62.7%) self transferred to other CTCs. Proper patient documentation with actual residence address is a crucial aspect for adherence. Similarly, frequent prompt tracing of patient should be part of any drug interventional programme linking   facility and communities.

scholarly journals HIV care and treatment clinic performance following President’s Emergency Plan for AIDS Relief-funded infrastructure improvement in Tanzania

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Boniphace M. Idindili ◽  
Simon J. King ◽  
Kristen Stolka ◽  
Irene Mashasi ◽  
Philberth Bashosho ◽  
...  
Keyword(s):  
Retention In Care ◽  
Adult Patients ◽  
Hiv Care ◽  
Emergency Plan ◽  
Number Of Patients ◽  
The Mean ◽  
Care And Treatment ◽  
Patient Enrolment ◽  
Lost To Follow Up

Purpose: To assess how the infrastructure improvements supported by the US Centers for Disease Control and Prevention (CDC) and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) contributed to facility-level quarterly and annual new patient enrolment in HIV care and treatment and antiretroviral therapy (ART) uptake and retention in care.Methods: Aggregate quarterly and annual facility-based HIV care and treatment data from the CDC-managed PEPFAR Reporting Online and Management Information System database collected between 2005 and 2012 were analysed for the 11 rural and 32 urban facilities that met the eligibility criteria. Infrastructure improvements, including both renovations and new construction, occurred on different dates for the facilities; therefore, data were adjusted such that pre- and post-infrastructure improvements were aligned and date-time was ignored. The analysis calculated the mean (95% confidence interval) number of patients per facility who were (1) newly enrolled in HIV care, (2) patients initiated on ART, (3) patients retained in care, defined as alive and on ART, and (4) reasons for attrition, defined as transferred out, lost to follow-up, deceased or stopped ART.Results: The overall mean number of adult patients newly enrolled in HIV care clinics per quarter declined from 187.7 (151.4–223.9) to 135.2 (117.4–152.9) after infrastructure improvements but was not statistically significant (p = 0.20). However, the mean number of patients who were alive and remained on ART increased from 193.2 (145.3–241.1) to 273.2 (219.0–327.3) after improvements in both rural and urban facilities, although not significantly (p = 0.59). A similar picture was observed for overall paediatric enrolment and retention in care. Health facility-specific case studies show variations in new patient enrolment and retention in care between health facilities depending on the catchment area, population HIV prevalence and coverage of ART facilities. Regarding attrition, the mean number of adult patients lost to follow-up changed from 76.6 (20.8–132.3) to 139.4 (79.6–199.1) (p = 0.65) among rural facilities, while the mean number of children lost to follow-up increased significantly from 3.4 (0.5–6.3) to 8.7 (5.0–12.3) (p = 0.02) after improvements.Conclusion: Patient retention in care improved in HIV care and treatment facilities with infrastructure improvements. However, the overall number of patients newly enrolled and initiated on ART declined and attrition increased in facilities after improvements.

scholarly journals Results of early versus standard silicone stent removal following external dacryocystorhinostomy under local anesthesia

2020 ◽  
Vol 17 (3) ◽  
pp. 263-272
Author(s):  
Ben Limbu ◽  
Benjamin Sim ◽  
Mohan K. Shrestha ◽  
Geoffrey Tabin ◽  
Rohit Saiju
Keyword(s):  
Statistical Difference ◽  
Financial Burden ◽  
Controlled Trial ◽  
Silicone Tube ◽  
Number Of Patients ◽  
Tube Removal ◽  
Silicone Stent ◽  
External Dacryocystorhinostomy ◽  
Lost To Follow Up

Introduction: Many patients in Nepal travel vast distances to have their surgeries in Kathmandu. They often remain close by until their follow-up visit for their silicone tube removal, which contributes to a large financial burden on them and their families. Hence, reducing the time for which silicone tubes remain in situ following external dacryocystorhinostomy (DCR) provides significant benefits to patients. Furthermore, this is the first comparative study which has successfully demonstrated the earliest timeframe for which silicone tubes can be removed following DCR in the medical literature. Methods: A randomized controlled trial consisting of 144 patients was designed to compare patient outcomes after early (2 weeks postoperatively) versus standard (6 weeks postoperatively) removal of silicone stents. The success of their procedures was determined when patients were assessed both symptomatically and anatomically at their 6-month follow-up. Results: The surgical success in both groups was high at 97.8% collectively in both groups and there were only a small number of patients who were lost to follow-up (5 patients) at 6 months. There was no statistical difference at removing silicone stents at 2 or 6 weeks postoperatively. Conclusion: These results were consistent with our pilot study, which showed no statistical difference in long-term success following silicone tube removal at 2 and 6 weeks.

