dc.contributor.author | Sarna, A | |
dc.contributor.author | Luchters, S | |
dc.contributor.author | Geibel, S | |
dc.contributor.author | Chersich, MF | |
dc.contributor.author | Munyao, P | |
dc.contributor.author | Kaai, S | |
dc.contributor.author | Mandaliya, KN | |
dc.contributor.author | Shikely, KS | |
dc.contributor.author | Temmerman, M | |
dc.contributor.author | Rutenberg, N | |
dc.date.accessioned | 2013-06-11T12:01:32Z | |
dc.date.available | 2013-06-11T12:01:32Z | |
dc.date.issued | 2008-08 | |
dc.identifier.citation | J Acquir Immune Defic Syndr. 2008 Aug 15;48(5):611-9. doi: 10.1097/QAI.0b013e3181806bf1 | en |
dc.identifier.uri | http://hinari-gw.who.int/whalecomwww.ncbi.nlm.nih.gov/whalecom0/pubmed/18645509 | |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/31554 | |
dc.description.abstract | Objectives:To determine short- and long-term efficacy of modified directly observed therapy (m-DOT) on antiretroviral adherence. Design:Randomized controlled trial. SETTING AND ANALYTIC APPROACH: From September 2003 to November 2004, 234 HIV-infected adults were assigned m-DOT (24 weeks of twice weekly health center visits for nurse-observed pill ingestion, adherence support, and medication collection) or standard care. Follow-up continued until week 72. Self-reported and pill-count adherence and, secondarily, viral suppression and body mass index measures are reported. Generalized estimating equations adjusted for intraclient clustering and covariates were used. Results:During weeks 1-24, 9.1% (9/99) of m-DOT participants reported missing doses compared with 19.1% (20/105) of controls (P = 0.04) and 96.5% (517/571) of m-DOT pill-count measures were >or=95% compared with 86.1% (445/517) in controls [adjusted odds ratio = 4.4; 95% confidence interval (CI) = 2.6 to 7.5; P < 0.001. Adherence with m-DOT was 4.8 times greater (95% CI = 2.7 to 8.6; P < 0.001) with adjustment for depression and HIV-related hospitalization. In weeks 25-48, adherence with m-DOT (488/589) was similar to controls (507/630). Viral suppression at 48 weeks was 2.0 times (95% CI = 0.8 to 5.2; P = 0.13) as likely in m-DOT participants as controls. M-DOT patients had larger body mass index increases at 24 weeks (2.2 vs 1.4 kg/m3; P = 0.014). Viral suppression was more likely at week 48 (21/25 vs 13/22; P = 0.057) and week 72 (27/30 vs 15/23; P = 0.027) among depressed participants receiving m-DOT. Conclusions:M-DOT increased adherence, most notably among depressed participants | en |
dc.language.iso | en | en |
dc.publisher | University of Nairobi | en |
dc.title | Short- and long-term efficacy of modified directly observed antiretroviral treatment in Mombasa, Kenya: a randomized trial | en |
dc.type | Article | en |
local.publisher | College of Health Sciences | en |