Resumen

Background: In Malawi, WHO stage 3 is the commonest reason for HIV-infected patients to be started on antiretroviral therapy (ART). The aim of the study was to document disease conditions with which patients are classified in Stage 3 and their relationship to 6-month treatment outcomes. Methodology: A retrospective survey was carried out examining ART patient treatment cards and ART registers in 6 public-sector health facilities in Southern Malawi. Results: There were 490 adult patients in Stage 3 who were started on ART, of whom 458 (93.5%) were started due to one disease condition. Of these patients, symptomatic conditions (unexplained weight loss or chronic/intermittent fever for more than 1 month or chronic diarrhea for more than 1 month) were documented in 216 (47.2%) patients, and active and previous tuberculosis in 148 (32.3%) patients. There were no patients with oral hairy leukoplakia, severe mouth ulceration, or haematological abnormalities. At 6 months, 75% of patients were alive on ART, 14% were dead, 6% were lost to follow-up and 4% were transferred out. Adverse outcomes of death and lost to follow-up were more common in the group with a symptomatic condition (24.9%) compared with the group with a specific disease condition (17.6%) – OR 1.55 [95% CI 0.95-2.53]. Conclusions: Nearly half the ART patients in Stage 3 started therapy due to a symptomatic condition, with outcomes inferior to those starting with a specific diagnosis. A better assessment of patients is needed so that serious, unrecognized diseases, for example tuberculosis, are not missed before starting ART.

Palabras clave: Antiretroviral therapy ART Malawi Stage 3 treatment outcomes.

2007-11-06   |   725 visitas   |   Evalua este artículo 0 valoraciones

Vol. 1 Núm.2. Octubre 2007 Pags. 118-122 J Infect Developing Countries 2007; 1(2)