Why are patients lost to follow-up in a gynecologic oncology clinic?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17571-e17571 ◽  
Author(s):  
V. C. Garcia ◽  
A. M. Manalo ◽  
J. B. Toral ◽  
M. L. Siasu
Keyword(s):  
Educational Attainment ◽  
Marital Status ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Cancer Type ◽  
Monthly Income ◽  
Family Commitment ◽  
Number Of Patients ◽  
Lost To Follow Up

e17571 Background: The aim of this study is to investigate why patients are lost to follow-up in a gynecologic oncology clinic. Methods: Patients who had been lost to follow up previously, and eventually followed up between April and August 2007 were given a consent form and questionnaire to answer. An approximately equal number of patients who were not lost to follow-up were given the same questionnaire as controls. The first part of the questionnaire included the age, marital status, location, diagnosis/type of gynecologic cancer, type of intervention, educational attainment, occupation and monthly income. The second part asked directly the reason why they were lost to follow-up. Data were recorded in a computerized database via Microsoft Excel. Descriptive statistics were presented in mean, median, standard deviation, minimum, maximum and frequencies. Differences between patients who failed to follow-up (LF) and their controls (NLF) with respect to demographics, disease and treatment characteristics were assessed by an x2 test or independent t test, depending on the variable. SPSS version 15 was used to perform all analyses. A p < 0.05 was considered significant. Results: There were 50 patients who were not lost and 52 patients who were lost to follow-up. The demographic characteristics between these two groups; i.e., age, marital status, location, diagnosis/type of gynecologic cancer, type of intervention, educational attainment, occupation, and monthly income of patients were all not statistically significant. The most common reason why patients were lost to follow-up was they had no money. Other reasons included: symptoms became better or problems resolved, the follow up was at an inconvenient time and I had family commitment. Conclusions: Patients expressed that the main reason for not following-up was the lack of funds. The majority in these respondents lived below the minimum salary wages. No significant financial relationships to disclose.

scholarly journals Tuberculosis in North-East India: patient profile and treatment outcome of patient attending RNTCP

2019 ◽  
Vol 6 (7) ◽  
pp. 2856
Author(s):  
T. Kayia Priscilla Kayina ◽  
M. Shyami Tarao ◽  
Polly Nula
Keyword(s):  
Treatment Outcome ◽  
Effective Prevention ◽  
Pulmonary Tb ◽  
North East India ◽  
Patient Profile ◽  
North East ◽  
The North ◽  
Number Of Patients ◽  
North Eastern ◽  
Extra Pulmonary

Background: Tuberculosis is a disease of global concern. India with its high burden of Tuberculosis, HIV and HIV-TB co-infection, this disease continue to have tremendous impact on its denizens especially the north-eastern states of the country because of its problem of HIV. It is imperative to understand every aspects of the disease for effective prevention and control.Methods: A retrospective record study of tuberculosis units was conducted.Results: The proportion of males was more as compared to females, with more cases seen with increasing age. Pulmonary TB was seen more among males, whereas extra-pulmonary TB was seen more among females. Favorable treatment outcome was seen in 84.7% of the population. HIV-TB Co-infection was seen 6.5% of the patients, with 46.3% having extra-pulmonary TB. Favorable treatment outcome was seen among them too.Conclusions: More common in males, showing increasing number of patients in older age group with favourable outcomes on treatment in all categories including HIV-TB co-infection patients.

scholarly journals Paediatric Tuberculosis at the Directly Observed Treatment Short-Course Clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

2020 ◽  
pp. 32-38
Author(s):  
B. I. Garba ◽  
T. Yusuf ◽  
L. K. Coker ◽  
K. O. Isezuo ◽  
M. O. Ugege ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Relevant Information ◽  
University Teaching ◽  
First Line ◽  
Successful Treatment Outcome ◽  
Short Course ◽  
Directly Observed Treatment ◽  
Lost To Follow Up ◽  
Paediatric Tuberculosis

