Document Detail


Evaluation of three sampling methods to monitor outcomes of antiretroviral treatment programmes in low- and middle-income countries.
MedLine Citation:
PMID:  21085709     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Retention of patients on antiretroviral therapy (ART) over time is a proxy for quality of care and an outcome indicator to monitor ART programs. Using existing databases (Antiretroviral in Lower Income Countries of the International Databases to Evaluate AIDS and Médecins Sans Frontières), we evaluated three sampling approaches to simplify the generation of outcome indicators.
METHODS AND FINDINGS: We used individual patient data from 27 ART sites and included 27,201 ART-naive adults (≥15 years) who initiated ART in 2005. For each site, we generated two outcome indicators at 12 months, retention on ART and proportion of patients lost to follow-up (LFU), first using all patient data and then within a smaller group of patients selected using three sampling methods (random, systematic and consecutive sampling). For each method and each site, 500 samples were generated, and the average result was compared with the unsampled value. The 95% sampling distribution (SD) was expressed as the 2.5(th) and 97.5(th) percentile values from the 500 samples. Overall, retention on ART was 76.5% (range 58.9-88.6) and the proportion of patients LFU, 13.5% (range 0.8-31.9). Estimates of retention from sampling (n = 5696) were 76.5% (SD 75.4-77.7) for random, 76.5% (75.3-77.5) for systematic and 76.0% (74.1-78.2) for the consecutive method. Estimates for the proportion of patients LFU were 13.5% (12.6-14.5), 13.5% (12.6-14.3) and 14.0% (12.5-15.5), respectively. With consecutive sampling, 50% of sites had SD within ±5% of the unsampled site value.
CONCLUSIONS: Our results suggest that random, systematic or consecutive sampling methods are feasible for monitoring ART indicators at national level. However, sampling may not produce precise estimates in some sites.
Authors:
Jean-Michel Tassie; Karen Malateste; Mar Pujades-Rodríguez; Elisabeth Poulet; Diane Bennett; Anthony Harries; Mary Mahy; Mauro Schechter; Yves Souteyrand; François Dabis;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-10
Journal Detail:
Title:  PloS one     Volume:  5     ISSN:  1932-6203     ISO Abbreviation:  PLoS ONE     Publication Date:  2010  
Date Detail:
Created Date:  2010-11-18     Completed Date:  2011-04-27     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  101285081     Medline TA:  PLoS One     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e13899     Citation Subset:  IM    
Affiliation:
Department of HIV/AIDS, World Health Organisation, Geneva, Switzerland. tassiej@who.int
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / drug therapy*,  mortality,  virology
Adult
Africa South of the Sahara
Anti-HIV Agents / therapeutic use*
Cambodia
Developing Countries
HIV-1 / drug effects*
Humans
India
Lost to Follow-Up
Outcome Assessment (Health Care) / methods,  statistics & numerical data
Patient Compliance / statistics & numerical data
Patient Dropouts / statistics & numerical data
Program Evaluation / methods*,  statistics & numerical data
Survival Rate
Time Factors
Grant Support
ID/Acronym/Agency:
U01 AI069919/AI/NIAID NIH HHS; U01 AI069924/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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