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Sampling-Based Approaches to Improve Estimation of Mortality among Patient Dropouts: Experience from a Large PEPFAR-Funded Program in Western Kenya

Author

Listed:
  • Constantin T Yiannoutsos
  • Ming-Wen An
  • Constantine E Frangakis
  • Beverly S Musick
  • Paula Braitstein
  • Kara Wools-Kaloustian
  • Daniel Ochieng
  • Jeffrey N Martin
  • Melanie C Bacon
  • Vincent Ochieng
  • Sylvester Kimaiyo

Abstract

Background: Monitoring and evaluation (M&E) of HIV care and treatment programs is impacted by losses to follow-up (LTFU) in the patient population. The severity of this effect is undeniable but its extent unknown. Tracing all lost patients addresses this but census methods are not feasible in programs involving rapid scale-up of HIV treatment in the developing world. Sampling-based approaches and statistical adjustment are the only scaleable methods permitting accurate estimation of M&E indices. Methodology/Principal Findings: In a large antiretroviral therapy (ART) program in western Kenya, we assessed the impact of LTFU on estimating patient mortality among 8,977 adult clients of whom, 3,624 were LTFU. Overall, dropouts were more likely male (36.8% versus 33.7%; p = 0.003), and younger than non-dropouts (35.3 versus 35.7 years old; p = 0.020), with lower median CD4 count at enrollment (160 versus 189 cells/ml; p

Suggested Citation

  • Constantin T Yiannoutsos & Ming-Wen An & Constantine E Frangakis & Beverly S Musick & Paula Braitstein & Kara Wools-Kaloustian & Daniel Ochieng & Jeffrey N Martin & Melanie C Bacon & Vincent Ochieng &, 2008. "Sampling-Based Approaches to Improve Estimation of Mortality among Patient Dropouts: Experience from a Large PEPFAR-Funded Program in Western Kenya," PLOS ONE, Public Library of Science, vol. 3(12), pages 1-8, December.
    • Handle: RePEc:plo:pone00:0003843
    DOI: 10.1371/journal.pone.0003843
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