Table 5.
Sensitivity Analyses Examining the Effect of Loss to Follow-up on Mortality Rates at each Site
| Barbados (n=560) | DR (n=1207) | Haiti (n=4717) | Jamaica (n=476) | Martinique (n=325) | Trinidad (n=725) | Puerto Rico (n=193) | Combined (n=8203) | |
|---|---|---|---|---|---|---|---|---|
| Total Patient Months of Follow-up | 27951 | 25843 | 150722 | 17037 | 13078 | 32918 | 7759 | 275308 |
| Loss to Follow-up – Number (%) | 41 (7) | 155 (13) | 602 (13) | 77 (16) | 14 (4) | 54 (7) | 90 (47) | 1033 (13) |
| Unadjusted Deaths – Number (%) | 85 (15) | 181 (15) | 598 (13) | 38 (8) | 21 (6) | 78 (11) | 47 (24) | 1048 (13) |
| LTFU Per 100 Person-Years of Follow-up | 1.8 | 7.2 | 4.8 | 5.4 | 1.3 | 2.0 | 13.9 | 4.5 |
| Unadjusted Mortality Per 100 Person-Years | 3.6 | 8.4 | 4.8 | 2.7 | 1.9 | 2.8 | 7.3 | 4.6 |
| Sensitivity Analyses – Effect of LTFU on Mortality – Number (Percentage) of Deaths | ||||||||
| Assume Death in 27% of Patients LTFU – No. (%)* | 96 (17) | 223 (18) | 761 (16) | 59 (12) | 25 (8) | 93 (13) | 71 (37) | 1327 (16) |
| Assume Death in 40% of Patients LTFU – No. (%)** | 101 (18) | 243 (20) | 839 (18) | 69 (14) | 27 (8) | 100 (14) | 83 (43) | 1461 (18) |
| Assume Death in 87% of Patients LTFU – No. (%)* | 121 (22) | 316 (26) | 1122 (24) | 105 (22) | 33 (10) | 125 (17) | 125 (65) | 1947 (24) |
| Assume Death if LTFU and CD4 <50 Cells/mm3 | 95 (17) | 230 (19) | 734 (16) | 57 (12) | 24 (7) | 90 (12) | 59 (31) | 1289 (16) |
| Assume Death if LTFU and CD4 <100 Cells/mm3 | 99 (18) | 253 (21) | 834 (18) | 66 (14) | 24 (7) | 100 (14) | 70 (36) | 1446 (18) |
| Sensitivity Analyses – Effect of LTFU on Mortality – Mortality Rates Per 100 Person-Years of Follow-up | ||||||||
| Assume Death in 27% of Patients LTFU – No. (%)* | 4.1 | 10.3 | 6.1 | 4.1 | 2.3 | 3.4 | 11.0 | 5.8 |
| Assume Death in 40% of Patients LTFU – No. (%)** | 4.4 | 11.3 | 6.7 | 4.8 | 2.4 | 3.6 | 12.8 | 6.4 |
| Assume Death in 87% of Patients LTFU – No. (%)* | 5.2 | 14.7 | 8.9 | 7.4 | 3.0 | 4.6 | 19.4 | 8.5 |
| Assume Death if LTFU and CD4 <50 Cells/mm3 | 4.1 | 10.7 | 5.8 | 4.0 | 2.2 | 3.3 | 9.1 | 5.6 |
| Assume Death if LTFU and CD4 <100 Cells/mm3 | 4.3 | 11.7 | 6.6 | 4.6 | 2.2 | 3.6 | 10.8 | 6.3 |
*
The lowest mortality rate in the published literature from low and middle-income countries from tracking studies of ART patients presumed LTFU is 27% and the highest mortality is 87% [39, 40].
**
In a meta-analysis of 17 studies from low and middle-income countries by Brinkhof et al. [41] the combined mortality of ART patients from tracking studies of patients presumed LTFU was 40% (95% CI: 33–48%).