Introduction: Tuberculosis (TB) is the leading infectious disease killer worldwide, despite significant progress against the disease in recent years. Most cases of TB in children occur in the TB endemic countries but the actual burden of paediatric TB is unknown. With early diagnosis and treatment using the first-line anti-tuberculous drugs, most people who develop the disease can be cured and onward transmission of infection curtailed. Objective: To determine the pattern and outcome of paediatric tuberculosis managed at a tertiary facility in Sokoto, Nigeria. Materials and Methods: Records of children managed for TB at the Directly observed treatment short-course (DOTS) clinic over a three-and-a-half-year period were reviewed retrospectively. All children (≤ 15 years) treated for TB over the study period was included. Relevant information was retrieved from the register and analysed accordingly. Results: 74 children were treated with 33(44.6%) being males, giving a M: F ratio of 1:1.2. Mean (±SD) age was 85.78 (±55.40) months and 34 (45.9%) belonged to the 0.0-5.0-year age group. Seventy-one (95.9%) were new cases and three (4.1%) were relapse. Pulmonary TB (PTB) was seen in 50 (67.6%), more females had PTB than males, which was not significant (χ2=0.4, p=0.52). Acid fast bacilli (AFB) were positive in only 8 (10.8%) while GeneXpert MTB/RIF sensitivity was detected in 7 (9.2%). Majority 36 (48.6%) were lost to follow up, 30 (40.5%) completed treatment, only 4(5.4%) were cured with no recorded mortality. Successful treatment outcome was low (45.9%). Conclusion: Treatment outcome using DOTS strategy was poor, far below the WHO benchmark. There is need to improve adherence to DOTs therapy to prevent development of multi drug resistant TB. 

Leap forward in the treatment of Pythium insidiosum keratitis

2018 ◽  
Vol 102 (12) ◽  
pp. 1629-1633 ◽  
Author(s):  
Bhupesh Bagga ◽  
Savitri Sharma ◽  
Sai Jeevan Madhuri Guda ◽  
Ritu Nagpal ◽  
Joveeta Joseph ◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
Disc Diffusion ◽  
Pythium Insidiosum ◽  
Exact Test ◽  
Number Of Patients ◽  
Lost To Follow Up ◽  
Diffusion Assay ◽  
Culture Positive

BackgroundPythium insidiosum is a parafungus that causes keratitis resembling fungal keratitis. This study compares outcome in a large cohort of patients with P insidiosum keratitis treated with antifungal drugs, to a pilot group treated with antibacterial antibiotics.MethodsBetween January 2014 and December 2016, 114 patients with culture positive P insidiosum keratitis were included in the study. A subset of culture isolates was tested in vitro for response to nine antibacterial antibiotics by disc diffusion and E test. Patients were treated with topical natamycin in 2014, 2015 and up until mid 2016. Thereafter, the patients received a combination of topical linezolid and topical and oral azithromycin. Therapeutic penetrating keratoplasty (TPK) was done for patients not responding to medical therapy.ResultsIn vitro disc diffusion assay showed linezolid to be most effective. The rate of TPK was significantly higher in 2015 compared with 2016 (43/45, 95.6% vs 22/32, 68.8%; p=0.002). Eighteen patients were treated with antibacterial and 14 were treated with antifungal antibiotic in 2016. One patient was lost to follow-up in each group. The rate of TPK was higher and proportion of healed ulcers was lower (p=0.21, Fisher’s exact test) in the group on antifungal therapy (TPK—11/13, 84.6%; Healed—2/13, 15.3%) compared with the group on antibacterial therapy (TPK—11/17, 64.7%; Healed—6/17, 35.2%).ConclusionsWe report favourable but not statistically significant response of P insidiosum keratitis to antibacterial agents in a pilot series of patients. Further evaluation of this strategy in larger number of patients is recommended.

scholarly journals Prostate Cancer Burden at the Uganda Cancer Institute

2016 ◽  
Vol 2 (4) ◽  
pp. 181-185 ◽  
Author(s):  
Fred Okuku ◽  
Jackson Orem ◽  
George Holoya ◽  
Chris De Boer ◽  
Cheryl L. Thompson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Stage Iv ◽  
Cord Compression ◽  
Hormonal Manipulation ◽  
Number Of Patients ◽  
Stage Iv Disease ◽  
Metastatic Sites ◽  
Lost To Follow Up

