Recall of lost-to-follow-up pre-antiretroviral therapy patients in the Eastern Cape: Effect of mentoring on patient care

Martin Jones, Maryna Stander, Marlene van Zyl, David Cameron


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' affiliations

Martin Jones, East Sussex Healthcare NHS Trust, Eastbourne

Maryna Stander, Foundation for Professional Development, Eastern Cape

Marlene van Zyl, Foundation for Professional Development, Eastern Cape

David Cameron, Department of Family Medicine, University of Pretoria, and Foundation for Professional Development, Pretoria

Full Text



Mentoring; Antiretroviral therapy; nurses;Recall

Cite this article

South African Medical Journal 2012;102(9):768-769. DOI:10.7196/SAMJ.5957

Article History

Date submitted: 2012-04-30
Date published: 2012-08-22

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