{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:21:32Z","timestamp":1779888092481,"version":"3.53.1"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T00:00:00Z","timestamp":1720396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe rates of retention in care and control of hypertension, diabetes and HIV among participants receiving integrated care services for a period of up to 24\u2009months in East Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 5 October 2018 and 23 June 2019 participants enrolled into a prospective cohort study evaluating the feasibility of integrated care delivery for HIV, diabetes and hypertension from a single point of care in Tanzania and Uganda (MOCCA study). Integrated care clinics were established in 10 primary healthcare facilities and care was provided routinely according to national guidelines. Initial follow\u2010up was 12\u2009months. Outcomes were rates of retention in care, proportions of participants with controlled hypertension (blood pressure &lt;140\/90\u2009mmHg), diabetes (fasting blood glucose &lt;7.0\u2009mmol\/L) and HIV (plasma viral load &lt;1000 copies\/ml). The study coincided with the COVID\u201019 pandemic response. Afterwards, all participants were approached for extended follow\u2010up by a further 12\u2009months in the same clinics. We evaluated outcomes of the cohort at the end of long\u2010term follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The MOCCA study enrolled 2273 participants of whom 1911 (84.5%) were retained in care after a median follow\u2010up of 8\u2009months (Interquartile range: 6.8\u201310.7). Among these, 1283\/1911 (67.1%) enrolled for a further year of follow\u2010up, 458 (24.0%) were unreachable, 71 (3.7%) reverted to vertical clinics (clinics providing services dedicated to study conditions), 31 (1.6%) died and 68 (3.6%) refused participation. Among participants who enrolled for longer follow\u2010up, mean age was 51.4\u2009\u00b1\u200911.7\u2009years, 930 (72.5%) were female and 509 (39.7%) had multiple chronic conditions. Overall, 1236 (96.3%) [95% confidence interval 95.2%\u201397.3%] participants were retained in care, representing 1236\/2273 (54.3%) [52.3%\u201356.4%] of participants ever enrolled in the study. Controlled hypertension, diabetes and HIV at the end of follow\u2010up was, 331\/618 (53.6%) [49.5%\u201357.5%], 112\/354 (31.6%) [26.8%\u201336.8%] and 332\/343 (96.7%) [94.3%\u201398.4%] respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Integrated care can achieve high rates of retention in care long term, but control of blood pressure and blood sugar remains low.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.14026","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T07:08:12Z","timestamp":1720422492000},"page":"723-730","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Long\u2010term impact of an integrated <scp>HIV<\/scp>\/non\u2010communicable disease care intervention on patient retention in care and clinical outcomes in East Africa"],"prefix":"10.1111","volume":"29","author":[{"given":"Ivan","family":"Namakoola","sequence":"first","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit  Entebbe Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faith","family":"Moyo","sequence":"additional","affiliation":[{"name":"Institute for Global Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Birungi","sequence":"additional","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit  Entebbe Uganda"},{"name":"School of Psychology and Public Health La Trobe University  Melbourne Victoria Australia"},{"name":"The AIDS Support Organization  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sokoine","family":"Kivuyo","sequence":"additional","affiliation":[{"name":"Muhimbili Medical Research Centre National Institute for Medical Research\u2014Muhimbili Centre  Dar Es Salaam Tanzania"},{"name":"Barcelona Institute for Global Health Hospital Clinic University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Karoli","sequence":"additional","affiliation":[{"name":"Muhimbili Medical Research Centre National Institute for Medical Research\u2014Muhimbili Centre  Dar Es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayoki","family":"Mfinanga","sequence":"additional","affiliation":[{"name":"Muhimbili Medical Research Centre National Institute for Medical Research\u2014Muhimbili Centre  Dar Es Salaam Tanzania"},{"name":"Department of International Public Health Liverpool School of Tropical Medicine  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moffat","family":"Nyirenda","sequence":"additional","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit  Entebbe Uganda"},{"name":"Faculty of Epidemiology and Public Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shabbar","family":"Jaffar","sequence":"additional","affiliation":[{"name":"Institute for Global Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam","family":"Garrib","sequence":"additional","affiliation":[{"name":"Institute for Global Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,8]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Diabetes Atlas 10th Edition 2021.International Diabetes Fund. 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