PLoS Articles
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UNC-authored articles published by the Public Library of Science (PLoS)
Works (2112)
1861. Exploring factors associated with ART adherence and retention in care under Option B+ strategy in Malawi: A qualitative study
- Title Tesim:
- Exploring factors associated with ART adherence and retention in care under Option B+ strategy in Malawi: A qualitative study
- Creator:
- Sikwese, Pascal, O’Malley, Gabrielle, Gugsa, Salem, Phiri, Sam, Chikonda, Janet, Sande, Odala, Potter, Katy, and Tweya, Hannock
- Date of publication:
- 2017
- Abstract Tesim:
- Although several studies have documented challenges related to inadequate adherence to antiretroviral therapy (ART) and high loss to follow-up (LTFU) among Option B+ women, there is limited understanding of why these challenges occur and how to address them. This qualitative study examines women’s experiences with ART adherence and retention in care. Between July and October 2015, in-depth interviews were conducted with 39 pregnant and lactating women who initiated ART at Bwaila Hospital in Lilongwe, Malawi. Study participants included 14 in care and 25 out of care women, according to facility records. Data were analyzed using an inductive, open-coding approach to thematic analysis. Ten of the respondents (7 out of care, 3 in-care) had stopped and re-started treatment before the interview date. One of the most important factors influencing adherence and retention was the strength of women’s support systems. In contrast to women in-care, most out-of-care women lacked emotional and financial support from male partners, received minimal counseling from providers at initiation, lacked designated guardians to assist with medication refills or clinic appointments, and were highly mobile. Mobility led to difficulties in accessing treatment in new settings. The most common reasons women re-started treatment following interruptions were due to providers’ counseling and encouragement and the mother’s desire to be healthy. Improved counseling at initiation, active follow-up counseling, women’s economic empowerment interventions, promotion of peer counseling schemes and meaningful engagement of male partners can help in addressing the identified barriers and promoting sustained retention of Option B+ women.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Medicine
- Deposit Record:
- http://windsor.libint.unc.edu:8181/fcrepo/rest/prod/e2/82/bb/5c/e282bb5c-ecfc-4dd2-8603-2a46b5cc8e4b
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/gx7k-3v95
- Identifier:
- Publisher DOI: https://doi.org/10.1371/journal.pone.0179838, PMCID: PMC5479573, PMID: 28636669, and Onescience id: bcc40d3b9570405ff414938ce15ae22d93a4d422
- ISSN:
- 1932-6203
- Journal Issue:
- 6
- Journal Title:
- PloS One
- Journal Volume:
- 12
- Keyword:
- Qualitative Research, Adult, Malawi, Breast Feeding, Interviews as Topic, HIV Infections, Medication Adherence, Young Adult, Counseling, Anti-Retroviral Agents, Program Development, Humans, and Female
- Language Label:
- English
- ORCID:
- Other Affiliation:
- Lighthouse Trust, International Training and Education Center for Health (I-TECH); University of Washington; Department of Global Health, University of Malawi; College of Medicine; School of Public Health and Family Medicine; Department of Public Health, Ministry of Health; District Health Office, and International Union Against Tuberculosis and Lung Disease
- Page Start:
- e0179838
- Person:
- Sikwese, Pascal, O’Malley, Gabrielle, Gugsa, Salem, Phiri, Sam, Chikonda, Janet, Sande, Odala, Potter, Katy, and Tweya, Hannock
- Rights Statement Label:
- In Copyright
- Source:
- 73666956n
1862. Effects of patient load and travel distance on HIV transmission in rural China: Implications for treatment as prevention
- Title Tesim:
- Effects of patient load and travel distance on HIV transmission in rural China: Implications for treatment as prevention
- Creator:
- Cohen, Myron S., Ning, Chuanyi, He, Wensheng, Wang, Ning, Liu, Huixin, Smith, M. Kumi, and Miller, William C.
- Date of publication:
- 2017
- Abstract Tesim:
- Sustained viral suppression through ART reduces sexual HIV transmission risk, but may require routine access to reliable and effective medical care which may be difficult to obtain in resource constrained areas. We investigated the roles of patient load and travel distance to HIV care clinic on transmission risk in HIV serodiscordant couples in Henan Province, China.
