title: Assessing factors for loss to follow-up of HIV infected patients in Guinea-Bissau.
abstract: OBJECTIVE
  The objective of this study was to ascertain vital status of patients considered lost to follow-up at an HIV clinic in Guinea-Bissau, and describe reasons for loss to follow-up (LTFU).
  
  
  METHODS
  This study was a cross-sectional sample of a prospective cohort, carried out between May 15, 2013, and January 31, 2014. Patients lost to follow-up, who lived within the area of the Bandim Health Project, a demographic surveillance site (DSS), were eligible for inclusion. Active follow-up was attempted by telephone and tracing by a field assistant. Semi-structured interviews were done face to face or by phone by a field assistant and patients were asked why they had not shown up for the scheduled appointment. Patients were included by date of HIV testing and risk factors for LTFU were assessed using Cox proportional hazard model.
  
  
  RESULTS
  Among 561 patients (69.5 % HIV-1, 18.0 % HIV-2 and 12.6 % HIV-1/2) living within the DSS, 292 patients had been lost to follow-up and were, therefore, eligible for active follow-up. Vital status was ascertained in 65.9 % of eligible patients and 42.7 % were alive, while 23.2 % had died. Information on reasons for LTFU existed for 103 patients. Major reasons were moving (29.1 %), travelling (17.5 %), and transferring to other clinics (11.7 %).
  
  
  CONCLUSIONS
  A large proportion of the patients at the clinic were lost to follow-up. The main reason for this was found to be the geographic mobility of the population in Guinea-Bissau.
authors.affiliation: Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau.|Department of Infectious Diseases, Aarhus University Hospital, 8200, Aarhus N, Denmark.
authors.forename: Pernille Bejer
authors.initials: PB
authors.lastname: Nordentoft
authors.affiliation: Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau.|Department of Infectious Diseases, Aarhus University Hospital, 8200, Aarhus N, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Engell-Sørensen
authors.affiliation: Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau.|Department of Infectious Diseases, Aarhus University Hospital, 8200, Aarhus N, Denmark.
authors.forename: Sanne
authors.initials: S
authors.lastname: Jespersen
authors.affiliation: National HIV Programme, Ministry of Health, Bissau, Guinea-Bissau.
authors.forename: Faustino Gomes
authors.initials: FG
authors.lastname: Correia
authors.affiliation: National HIV Programme, Ministry of Health, Bissau, Guinea-Bissau.
authors.forename: Candida
authors.initials: C
authors.lastname: Medina
authors.affiliation: National HIV Programme, Ministry of Health, Bissau, Guinea-Bissau.
authors.forename: David
authors.initials: D
authors.lastname: da Silva Té
authors.affiliation: Department of Infectious Diseases, Aarhus University Hospital, 8200, Aarhus N, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Østergaard
authors.affiliation: Department of Infectious Diseases, Aarhus University Hospital, 8200, Aarhus N, Denmark.
authors.forename: Alex Lund
authors.initials: AL
authors.lastname: Laursen
authors.affiliation: Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau. wejse@dadlnet.dk.|Department of Infectious Diseases, Aarhus University Hospital, 8200, Aarhus N, Denmark. wejse@dadlnet.dk.|GloHAU, Center for Global Health, School of Public Health, Aarhus University, 8000, Aarhus C, Denmark. wejse@dadlnet.dk.
authors.forename: Christian
authors.identifier: http://orcid.org/0000-0002-2534-2942
authors.initials: C
authors.lastname: Wejse
authors.affiliation: Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau.|Department of Infectious Diseases, Aarhus University Hospital, 8200, Aarhus N, Denmark.|Department of Clinical Immunology, Aarhus University Hospital, 8200, Aarhus N, Denmark.
authors.forename: Bo Langhoff
authors.initials: BL
authors.lastname: Hønge
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006169:Guinea-Bissau; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007407:Interviews as Topic; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
keywords: Guinea-Bissau; HIV; Loss to follow-up; Mortality; Retention; West Africa