Purpose In Uganda, the incidence of prostate cancer is increasing at a rate of 5.2% annually. Data describing presentation and outcomes for patients with prostate cancer are lacking. Methods A retrospective review of medical records for men with histologically confirmed prostate cancer at the Uganda Cancer Institute (UCI) from January 1 to December 17, 2012, was performed. Results Our sample included 182 men whose mean age was 69.5 years (standard deviation, 9.0 years). Patients who presented to the UCI had lower urinary tract symptoms (73%; n = 131), bone pain (18%; n = 32), increased prostate-specific antigen (PSA; 3%; n = 5), and other symptoms (6%; n = 11). Median baseline PSA was 91.3 ng/mL (interquartile range, 19.5-311.3 ng/mL), and 51.1% of the patients (n = 92) had a PSA value above 100 ng/mL. Gleason score was 9 or 10 in 66.7% of the patients (n = 120). Ninety percent (n = 136) had stage IV disease, and metastatic sites included bone (73%; n = 102), viscera (21%; n = 29), and lymph nodes (4%; n = 5). Spinal cord compression occurred in 30.9% (n = 55), and 5.6% (n = 10) experienced a fracture. A total of 14.9% (n = 27) underwent prostatectomy, and 17.7% (n = 32) received radiotherapy. Gonadotropin-releasing hormone agonist was given to 45.3% (n = 82), 29.2% (n = 53) received diethylstilbestrol, and 26% (n = 47) underwent orchiectomy. Chemotherapy was administered to 21.6% (n = 39), and 52.5% (n = 95) received bisphosphonates. During the 12 months of study, 23.8% of the men (n = 43) died, and 54.4% (n = 98) were lost to follow-up. Conclusion UCI patients commonly present with high PSA, aggressive Gleason scores, and stage IV disease. The primary treatments are hormonal manipulation and chemotherapy. Almost 25% of patients succumb within a year of presentation, and a large number of patients are lost to follow-up.

scholarly journals Clinical Characteristics and Treatment Outcome of Pediatric Rhabdomyosarcoma; Retrospective Review

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Zunaira Shaukat ◽  
Raheela Mansoor ◽  
Najma Shaheen ◽  
Saliha Sarfraz ◽  
Komal Seher
Keyword(s):  
Treatment Outcome ◽  
Clinical Characteristics ◽  
Chart Review ◽  
Treatment Plan ◽  
Retrospective Chart Review ◽  
Group Classification ◽  
Primary Tumor Site ◽  
Lost To Follow Up ◽  
Late Stages

Introduction: Rhabdomyosarcoma is the most common soft tissue sarcoma in children. This paper aimed to assess the stage, site, and treatment outcome among rhabdomyosarcoma (RMS) patients. Materials and Methods: A retrospective chart review was completed from January 2011 to December 2017 of patients that presented to the Department of Pediatric Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, for the management of RMS. Data collection included clinical characteristics, staging, grouping, risk stratification, treatment plan, radiotherapy doses, and treatment outcome. Results: Among 24 subjects, there were a total of 13 (54.2%) males and 11 (45.8%) females. The median age at the time of diagnosis was 2.5 years (range: 0.75 - 17 years). The majority of the subjects (91.7%) were less than 10 years of age. The median follow-up time was 0.6 years. According to the Children's Oncology Group Classification, 4 (16.7%) subjects were classified as low risk, 14 (58.3%) subjects were rated as intermediate risk, and 6 (0.25%) subjects were stratified as high risk. The most common primary tumor site were genitourinary (62.5%) and abdomen/retroperitoneal (20.8%) regions. At the time of analysis, nine (37.5%) subjects had died because of the disease, twelve (50%) were alive with no evidence of disease, and one subject had a recurrence of disease and was alive. One subject had abandoned the therapy, and another was lost to follow-up. Conclusion: Patients with Rhabdomyosarcoma presented at the late stages of the disease, and it most frequently affected genitourinary and abdomen or retroperitoneal areas. Overall, Rhabdomyosarcoma was found to have a poor outcome to therapy.

scholarly journals Understanding preferences for HIV care and treatment in Zambia: Evidence from a discrete choice experiment among patients who have been lost to follow-up

PLoS Medicine ◽  
2018 ◽  
Vol 15 (8) ◽  
pp. e1002636 ◽  
Author(s):  
Arianna Zanolini ◽  
Kombatende Sikombe ◽  
Izukanji Sikazwe ◽  
Ingrid Eshun-Wilson ◽  
Paul Somwe ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Hiv Care ◽  
Care And Treatment ◽  
Lost To Follow Up
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