- Resource type:
- Article
- Affiliation Label Tesim:
- University of North Carolina at Chapel Hill and Department of Epidemiology
- Deposit Record:
- http://windsor.libint.unc.edu:8181/fcrepo/rest/prod/e2/82/bb/5c/e282bb5c-ecfc-4dd2-8603-2a46b5cc8e4b
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/rf6m-0k06
- Identifier:
- Publisher DOI: https://doi.org/10.1371/journal.pone.0177976, PMCID: PMC5451043, PMID: 28562661, and Onescience id: 1edd463a36daf0c3003f9120a493663752f95204
- ISSN:
- 1932-6203
- Journal Issue:
- 5
- Journal Title:
- PloS One
- Journal Volume:
- 12
- Keyword:
- Travel, Male, Humans, Middle Aged, China, HIV Infections, Female, Adult, Rural Population, Health Services Accessibility, and Sexual Partners
- Language Label:
- English
- ORCID:
- Other Affiliation:
- Zhumadian City Centers for Disease Control, National Centre for AIDS/STD Control and Prevention; China Centers for Disease Control and Prevention, Department of Clinical Epidemiology; Peking University People's Hospital, and Ohio State University College of Public Health
- Page Start:
- e0177976
- Person:
- Cohen, Myron S., Ning, Chuanyi, He, Wensheng, Wang, Ning, Liu, Huixin, Smith, M. Kumi, and Miller, William C.
- Rights Statement Label:
- In Copyright
- Source:
- gm80j1528
1863. Effect of innate antiviral glycoproteins in breast milk on seroconversion to rotavirus vaccine (Rotarix) in children in Lusaka, Zambia
- Title Tesim:
- Effect of innate antiviral glycoproteins in breast milk on seroconversion to rotavirus vaccine (Rotarix) in children in Lusaka, Zambia
- Creator:
- Bosomprah, Samuel, Simuyandi, Michelo, Chilengi, Roma, Permar, Sallie Robey, Laban, Natasha Makabilo, Chisenga, Caroline Cleopatra, Garcia, Miguel Pugliese, Munsaka, Sody, and Mwila-Kazimbaya, Katayi
- Date of publication:
- 2017
- Abstract Tesim:
- Rotavirus vaccines have been introduced into national immunization programmes to mitigate morbidity and mortality associated rotavirus diarrhoea. Lower vaccine effectiveness has however been noted in low-middle income countries, but little is known about the role of maternal components found in breast milk. This study assessed the effect of lactoferrin, lactadherin, and tenascin-c on rotavirus vaccine seroconversion.
- Resource type:
- Article
- Affiliation Label Tesim:
- School of Medicine
- Deposit Record:
- http://windsor.libint.unc.edu:8181/fcrepo/rest/prod/e2/82/bb/5c/e282bb5c-ecfc-4dd2-8603-2a46b5cc8e4b
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/ct6n-bw43
- Identifier:
- PMCID: PMC5746212, Onescience id: 2c21f100df080450756df5539d48a6f133f9d725, PMID: 29284036, and Publisher DOI: https://doi.org/10.1371/journal.pone.0189351
- ISSN:
- 1932-6203
- Journal Issue:
- 12
- Journal Title:
- PloS One
- Journal Volume:
- 12
- Keyword:
- Male, Milk, Human, Adolescent, Rotavirus Vaccines, Adult, Infant, Immunity, Innate, Female, Humans, Glycoproteins, and Zambia
- Language Label:
- English
- ORCID:
- Other Affiliation:
- Department of Biostatistics; School ofPublic Health; University of Ghana, Centre for Infectious Disease Research in Zambia, Department of Paediatrics; Human VaccineInstitute; Duke University, and Department of biomedical sciences; School of Health sciences; University of Zambia
- Page Start:
- e0189351
- Person:
- Bosomprah, Samuel, Simuyandi, Michelo, Chilengi, Roma, Permar, Sallie Robey, Laban, Natasha Makabilo, Chisenga, Caroline Cleopatra, Garcia, Miguel Pugliese, Munsaka, Sody, and Mwila-Kazimbaya, Katayi
- Rights Statement Label:
- In Copyright
- Source:
- kd17d031j
1864. Early resumption of sexual activity following voluntary medical male circumcision in Botswana: A qualitative study
- Title Tesim:
- Early resumption of sexual activity following voluntary medical male circumcision in Botswana: A qualitative study
- Creator:
- Semo, Bazghina-Werq, Barnhart, Scott, Ntsuape, Conrad, Ramabu, Nankie M., Ledikwe, Jenny H., Spees, Lisa P., and Wirth, Kathleen E.
