An audit of how patients get on to antiretroviral therapy in Malawi, and the weight gain they experience in the first six months

Abstract

An operational study was conducted in 6 public sector health
facilities in the Southern Region of Malawi to determine a)
drop-out rates during the referral process of patients to
antiretroviral therapy (ART) and b) weight gained during
the first 6 months in patients who were alive and on ART
at that time. There were 738 adult HIV-infected eligible
patients booked for group counseling, of whom 550 (74.5%)
attended individual counseling and started ART. 16% of
patients dropped out between booking and group counseling
and 9.5% between group counseling and start of ART. In
patients who were alive and on ART 6 months after starting,
there was a gradual increase in weight with a mean gain of 6.0
kg in men and 5.0 kg in women. There was a slight increase
in weight gain in patients in WHO Clinical Stage 3 and 4
compared with those in Stage 1&2, although this was only
significant at 6-months between women in Stage 4 compared
with women in Stage 1&2 (p <0.05). More information is
needed on why patients drop out of the counseling process
before starting ART, and whether weight gain is a marker for
survival in the early months of ART.

Malawi Medical Journal Vol. 19 (3) 2007: pp. 104-106