Demographic characteristics and opportunistic diseases associated with attrition during preparation for antiretroviral therapy in primary health centres in Kibera, Kenya.

Using routine data from HIV-positive adult patients eligible for antiretroviral therapy (ART), we report on routinely collected demographic characteristics and opportunistic diseases associated with pre-ART attrition (deaths and loss to follow-up). Among 2471 ART eligible patients, enrolled between January 2005 and November 2008, 446 (18%) were lost to attrition pre-ART. Adjusted risk factors significantly associated with pre-ART attrition included age <35 years (Odds Ratio, OR 1.4, 95% Confidence Interval, CI 1.1-1.8), severe malnutrition (OR 1.5, 95% CI 1.1-2.0), active pulmonary tuberculosis (OR 1.6, 95% CI 1.1-2.4), severe bacterial infections including severe bacterial pneumonia (OR 1.9, 95% CI 1.2-2.8) and prolonged unexplained fever (>1 month), (OR 2.6, 95% CI 1.3-5.2). This study highlights a number of clinical markers associated with pre-ART attrition that could serve as 'pointers' or screening tools to identify patients who merit fast-tracking onto ART and/or closer clinical attention and follow-up

Knowledge and Caring Attitude of Sri Lankan Nurses in Providing Care for Dying Patients ― A Cohort Study

This research identified evidence of knowledge and caring attitude among Sri Lankan nurses caring for dying patients; and identified the factors affecting nursing care for the dying in the eastern province of Sri Lanka. A quantitative cohort study design was used having questionnaires as the means of collecting the data. The purposive way of sampling selected 120 staff nurses employed in a government hospital as respondents who falls under the inclusion and exclusion criteria. There was significant evidence of caring attitude towards the dying (p = 0.005534) and knowledge on the end-of-life nursing care (p = 0.0004703) for the dying patients. Educational attainment (p = 0.050001), clinical experiences (p = 0.01499), age (p = 0.01061) and civil status (p = 0.001782) were factors affecting the knowledge and attitude of Sri Lankan nurses in delivering nursing care for the dying patients admitted to a government hospital