- Date of publication:
- 2017
- Abstract Tesim:
- Unprotected sexual intercourse after undergoing voluntary medical male circumcision but prior to complete wound healing can lead to major adverse events including HIV acquisition. To better understand perceptions related to early resumption of sex prior to wound healing, 27 focus group discussions were conducted among 238 adult men, women, and community leaders in Botswana. Median age among all participants was 31 years of whom 60% were male and 51% were either employed and receiving salary or self-employed. Only 12% reported being currently married. Pain, not risk of HIV acquisition, was perceived as the main adverse consequence of early resumption of sex. In fact, no participant mentioned that early resumption of sex could lead to an increase in HIV risk. Demonstrating masculinity and virility, fear of losing female partners, and misperception about post-operative wound healing also played key roles in the decision to resume sex prior to complete wound healing. Findings from this study highlight a potentially widespread lack of awareness of the increased risk of HIV acquisition during the wound healing period. Strengthening post-operative counseling and identifying strategies to discourage the early resumption of sex will be increasingly important as older men and HIV-positive men seek voluntary medical male circumcision services.
- Resource type:
- Article
- Affiliation Label Tesim:
- Cecil G. Sheps Center for Health Services Research
- Deposit Record:
- http://windsor.libint.unc.edu:8181/fcrepo/rest/prod/e2/82/bb/5c/e282bb5c-ecfc-4dd2-8603-2a46b5cc8e4b
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/kebx-zq86
- Identifier:
- PMID: 29136009, Publisher DOI: https://doi.org/10.1371/journal.pone.0186831, PMCID: PMC5685600, and Onescience id: 8ba2957c6acdef73998000371013079a029838d7
- ISSN:
- 1932-6203
- Journal Issue:
- 11
- Journal Title:
- PloS One
- Journal Volume:
- 12
- Keyword:
- Retroviruses, Biology and Life Sciences, HIV, Microbial Pathogens, Surgical and Invasive Medical Procedures, Biology and life sciences, Pathogens, Wound Healing, Viral Pathogens, Viruses, Pathology and Laboratory Medicine, Physiology, Reproductive System Procedures, Circumcision, Microbiology, Physiological Processes, RNA viruses, Immunodeficiency Viruses, Lentivirus, Medicine and health sciences, Medical Microbiology, Tissue Repair, Medicine and Health Sciences, and Organisms
- Language Label:
- English
- ORCID:
- Other Affiliation:
- Botswana International Training and Education Center for Health (I-TECH), Department of Global Health; University of Washington, Department of HIV/AIDS Prevention and Care; Botswana Ministry of Health, Department of Immunology and Infectious Diseases; Harvard T. H. Chan School of Public Health, and Department of Epidemiology; Harvard T.H. Chan School of Public Health
- Page Start:
- e0186831
- Person:
- Semo, Bazghina-Werq, Barnhart, Scott, Ntsuape, Conrad, Ramabu, Nankie M., Ledikwe, Jenny H., Spees, Lisa P., and Wirth, Kathleen E.
- Rights Statement Label:
- In Copyright
- Source:
- t435gk23b
1865. Early childhood lung function is a stronger predictor of adolescent lung function in cystic fibrosis than early Pseudomonas aeruginosa infection
- Title Tesim:
- Early childhood lung function is a stronger predictor of adolescent lung function in cystic fibrosis than early Pseudomonas aeruginosa infection
- Creator:
- Pittman, Jessica E., Accurso, Frank J., Knowles, Michael R., Leigh, Margaret W., Davis, Stephanie D., Calloway, Hollin E., Drumm, Mitchell, Sontag, Marci K., Sagel, Scott D., and Noah, Hannah
- Date of publication:
- 2017
- Abstract Tesim:
- Pseudomonas aeruginosa has been suggested as a major determinant of poor pulmonary outcomes in cystic fibrosis (CF), although other factors play a role. Our objective was to investigate the association of early childhood Pseudomonas infection on differences in lung function in adolescence with CF.
