Treatment interruption in HIV-positive patients followed up in Cameroon's antiretroviral treatment programme: individual and health care supply-related factors (ANRS-12288 EVOLCam survey)

Christelle Tong; Marie Suzan-Monti; Luis Sagaon-Teyssier; Mohamed Mimi; Christian Laurent; Gwenaëlle Maradan; Marie-Thérèse Mengue; Bruno Spire; Christopher Kuaban; Laurent Vidal; Sylvie Boyer; EVOL Cam group

doi:10.1111/tmi.13030

Treatment interruption in HIV-positive patients followed up in Cameroon's antiretroviral treatment programme: individual and health care supply-related factors (ANRS-12288 EVOLCam survey)

Trop Med Int Health. 2018 Mar;23(3):315-326. doi: 10.1111/tmi.13030. Epub 2018 Feb 2.

Authors

Christelle Tong¹, Marie Suzan-Monti^{1

2}, Luis Sagaon-Teyssier^{1

2}, Mohamed Mimi^{1

2}, Christian Laurent³, Gwenaëlle Maradan^{1

2}, Marie-Thérèse Mengue⁴, Bruno Spire^{1

2}, Christopher Kuaban⁵, Laurent Vidal¹, Sylvie Boyer^{1

2}; EVOL Cam group

Collaborators

EVOL Cam group:
A Ambani, O Ndalle, P Momo, V Boyer, L March, M Mora, M de Sèze, F Liégeois, E Delaporte, V Boyer, S Eymard-Duvernay, F Chabrol, E Kouakam, O Ossanga, H Essama Owona, C Biloa, E Mpoudi-Ngolé, P J Fouda, C Kouanfack, H Abessolo, N Noumssi, M Defo, H Meli, Z Nanga, Y Perfura, M Ngo Tonye, O Kouambo, U Olinga, E Soh, C Ejangue, E Njom Nlend, A Simo Ndongo, E Abeng Mbozo'o, M Mpoudi Ngole, N Manga, C Danwe, L Ayangma, B Taman, E C Njitoyap Ndam, B Fangam Molu, J Meli, H Hadja, J Lindou, J M Bob Oyono, S Beke, D Eloundou, G Touko, J J Ze, M Fokoua, L Ngum, C Ewolo, C Bondze, J D Ngan Bilong, D S Maninzou, A Nono Toche, M Tsoungi Akoa, P Ateba, S Abia, A Guterrez, R Garcia, P Thumerel, E Belley Priso, Y Mapoure, A Malongue, A P Meledie Ndjong, B Mbatchou, J Hachu, S Ngwane, J Dissongo, M Mbangue, Ida Penda, H Mossi, G Tchatchoua, Yoyo Ngongang, C Nouboue, I Wandji, L Ndalle, J Djene, M J Gomez, A Mafuta, M Mgantcha, E H Moby, M C Kuitcheu, A L Mawe, Ngam Engonwei, L J Bitang, M Ndam, R B Pallawo, Issiakou Adamou, G Temgoua, C Ndjie Essaga, C Tchimou, A Yeffou, I Ngo, H Fokam, H Nyemb, L R Njock, S Omgnesseck, E Kamto, B Takou, L J-G Buffeteau, F Ndoumbe, J-D Noah, I Seyep

Affiliations

¹ Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques, & Sociales de la Santé & Traitement de l'Information Médicale, Université Aix Marseille, Marseille, France.
² Observatoire régional de la santé Provence Alpes Côte d'Azur, Marseille, France.
³ TransVIHMI, IRD UMI 233, INSERM U1175 & Université de Montpellier, Montpellier, France.
⁴ Université Catholique d'Afrique Centrale, Yaoundé, Cameroun.
⁵ Department of Internal Medicine and Subspecialties, University of Yaoundé I, Yaoundé, Cameroon.

PMID: 29327419
DOI: 10.1111/tmi.13030

Abstract

Introduction: Decreasing international financial resources for HIV and increasing numbers of antiretroviral treatment (ART)-treated patients may jeopardise treatment continuity in low-income settings. Using data from the EVOLCam ANRS-12288 survey, this study aimed to document the prevalence of unplanned treatment interruption for more than 2 consecutive days (TI>2d) and investigate the associated individual and health care supply-related factors within the Cameroonian ART programme.

Methods: A cross-sectional mixed methods survey was carried out between April and December 2014 in 19 HIV services of the Centre and Littoral regions. A multilevel logistic model was estimated on 1885 ART-treated patients in these services to investigate factors of TI>2d in the past 4 weeks.

Results: Among the study population, 403 (21%) patients reported TI>2d. Patients followed up in hospitals reporting ART stock-outs were more likely to report TI>2d while those followed up in the Littoral region, in medium- or small-sized hospitals and in HIV services proposing financial support were at lower risk of TI>2d. The following individual factors were also associated with a lower risk of TI>2d: living in a couple, having children, satisfaction with attention provided by doctor, tuberculosis co-infection and not having consulted a traditional healer.

Conclusions: Besides identifying individual factors of TI>2d, our study highlighted the role of health care supply-related factors in shaping TI in Cameroon's ART programme, especially the deleterious effect of ART stock-outs. Our results also suggest that the high proportion of patients reporting TI could jeopardise progress in the fight against HIV in the country, unless effective measures are quickly implemented like ensuring the continuity of ART supply.

Keywords: HIV; VIH; Cameroon; Cameroun; antiretroviral treatment interruption; facteurs individuels; facteurs liés à l'offre des soins de santé; health care supply-related factors; individual factors; interruption du traitement antirétroviral.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-HIV Agents / therapeutic use*
Antiretroviral Therapy, Highly Active / psychology*
Antiretroviral Therapy, Highly Active / statistics & numerical data
Cameroon
Cross-Sectional Studies
HIV Infections / drug therapy*
HIV Infections / psychology*
Health Knowledge, Attitudes, Practice
Health Services Accessibility / statistics & numerical data*
Humans
Patient Acceptance of Health Care / psychology*
Patient Acceptance of Health Care / statistics & numerical data
Patient Compliance / psychology
Patient Compliance / statistics & numerical data

Substances

Anti-HIV Agents