A national survey of prisoners on antiretroviral therapy in Malawi: access to treatment and outcomes on therapy

  • Simon D. Makombe Clinical HIV Unit, Ministry of Health, PO Box 30377, Lilongwe
  • Andreas Jahn Lighthouse Trust, Lilongwe
  • Hannock Tweya Lighthouse Trust, Lilongwe
  • Lameck Thambo Lighthouse Trust, Lilongwe
  • Joseph Kwong-Leung Yu Taiwan Medical Mission, Mzuzu Central Hospital, Mzuzu
  • Bethany Hedt Harvard School of Public Health
  • Ralf Weigel Lighthouse Trust, Lilongwe
  • Amon Nkhata Clinical HIV Unit, Ministry of Health, PO Box 30377, Lilongwe
  • Erik J. Schouten Clinical HIV Unit, Ministry of Health, PO Box 30377, Lilongwe
  • Kelita Kamoto Clinical HIV Unit, Ministry of Health, PO Box 30377, Lilongwe
  • Anthony D. Harries Clinical HIV Unit, Ministry of Health, PO Box 30377, Lilongwe

Abstract

Background: Malawi is making good progress scaling up antiretroviral therapy (ART), but we do not know the levels of access of high-risk, disadvantaged groups such as prisoners. The aim of this study was to measure access and treatment outcomes of prisoners on ART at the national level.
Methodology: A retrospective cohort study was conducted examining patient follow-up records from all 103 public sector ART clinics in Malawi, and observations were censored on December 31, 2006.
Results: By December 31, 2006, a total of 81,821 patients had been started on ART. Of these, 103 (0.13%) were prisoners. At ART initiation, 93% of prisoners were in World Health Organization (WHO) clinical stage 3 or 4 while 7% started in stage 1 or 2 with a CD4-lymphocyte count of ≤250/mm3. Treatment outcomes by the end of December 2006 were as follows: 66 (64%) alive and on ART at their registration facility; 9 (9%) dead; 8 (8%) lost to follow-up; and 20 (19%) transferred out to another facility. The probability of being alive and on ART at 6 and 12 months was 82.5% and 77.7%.
Conclusions: In spite of the rapid scale-up of ART, only a small number of HIV-positive prisoners had accessed ART by the end of 2006. Treatment outcomes were good. Initiatives are now needed to improve access to HIV testing and ART in Malawi’s prisons.
Published
2007-12-01
How to Cite
Makombe S, Jahn A, Tweya H, Thambo L, Yu J, Hedt B, Weigel R, Nkhata A, Schouten E, Kamoto K, Harries A (2007) A national survey of prisoners on antiretroviral therapy in Malawi: access to treatment and outcomes on therapy. The Journal Of Infection In Developing Countries 1 (03): 303-307. https://doi.org/10.3855/jidc.368
Section
Original Articles

Keywords

Prisoners; antiretroviral therapy; access to treatment; treatment outcomes; Malawi