- Resource type:
- Article
- Affiliation Label Tesim:
- Marsico Lung Institute/UNC Cystic Fibrosis Center, Department of Pediatrics, and School of Medicine
- Deposit Record:
- http://windsor.libint.unc.edu:8181/fcrepo/rest/prod/e2/82/bb/5c/e282bb5c-ecfc-4dd2-8603-2a46b5cc8e4b
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/zrda-vn62
- Identifier:
- Onescience id: 2ea8283312b8eabc955b7ad846112f39be6461c1, PMCID: PMC5432103, Publisher DOI: https://doi.org/10.1371/journal.pone.0177215, and PMID: 28505188
- ISSN:
- 1932-6203
- Journal Issue:
- 5
- Journal Title:
- PloS One
- Journal Volume:
- 12
- Keyword:
- Child, Prognosis, Humans, Male, Pseudomonas aeruginosa, Pseudomonas Infections, Child, Preschool, Alleles, Cystic Fibrosis Transmembrane Conductance Regulator, Age Factors, Female, Infant, Adolescent, Registries, Cystic Fibrosis, Lung, and Case-Control Studies
- Language Label:
- English
- ORCID:
- Other Affiliation:
- Washington University School of Medicine; Division of Pediatric Allergy; Immunology; and Pulmonary Medicine, Department of Pediatrics; Children's Hospital Colorado; University of Colorado School of Medicine, Marsico Lung Institute, Indiana University School of Medicine; Riley Hospital for Children; Section of Pediatric Pulmonology; Allergy; and Sleep Medicine, Stanford University School of Medicine; Department of Otolaryngology and Neck Surgery, and Departments of Pediatrics and Genetics and Genome Sciences; Case Western Reserve University
- Page Start:
- e0177215
- Person:
- Pittman, Jessica E., Accurso, Frank J., Knowles, Michael R., Leigh, Margaret W., Davis, Stephanie D., Calloway, Hollin E., Drumm, Mitchell, Sontag, Marci K., Sagel, Scott D., and Noah, Hannah
- Rights Statement Label:
- In Copyright
- Source:
- 0g354m31c
1866. Dynamic patterns of expression for genes regulating cytokinin metabolism and signaling during rice inflorescence development
- Title Tesim:
- Dynamic patterns of expression for genes regulating cytokinin metabolism and signaling during rice inflorescence development
- Creator:
- Kieber, Joseph J., Schaller, G. Eric, and Yamburenko, Maria V.
- Date of publication:
- 2017
- Abstract Tesim:
- Inflorescence development in cereals, including such important crops as rice, maize, and wheat, directly affects grain number and size and is a key determinant of yield. Cytokinin regulates meristem size and activity and, as a result, has profound effects on inflorescence development and architecture. To clarify the role of cytokinin action in inflorescence development, we used the NanoString nCounter system to analyze gene expression in the early stages of rice panicle development, focusing on 67 genes involved in cytokinin biosynthesis, degradation, and signaling. Results point toward key members of these gene families involved in panicle development and indicate that the expression of many genes involved in cytokinin action differs between the panicle and vegetative tissues. Dynamic patterns of gene expression suggest that subnetworks mediate cytokinin action during different stages of panicle development. The variation of expression during panicle development is greater among genes encoding proteins involved in cytokinin metabolism and negative regulators of the pathway than for the genes in the primary response pathway. These results provide insight into the expression patterns of genes involved in cytokinin action during inflorescence development in a crop of agricultural importance, with relevance to similar processes in other monocots. The identification of subnetworks of genes expressed at different stages of early panicle development suggests that manipulation of their expression could have substantial effects on inflorescence architecture.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Biology
- Deposit Record:
- http://windsor.libint.unc.edu:8181/fcrepo/rest/prod/e2/82/bb/5c/e282bb5c-ecfc-4dd2-8603-2a46b5cc8e4b
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/6tmw-4m34
- Identifier:
- PMID: 28419168, Onescience id: 9a40ff65784ae4d344efa5b12ea9d104e4fb5647, Publisher DOI: https://doi.org/10.1371/journal.pone.0176060, and PMCID: PMC5395194
- ISSN:
- 1932-6203
- Journal Issue:
- 4
- Journal Title:
- PloS One
- Journal Volume:
- 12
- Keyword:
- Cytokinins, Signal Transduction, Crops, Agricultural, Multigene Family, Plant Proteins, Oryza, Genes, Plant, Metabolic Networks and Pathways, Gene Expression Regulation, Developmental, Inflorescence, and Gene Expression Regulation, Plant
- Language Label:
- English
- ORCID:
- Other Affiliation:
- Department of Biological Sciences; Dartmouth College
- Page Start:
- e0176060
- Person:
- Kieber, Joseph J., Schaller, G. Eric, and Yamburenko, Maria V.
