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Effects of Physical Tracing on Estimates of Loss to Follow-Up, Mortality and Retention in Low and Middle Income Country Antiretroviral Therapy Programs: A Systematic Review

Author

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  • James H McMahon
  • Julian H Elliott
  • Steven Y Hong
  • Silvia Bertagnolio
  • Michael R Jordan

Abstract

Background: A large proportion of patients receiving antiretroviral therapy (ART) in low and middle income countries (LMICs) have unknown treatment outcomes and are classified as lost to follow-up (LTFU). Physical tracing of patients classified as LTFU is common; however, effects of tracing on outcomes remains unclear. The objective of this systematic review is to compare estimates of LTFU, mortality and retention in LMIC in cohorts of patients with and without physical tracing. Methods and Findings: We systematically identified studies in LMIC programmatic settings using MEDLINE (2003–2011) and HIV conference abstracts (2009–2011). Studies reporting the proportion LTFU 12-months after ART initiation were included. Tracing activities were determined from manuscripts or by contacting study authors. Studies were classified as “tracing studies” if physical tracing was available for the majority of patients. Summary estimates from the 2 groups of studies (tracing and non-tracing) for LTFU, mortality, stop of ART, transfers out, and retention on ART were determined. 261 papers and 616 abstracts were identified of which 39 studies comprising 54 separate cohorts (n = 187,666) met inclusion criteria. Of those, physical tracing was available for 46% of cohorts. Treatment programs with physical tracing activities had lower estimated LTFU (7.6% vs. 15.1%; p

Suggested Citation

  • James H McMahon & Julian H Elliott & Steven Y Hong & Silvia Bertagnolio & Michael R Jordan, 2013. "Effects of Physical Tracing on Estimates of Loss to Follow-Up, Mortality and Retention in Low and Middle Income Country Antiretroviral Therapy Programs: A Systematic Review," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-12, February.
    • Handle: RePEc:plo:pone00:0056047
    DOI: 10.1371/journal.pone.0056047
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    References listed on IDEAS

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    1. Martin W G Brinkhof & Mar Pujades-Rodriguez & Matthias Egger, 2009. "Mortality of Patients Lost to Follow-Up in Antiretroviral Treatment Programmes in Resource-Limited Settings: Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 4(6), pages 1-9, June.
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