title: Recall of lost-to-follow-up pre-antiretroviral therapy patients in the Eastern Cape: effect of mentoring on patient care.
abstract: BACKGROUND
  In 2011 an experienced HIV nurse from the UK was deployed for 3 months to act as a mentor to nurses learning to initiate antiretroviral therapy (ART) in primary care clinics in a small town in the Eastern Cape, South Africa.
  
  
  METHODS
  A review of existing pre-ART patient files (N=286) was carried out and lost-to-follow-up (LTFU) HIV patients were recalled.
  
  
  RESULTS
  Only 24% of patients had attended the clinics within the preceding 6 months and 20% had not attended for longer than 2 years. Two lay counsellors visited 222 patients to encourage them to return to care; 65/286 (23%) were untraceable, 11/286 (4%) had relocated, 30/286 (10%) declined, and 8/286 (3%) had died. In the 6 weeks following recall, 51/286 patients (18%) returned to the clinics. CD4 count testing was repeated and screening for tuberculosis (TB) and other opportunistic infections was performed for all patients; ART was initiated in 13/51 (25%), 1 patient tested positive for TB, and isionazid (INH) prophylaxis was initiated in 23/51 (45%). The cost of recall was R130/patient. Within 6 months, all clinics began providing full ART services, 17 professional nurses were mentored and they initiated ART in 55 patients.
  
  
  CONCLUSIONS
  Mentoring plays an important role in professional nurse training and support. Recall of LTFU patients is feasible and effective in improving ART services in rural settings.
authors.affiliation: East Sussex Healthcare NHS Trust, Eastbourne, UK. david.cameron@up.ac.za
authors.forename: Martin
authors.initials: M
authors.lastname: Jones
authors.forename: Maryna
authors.initials: M
authors.lastname: Stander
authors.forename: Marlene
authors.initials: M
authors.lastname: van Zyl
authors.forename: David
authors.initials: D
authors.lastname: Cameron
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D010349:Patient Compliance; D017010:Reminder Systems; D013019:South Africa
chemical_list: D019380:Anti-HIV Agents