- Rights Statement Label:
- In Copyright
- Source:
- mg74qs075
1867. Dose-Duration Reciprocity for G protein activation: Modulation of kinase to substrate ratio alters cell signaling
- Title Tesim:
- Dose-Duration Reciprocity for G protein activation: Modulation of kinase to substrate ratio alters cell signaling
- Creator:
- Sozzani, Rosangela, Melvin, Charles E., Jones, Roger D., Jones, Alan M., Elston, Timothy C., and Liao, Kang-Ling
- Date of publication:
- 2017
- Abstract Tesim:
- In animal cells, activation of heterotrimeric G protein signaling generally occurs when the system’s cognate signal exceeds a threshold, whereas in plant cells, both the amount and the exposure time of at least one signal, D-glucose, are used toward activation. This unusual signaling property called Dose-Duration Reciprocity, first elucidated in the genetic model Arabidopsis thaliana, is achieved by a complex that is comprised of a 7-transmembrane REGULATOR OF G SIGNALING (RGS) protein (AtRGS1), a Gα subunit that binds and hydrolyzes nucleotide, a Gβγ dimer, and three WITH NO LYSINE (WNK) kinases. D-glucose is one of several signals such as salt and pathogen-derived molecular patterns that operates through this protein complex to activate G protein signaling by WNK kinase transphosphorylation of AtRGS1. Because WNK kinases compete for the same substrate, AtRGS1, we hypothesize that activation is sensitive to the AtRGS1 amount and that modulation of the AtRGS1 pool affects the response to the stimulant. Mathematical simulation revealed that the ratio of AtRGS1 to the kinase affects system sensitivity to D-glucose, and therefore illustrates how modulation of the cellular AtRGS1 level is a means to change signal-induced activation. AtRGS1 levels change under tested conditions that mimic physiological conditions therefore, we propose a previously-unknown mechanism by which plants react to changes in their environment.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Biology and Department of Pharmacology
- Deposit Record:
- http://windsor.libint.unc.edu:8181/fcrepo/rest/prod/e2/82/bb/5c/e282bb5c-ecfc-4dd2-8603-2a46b5cc8e4b
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/99ng-c581
- Identifier:
- PMCID: PMC5747438, Publisher DOI: https://doi.org/10.1371/journal.pone.0190000, PMID: 29287086, and Onescience id: 27a321df27d82b120e2838a956e37b80f0339a87
- ISSN:
- 1932-6203
- Journal Issue:
- 12
- Journal Title:
- PloS One
- Journal Volume:
- 12
- Keyword:
- Seedlings, Luminescent Proteins, Science, Medicine, Physical Sciences, Cell Processes, Pharmaceutics, Yellow Fluorescent Protein, Organic Chemistry, R, Research Article, Biochemistry, Secretory Pathway, Endocytosis, Signal Transduction, Protein Kinase Signaling Cascade, Glucose Signaling, Proteins, Organic Compounds, Cell Biology, Eukaryota, Chemistry, Organisms, Glucose, Carbohydrates, Q, Monosaccharides, Biology and Life Sciences, Cell Signaling, Chemical Compounds, Signaling Cascades, Plants, G-Protein Signaling, and Medicine an
- Language Label:
- English
- ORCID:
- Other Affiliation:
- Department of Plant and Microbial Biology; North Carolina State University, Center for Complex Systems and Enterprises; Stevens Institute of Technology, Department of Pharmacology, and Department of Mathematics; Tamkang University
- Page Start:
- e0190000
- Person:
- Sozzani, Rosangela, Melvin, Charles E., Jones, Roger D., Jones, Alan M., Elston, Timothy C., and Liao, Kang-Ling
- Rights Statement Label:
- In Copyright
- Source:
