Background
Methods
The home based care services provided
Study population
Data collection
Study period and sample
Data analysis
Study ethics
Results
Demographic characteristics of enrolled patients
Patient characteristic | Year of assessment | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | Total | Extended Mantel-Haenszel test for trend | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Number |
%
| Number |
%
| Number |
%
| Number |
%
| Number |
%
| Number |
%
| Number |
%
| chi-sq. | DF | p | ||
Number | 247 | 174 | 213 | 290 | 213 | 129 | 1266 | |||||||||||
Sex | male | 102 |
41.3
| 75 |
43.1
| 94 |
44.1
| 105 |
36.2
| 81 |
38.0
| 51 |
39.5
| 508 |
40.1
| 1.41 | 1 | 0.24 |
female | 145 |
58.7
| 99 |
56.9
| 119 |
55.9
| 185 |
63.8
| 132 |
62.0
| 78 |
60.5
| 758 |
59.9
| ||||
Chronic fever, cough or diarrhoea | no | 222 |
89.9
| 145 |
83.3
| 189 |
88.7
| 272 |
93.8
| 204 |
95.8
| 123 |
95.3
| 1155 |
91.2
| 15.2 | 1 | < 0.001 |
yes | 25 |
10.1
| 29 |
16.7
| 24 |
11.3
| 18 |
6.2
| 9 |
4.2
| 6 |
4.7
| 111 |
8.8
| ||||
Bed-bound | not bedbound | 85 |
34.4
| 55 |
31.6
| 54 |
25.4
| 104 |
35.9
| 106 |
49.8
| 54 |
41.9
| 458 |
36.2
| 28.7 | 1 | < 0.001 |
bedridden less than half the day | 29 |
11.7
| 17 |
9.8
| 66 |
31.0
| 70 |
24.1
| 43 |
20.2
| 30 |
23.3
| 255 |
20.1
| ||||
bedridden more than half the day | 133 |
53.8
| 102 |
58.6
| 93 |
43.7
| 116 |
40.0
| 64 |
30.0
| 45 |
34.9
| 553 |
43.7
| ||||
Can leave house | yes | 173 |
71.2
| 128 |
75
| 130 |
61.0
| 203 |
72.2
| 151 |
72.9
| 81 |
68.1
| 866 |
70.2
| 0.77 | 1 | 0.38 |
no | 70 |
28.8
| 43 |
25
| 82 |
38.5
| 78 |
27.8
| 56 |
27.1
| 38 |
31.9
| 367 |
29.8
| ||||
Needs help bathing | yes | 39 |
15.8
| 55 |
31.6
| 49 |
23.0
| 35 |
12.1
| 27 |
12.7
| 19 |
14.8
| 224 |
18.5
| 58.3 | 1 | < 0.001 |
no | 158 |
64.0
| 118 |
67.8
| 163 |
76.5
| 255 |
87.9
| 185 |
87.3
| 109 |
85.2
| 988 |
81.5
| ||||
Needs help dressing | yes | 42 |
17.0
| 30 |
17.2
| 20 |
9.4
| 26 |
9.0
| 17 |
8.0
| 10 |
7.8
| 145 |
11.5
| 4.41 | 1 | 0.04 |
no | 205 |
83.0
| 144 |
82.8
| 193 |
90.6
| 262 |
90.3
| 196 |
92.0
| 119 |
92.2
| 1119 |
88.4
| ||||
Needs help eating | yes | 22 |
8.9
| 19 |
10.9
| 4 |
1.9
| 12 |
4.2
| 11 |
5.2
| 6 |
4.7
| 74 |
5.9
| 7.27 | 1 | 0.01 |
no | 224 |
90.7
| 155 |
89.1
| 209 |
98.1
| 273 |
95.8
| 201 |
94.8
| 123 |
95.3
| 1185 |
94.1
| ||||
Needs help walking | yes | 88 |
35.6
| 50 |
28.7
| 25 |
11.7
| 40 |
13.9
| 31 |
14.6
| 20 |
15.5
| 254 |
20.1
| 43 | 1 | < 0.001 |
no | 159 |
64.4
| 124 |
71.3
| 187 |
87.8
| 247 |
86.1
| 181 |
85.4
| 109 |
84.5
| 1007 |
79.9
| ||||
Needs help with toileting | yes | 70 |
28.3
| 40 |
23.0
| 24 |
11.3
| 40 |
14.1
| 29 |
13.9
| 19 |
15.0
| 222 |
17.8
| 21.4 | 1 | < 0.001 |
no | 176 |
