{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:33:51Z","timestamp":1790188431364,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,4,9]],"date-time":"2019-04-09T00:00:00Z","timestamp":1554768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["BMGF\u2010OPP1082114"],"award-info":[{"award-number":["BMGF\u2010OPP1082114"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The vital status of patients lost to follow\u2010up often remains unknown in antiretroviral therapy (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>) programmes in sub\u2010Saharan Africa because medical records are no longer updated once the patient disengages from care. Thus, we aimed to assess the outcomes of patients lost to follow\u2010up after ART initiation in north\u2010eastern South Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from a rural area in north\u2010eastern South Africa, we estimated the cumulative incidence of patient outcomes (i) after treatment initiation using clinical records, and (ii) after loss to follow\u2010up (<jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content>) using data from clients that have been individually linked to Agincourt Health and Demographic Surveillance System (<jats:styled-content style=\"fixed-case\">AHDSS<\/jats:styled-content>) database. Aside from <jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content>, we considered mortality, re\u2010engagement and migration out of the study site. Cox proportional hazards regression was used to identify covariates of these patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between April 2014 and July 2017, 3700 patients initiated <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> and contributed a total of 6818 person\u2010years of follow\u2010up time. Three years after <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> initiation, clinical record\u2010based estimates of <jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content>, mortality and documented transfers were 41.0% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 38.5\u201343.4%), 1.9% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.0\u20133.2%) and 0.1% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.0\u20130.9%), respectively. Among those who were <jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content>, the cumulative incidence of re\u2010engagement, out\u2010migration and mortality at 3\u00a0years were 38.1% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 33.1\u201343.0%), 49.4% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 43.1\u201355.3%) and 4.7% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 3.5\u20136.2%), respectively. Pregnant or breastfeeding women, foreigners and those who initiated <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> most recently were at an increased risk of <jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content> among patients starting <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> in north\u2010eastern South Africa is relatively high and has increased in recent years as more asymptomatic patients have initiated treatment. Even though this tendency is of concern in light of the prevention of onwards transmission, we also found that re\u2010engagement in care is common and mortality among persons LTFU relatively low.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13236","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T15:25:38Z","timestamp":1553786738000},"page":"747-756","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Outcomes of patients lost to follow\u2010up after antiretroviral therapy initiation in rural north\u2010eastern South Africa"],"prefix":"10.1111","volume":"24","author":[{"given":"Julie","family":"Ambia","sequence":"first","affiliation":[{"name":"Department of Population Health London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chodziwadziwa","family":"Kabudula","sequence":"additional","affiliation":[{"name":"MRC\/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Risher","sequence":"additional","affiliation":[{"name":"Department of Population Health London School of Hygiene &amp; 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