- 2z10ww042
1868. Does hysteroscopy worsen prognosis in women with type II endometrial carcinoma?
- Title Tesim:
- Does hysteroscopy worsen prognosis in women with type II endometrial carcinoma?
- Creator:
- Kong, Wei-Min, Song, Dan, Clark, Leslie H., Zhao, Hui, Yan, Zhen, Han, Chao, Zhang, Tong-Qing, Chen, Jiao, Jiao, Si-Meng, Zhou, Chunxiao, and Liu, Ting-Ting
- Date of publication:
- 2017
- Abstract Tesim:
- Prior studies evaluating the impact of hysteroscopy on outcomes in endometrial cancer have predominantly evaluated type I tumors. We sought to evaluate whether hysteroscopy worsens prognosis in type II endometrial cancer.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Obstetrics and Gynecology
- Deposit Record:
- http://windsor.libint.unc.edu:8181/fcrepo/rest/prod/e2/82/bb/5c/e282bb5c-ecfc-4dd2-8603-2a46b5cc8e4b
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/qyad-yf55
- Identifier:
- PMCID: PMC5363864, Publisher DOI: https://doi.org/10.1371/journal.pone.0174226, PMID: 28334032, and Onescience id: 871deb29491dcce749253e306e0b844136c0a93c
- ISSN:
- 1932-6203
- Journal Issue:
- 3
- Journal Title:
- PloS One
- Journal Volume:
- 12
- Keyword:
- Adenocarcinoma, Prognosis, Female, Humans, Survival Analysis, Disease-Free Survival, Middle Aged, Retrospective Studies, Endometrial Neoplasms, Hysteroscopy, and Kaplan-Meier Estimate
- Language Label:
- English
- ORCID:
- Other Affiliation:
- Department of Gynecological Oncology; Beijing Obstetrics and Gynecology Hospital; Capital Medical University and University of North Carolina at Chapel Hill
- Page Start:
- e0174226
- Person:
- Kong, Wei-Min, Song, Dan, Clark, Leslie H., Zhao, Hui, Yan, Zhen, Han, Chao, Zhang, Tong-Qing, Chen, Jiao, Jiao, Si-Meng, Zhou, Chunxiao, and Liu, Ting-Ting
- Rights Statement Label:
- In Copyright
- Source:
- c534fv018
1869. Do black lives matter in public health research and training?
- Title Tesim:
- Do black lives matter in public health research and training?
- Creator:
- Bengtson, Angela M., Rosenberg, Molly, Townes, Ashley, and Ranapurwala, Shabbar I.
- Date of publication:
- 2017
- Abstract Tesim:
- To examine whether investments made in public health research align with the health burdens experienced by white and black Americans.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Epidemiology
- Deposit Record:
- http://windsor.libint.unc.edu:8181/fcrepo/rest/prod/e2/82/bb/5c/e282bb5c-ecfc-4dd2-8603-2a46b5cc8e4b
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/k048-q998
- Identifier:
- PMCID: PMC5634659, Publisher DOI: https://doi.org/10.1371/journal.pone.0185957, PMID: 29016639, and Onescience id: ddcc8ecccc4ef202fb0f8f0a32f6c0ead5df8c49
- ISSN:
- 1932-6203
- Journal Issue:
- 10
- Journal Title:
- PloS One
- Journal Volume:
- 12
- Keyword:
- Male, Child, Adult, Bibliometrics, Life Expectancy, Cause of Death, Cross-Sectional Studies, European Continental Ancestry Group, Investments, Humans, Adolescent, Health Services Research, Myocardial Ischemia, Homicide, Female, and African Americans
- Language Label:
- English
- ORCID:
- Other Affiliation:
- Department of Epidemiology and Biostatistics; Indiana University School of Public Health-Bloomington and Department of Applied Health Sciences; Indiana University School of Public Health-Bloomington
- Page Start:
- e0185957
- Person:
- Bengtson, Angela M., Rosenberg, Molly, Townes, Ashley, and Ranapurwala, Shabbar I.