71.3
| 133 |
76.4
| 188 |
88.3
| 243 |
85.9
| 179 |
86.1
| 108 |
85.0
| 1027 |
82.2
| ||||
Past TB | yes | 82 |
34.0
| 60 |
35.3
| 86 |
42.0
| 99 |
34.7
| 56 |
27.2
| 40 |
31.0
| 423 |
34.2
| 1.99 | 1 | 0.16 |
no | 159 |
66.0
| 110 |
64.7
| 119 |
58.0
| 186 |
65.3
| 150 |
72.8
| 89 |
69.0
| 813 |
65.8
| ||||
On TB treatment at assessment | yes - pulmonary | 75 |
30.4
| 58 |
33.3
| 73 |
34.3
| 63 |
21.7
| 36 |
17.0
| 24 |
18.6
| 329 |
26.0
| 13.28 | 1 | < 0.001 |
yes - extra-pulmonary | 2 |
0.8
| 15 |
8.6
| 12 |
5.6
| 10 |
3.4
| 7 |
3.3
| 10 |
7.8
| 56 |
4.4
| ||||
no | 170 |
68.8
| 101 |
58.0
| 128 |
60.1
| 217 |
74.8
| 169 |
79.7
| 95 |
73.6
| 880 |
69.5
| ||||
HIV test done before assessment | yes | 47 |
19.0
| 72 |
41.4
| 97 |
45.5
| 186 |
64.1
| 154 |
72.3
| 96 |
74.4
| 652 |
51.5
| 185 | 1 | < 0.001 |
no | 200 |
81.0
| 102 |
58.6
| 116 |
54.5
| 104 |
35.9
| 59 |
27.7
| 33 |
25.6
| 614 |
48.5
| ||||
ART status | on ART before initial assessment | 0 |
0.0
| 0 |
0
| 0 |
0.0
| 35 |
12.1
| 75 |
35.2
| 48 |
37.2
| 158 |
12.5
| 207 | 1 | < 0.001 |
on ART after initial assessment | 19 |
7.7
| 28 |
16.1
| 37 |
17.4
| 66 |
22.8
| 28 |
13.1
| 14 |
10.9
| 192 |
15.2
| ||||
not on ART | 228 |
92.3
| 146 |
83.9
| 176 |
82.6
| 189 |
65.2
| 110 |
51.6
| 67 |
51.9
| 916 |
72.4
| ||||
WHO staging | 2 | 30 |
12.1
| 17 |
9.8
| 15 |
7.0
| 21 |
7.2
| 30 |
14.2
| 18 |
14.0
| 131 |
10.3
| 2.84 | 1 | 0.092 |
3 | 82 |
33.2
| 49 |
28.2
| 89 |
41.8
| 114 |
39.3
| 80 |
37.7
| 45 |
34.9
| 459 |
36.3
| ||||
4 | 135 |
54.7
| 108 |
62.1
| 109 |
51.2
| 155 |
53.4
| 102 |
48.1
| 66 |
51.2
| 675 |
53.3
| ||||
Sputum sent for AFB | yes | 0 |
0
| 0 |
0
| 18 |
8.5
| 26 |
9.2
| 14 |
6.6
| 6 |
4.7
| 64 |
5.1
| 15.7 | 1 | < 0.001 |
no | 247 |
100
| 174 |
100
| 195 |
91.5
| 263 |
92.9
| 199 |
93.4
| 122 |
95.3
| 1200 |
94.9
| ||||
Referred for ART | yes | 0 |
0
| 0 |
0
| 12 |
5.6
| 39 |
13.5
| 36 |
16.9
| 23 |
17.8
| 110 |
8.7
| 76.8 | 1 | < 0.001 |
no | 247 |
100
| 174 |
100
| 201 |
94.4
| 250 |
86.5
| 177 |
83.1
| 106 |
82.2
| 1155 |
91.2
| ||||
Died, alive or lost to follow up | died | 171 |
69.2
| 126 |
72.4
| 131 |
61.5
| 129 |
44.5
| 68 |
31.9
| 27 |
20.9
| 652 |
51.5
| 153 | 1 | < 0.001 |
lost | 8 |
3.2
| 9 |
5.2
| 29 |
13.6
| 27 |
9.3
| 19 |
8.9
| 3 |
2.3
| 95 |
7.5
| ||||
only seen once | 23 |
9.3
| 4 |
2.3
| 6 |
2.8
| 13 |
4.5
| 8 |
3.8
| 22 |
17.1
| 76 |
6.0
| ||||
alive | 45 |
18.2
| 35 |
20.1
| 47 |
22.1
| 121 |
41.7
| 118 |
55.4
| 77 |
59.7
| 443 |
35.0
| ||||
Rate
|
Rate
|
Rate
|
Rate
|
Rate
|
Rate
|
Rate
| ||||||||||||
First visit rate per 1000 population | 4.2 | 2.5 | 2.7 | 3.5 | 2.5 | 2.2 | 2.9 | 31.2 | 1 | < 0.001 | ||||||||
Follow up visit rate per 1000 pop | 10.7 | 18.1 | 23.6 | 27.0 | 21.4 | 17.6 | 20.1 | 84.2 | 1 | < 0.001 | ||||||||
