Journal of
AIDS and HIV Research

  • Abbreviation: J. AIDS HIV Res.
  • Language: English
  • ISSN: 2141-2359
  • DOI: 10.5897/JAHR
  • Start Year: 2009
  • Published Articles: 283

Full Length Research Paper

Investigating reasons for clinic absence among HIV-infected patients in Guinea-Bissau - a cohort study

Alcino Furtado
  • Alcino Furtado
  • Bandim Health Project, INDEPTH Network, Bissau Guinea-Bissau.
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Tina Madsen
  • Tina Madsen
  • Bandim Health Project, INDEPTH Network, Bissau Guinea-Bissau.
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Thomas Engell-Sørensen
  • Thomas Engell-Sørensen
  • Bandim Health Project, INDEPTH Network, Bissau Guinea-Bissau.
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Aminata Cande Balde
  • Aminata Cande Balde
  • National HIV program, Ministry of Health, Bissau, Guinea-Bissau.
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Candida Medina
  • Candida Medina
  • National HIV program, Ministry of Health, Bissau, Guinea-Bissau.
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Sanne Jespersen
  • Sanne Jespersen
  • Bandim Health Project, INDEPTH Network, Bissau Guinea-Bissau.
  • Google Scholar
Dlama Nggida Rasmussen
  • Dlama Nggida Rasmussen
  • Centre for Global Health University of Southern Denmark, Odense, Denmark.
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Morten Sodemann
  • Morten Sodemann
  • Centre for Global Health University of Southern Denmark, Odense, Denmark.
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Bo Langhoff Hønge
  • Bo Langhoff Hønge
  • Bandim Health Project, INDEPTH Network, Bissau Guinea-Bissau.
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  •  Received: 15 December 2020
  •  Accepted: 12 April 2021
  •  Published: 31 May 2021

Abstract

Clinic absence or lost to follow-up is still a big challenge in West Africa, especially in Guinea-Bissau, where retention in care is lower compared to all other low- or middle-income countries. The study aims to explore the reasons for clinic absence among HIV-infected patients in Guinea-Bissau, and to evaluate whether the telephone tracing is associated with patients returning to clinic follow-up. A prospective cohort analysis was conducted. Data were collected through telephone calls in which patients or their contact persons were asked for reasons for non-attendance. A total of 3,668 patients, who had been considered as clinic absent were enrolled in this study; 1,883 (51.3%) on antiretroviral treatment (ART) and 1,785 (48.7%) without ART. The median time between patients last clinic visit to time of calling was 203 days (interquartile range (IQR) 59 - 360 days). 748 (20.4%) patients and additional 364 (9.9%) contact persons were successfully reached. Reasons for clinic absence included traveling 346 (31.1%), death 211 (19.0%), and still having medicine 186 (16.7%). After tracing, 555 (49.9%) of the traced patients returned to the clinic. Nineteen percent of the absent HIV-infected patients had died by the time of calling, underscoring the need to improve patient follow-up in Guinea-Bissau. Telephone calls provide an important tool to address reasons for clinic absence and may lead to patients returning to clinical follow-up.

Key words: Clinic Absence, Loss to follow-up, Return, HIV, ART, Telephone, Sub Saharan Africa.