- Rights Statement Label:
- In Copyright
- Source:
- z603r354h
1870. Distance to care, enrollment and loss to follow-up of HIV patients during decentralization of antiretroviral therapy in Neno District, Malawi: A retrospective cohort study
- Title Tesim:
- Distance to care, enrollment and loss to follow-up of HIV patients during decentralization of antiretroviral therapy in Neno District, Malawi: A retrospective cohort study
- Creator:
- McBain, Ryan, Kalanga, Noel, Peckarsky, Matthew, Neumann, Christian, Bronson, Gay, Birru, Ermyas, Keck, James, Bilinski, Alyssa, Kachimanga, Chembe, Po-Chedley, Stephen, and Herce, Michael
- Date of publication:
- 2017
- Abstract Tesim:
- HIV/AIDS remains the second most common cause of death in low and middle-income countries (LMICs), and only 34% of eligible patients in Africa received antiretroviral therapy (ART) in 2013. This study investigated the impact of ART decentralization on patient enrollment and retention in rural Malawi. We reviewed electronic medical records of patients registered in the Neno District ART program from August 1, 2006, when ART first became available, through December 31, 2013. We used GPS data to calculate patient-level distance to care, and examined number of annual ART visits and one-year lost to follow-up (LTFU) in HIV care. The number of ART patients in Neno increased from 48 to 3,949 over the decentralization period. Mean travel distance decreased from 7.3 km when ART was only available at the district hospital to 4.7 km when ART was decentralized to 12 primary health facilities. For patients who transferred from centralized care to nearer health facilities, mean travel distance decreased from 9.5 km to 4.7 km. Following a transfer, the proportion of patients achieving the clinic’s recommended ≥4 annual visits increased from 89% to 99%. In Cox proportional hazards regression, patients living ≥8 km from a health facility had a greater hazard of being LTFU compared to patients <8 km from a facility (adjusted HR: 1.7; 95% CI: 1.5–1.9). ART decentralization in Neno District was associated with increased ART enrollment, decreased travel distance, and increased retention in care. Increasing access to ART by reducing travel distance is one strategy to achieve the ART coverage and viral suppression objectives of the 90-90-90 UNAIDS targets in rural impoverished areas.
- Resource type:
- Article
- Affiliation Label Tesim:
- Department of Medicine
- Deposit Record:
- http://windsor.libint.unc.edu:8181/fcrepo/rest/prod/e2/82/bb/5c/e282bb5c-ecfc-4dd2-8603-2a46b5cc8e4b
- Type:
- http://purl.org/dc/dcmitype/Text
- DOI:
- https://doi.org/10.17615/hzdm-yd05
- Identifier:
- Onescience id: 868499b73cdd5a6296f3ec06448fbfcb7273e43d, PMID: 28973035, Publisher DOI: https://doi.org/10.1371/journal.pone.0185699, and PMCID: PMC5626468
- ISSN:
- 1932-6203
- Journal Issue:
- 10
- Journal Title:
- PloS One
- Journal Volume:
- 12
- Keyword:
- Proportional Hazards Models, Anti-HIV Agents, HIV Infections, Male, Malawi, Female, Humans, Health Services Accessibility, Adult, Middle Aged, and Retrospective Studies
- Language Label:
- English
- ORCID:
- Other Affiliation:
- Abwenzi Pa Za Umoyo, Partners In Health, and Interfaculty Initiative in Health Policy; Harvard Graduate School of Arts and Sciences
- Page Start:
- e0185699
- Person:
- McBain, Ryan, Kalanga, Noel, Peckarsky, Matthew, Neumann, Christian, Bronson, Gay, Birru, Ermyas, Keck, James, Bilinski, Alyssa, Kachimanga, Chembe, Po-Chedley, Stephen, and Herce, Michael
- Rights Statement Label:
- In Copyright
- Source:
- c247dz100
Collection Details
- Total items
-
2112
- Size
-
unknown
- Date created
-
February 2, 2022