Mean
|
SD
|
Mean
|
SD
|
Mean
|
SD
|
Mean
|
SD
|
Mean
|
SD
|
Mean
|
SD
|
Mean
|
SD
|
Pearson r
|
Anova p
| |||
Body mass index | 18.6 |
3.2
| 17.9 |
2.3
| 18.1 |
2.7
| 18.3 |
3.2
| 18.3 |
2.9
| 18.0 |
3.3
| 18.3 |
3.0
| -0.022 | 0.47 | ||
Age | 31.8 |
7.9
| 33.0 |
8.0
| 32.8 |
8.1
| 34.8 |
9.0
| 34.4 |
8.1
| 34.0 |
9.2
| 33.5 |
8.4
| 0.11 | < 0.001 |
Stage of disease at presentation
HIV test status
Treatment prior to assessment
Nutritional status
Activities of daily living
Symptoms
Diagnoses
Specific HIV staging diagnoses | Number | Percent |
---|---|---|
recurrent URTI | 308 | 42.6% |
severe bacterial infection | 149 | 20.6% |
past oral candidiasis | 142 | 19.6% |
herpes simplex > 1 month | 30 | 4.1% |
oesophageal or lung candidiasis | 28 | 3.9% |
non-typhoidal salmonellosis | 23 | 3.2% |
cryptococcosis | 16 | 2.2% |
cardiomyopathy | 6 | 0.8% |
toxoplasmosis | 4 | 0.6% |
cryptosporidia | 4 | 0.6% |
HIV encephalopathy | 4 | 0.6% |
systemic mycosis | 3 | 0.4% |
PCP | 2 | 0.3% |
cancer cervix | 2 | 0.3% |
atypical mycobacteriosis | 1 | 0.1% |
acute necrotising gingivitis | 1 | 0.1% |
Total
|
723
|
Antiretroviral therapy
Survival
Cumulative survival - Kaplan Meier survival function of all followed up patients not on ART by HIV known status | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
At initial assessment | survive 1 yr | survive 2 yr | survive 3 yr | survive 4 yr | survive 5 yr | |||||||
Last known HIV status | WHO stage | number | percent | number known alive | percent | number known alive | percent | number known alive | percent | number known alive | percent | number known alive |
HIV Positive | Stage 2 | 32 | 80 | 8 | 54 | 3 | 54 | 1 | 54 | 1 | 54 | 1 |
Stage 3 | 131 | 36 | 32 | 25 | 15 | 20 | 5 | 20 | 2 | 0 | 0 | |
Stage 4 | 202 | 28 | 43 | 20 | 22 | 15 | 8 | 12 | 3 | 0 | 0 | |
Stages 3 + 4
|
291
|
30
|
60
|
22
|
27
|
18
|
9
|
15
|
4
|
0
|
0
| |
All cases | 365 | 34 | 83 | 24 | 40 | 19 | 14 | 17 | 6 | 13 | 1 | |
HIV not known | Stage 2 | 55 | 57 | 24 | 43 | 12 | 31 | 8 | 27 | 5 | 22 | 3 |
Stage 3 | 169 | 37 | 46 | 26 | 27 | 22 | 17 | 17 | 9 | 15 | 5 | |
Stage 4 | 263 | 35 | 74 | 23 | 38 | 20 | 24 | 17 | 16 | 17 | 10 | |
Stages 3 + 4
|
432
|
36
|
120
|
24
|
65
|
21
|
41
|
17
|
25
|
16
|
15
| |
All cases | 487 | 37 | 144 | 26 | 77 | 22 | 49 | 18 | 30 | 17 | 18 | |
All cases | Stage 2 | 87 | 64 | 32 | 47 | 15 | 36 | 9 | 32 | 6 | 26 | 4 |
Stage 3 | 300 | 37 | 78 | 26 | 42 | 21 | 22 | 17 | 11 | 14 | 5 | |
Stage 4 | 465 | 32 | 117 | 22 | 60 | 18 | 32 | 15 | 19 | 15 | 10 | |
Stages 3 + 4
|
765
|
34
|
195
|
23
|
102
|
19
|
54
|
16
|
30
|
15
|
15
| |
All cases | 852 | 37 | 227 | 25 | 117 | 21 | 63 | 18 | 36 | 16 | 19 |