Table 5.
Programme level predictors of attrition in multicountry retention study
| Nr Sites |
Nr Patients |
Retention proportion |
Hazard ratio (95% CI) | P-value* | |||
|---|---|---|---|---|---|---|---|
| 1 year | 2 years | 3 years | |||||
| Country | |||||||
| Tanzania | 7 | 1458 | 71.0 | 62.7 | 58.3 | 1 | 0.005 |
| Uganda | 6 | 1472 | 90.5 | 85.3 | 81.5 | 0.35 (0.19, 0.62) | |
| Zambia | 5 | 1217 | 73.2 | 64.3 | 56.8 | 1.05 (0.57, 1.92) | |
| General health facility characteristics | |||||||
| Level of health facility | |||||||
| National referral hospital | 4 | 749 | 76.9 | 67.3 | 61.8 | 1 | 0.043 |
| Provincial/regional hospital | 4 | 980 | 71.7 | 63.5 | 55.6 | 1.25 (0.57, 2.74) | |
| District hospital | 6 | 1432 | 75.2 | 67.1 | 63.0 | 1.17 (0.57, 2.39) | |
| Primary health centre/community based | 4 | 986 | 91.8 | 87.8 | 83.4 | 0.37 (0.17, 0.82) | |
| Type of health facility | |||||||
| Government | 9 | 2188 | 71.0 | 61.6 | 55.1 | 1 | 0.007 |
| Mission (faith based) | 5 | 973 | 85.5 | 80.5 | 75.9 | 0.44 (0.24, 0.79) | |
| Non-religious NGO | 4 | 986 | 88.8 | 83.0 | 79.1 | 0.35 (0.19, 0.67) | |
| Setting | |||||||
| Rural/periurban | 6 | 1441 | 74.2 | 66.7 | 62.7 | 1 | 0.383 |
| Urban | 12 | 2706 | 81.0 | 73.7 | 67.8 | 0.74 (0.38, 1.45) | |
| Number of adults on ARVs | |||||||
| <2000 | 8 | 1703 | 74.4 | 66.7 | 62.7 | 1 | 0.726 |
| 2000–4000 | 6 | 1474 | 83.7 | 77.3 | 72.1 | 0.74 (0.36, 1.53) | |
| >4000 | 4 | 970 | 78.4 | 70.1 | 61.1 | 0.93 (0.41, 2.11) | |
| Home-based care | |||||||
| No | 7 | 1732 | 77.2 | 68.7 | 62.0 | 1 | 0.625 |
| Yes | 11 | 2415 | 79.7 | 73.1 | 69.0 | 0.85 (0.44, 1.63) | |
| Physician-based care | |||||||
| No | 3 | 711 | 72.5 | 63.3 | 58.4 | 1 | 0.308 |
| Yes | 15 | 3436 | 79.9 | 72.8 | 67.5 | 0.66 (0.28, 1.51) | |
| ARV-dispensing Characteristics | |||||||
| Buddy needed for ART initiation | |||||||
| No | 3 | 744 | 67.0 | 56.6 | 46.6 | 1 | 0.078 |
| Yes | 15 | 3403 | 81.2 | 74.6 | 70.5 | 0.50 (0.23, 1.11) | |
| Three counselling sessions needed for ART initiation | |||||||
| No | 4 | 871 | 81.6 | 74.1 | 69.0 | 1 | 0.614 |
| Yes | 14 | 3276 | 77.9 | 70.5 | 65.1 | 1.22 (0.57, 2.64) | |
| Refill frequency (after 6 months) | |||||||
| Monthly | 6 | 1223 | 74.0 | 65.8 | 61.6 | 1 | 0.856 |
| Every 2 months | 8 | 1978 | 80.9 | 74.0 | 67.6 | 0.83 (0.40, 1.72) | |
| Every 3 months | 4 | 946 | 80.0 | 72.5 | 68.6 | 0.82 (0.34, 1.96) | |
| ARV drug dispensing in community | |||||||
| No | 14 | 3190 | 74.4 | 66.0 | 60.2 | 1 | 0.004 |
| Yes | 4 | 957 | 92.6 | 88.2 | 84.1 | 0.32 (0.17, 0.61) | |
| Sampling | |||||||
| Percentage of selected patient charts not found | |||||||
| <10% | 6 | 1465 | 63.6 | 53.5 | 45.6 | 1 | <0.001 |
| ≥10% to <20% | 6 | 1475 | 88.1 | 82.4 | 78.6 | 0.31 (0.21, 0.54) | |
| >20% | 6 | 1207 | 85.1 | 78.3 | 73.7 | 0.37 (0.22, 0.62) | |
ART, antiretroviral treatment; ARV, antiretroviral; CI, confidence interval.
*
P-value from Cox regression models describing the effects of each programme level characteristic, correcting for imbalances in patient characteristics between sites and adjusting for site using shared frailty methods.