Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe
Identifieur interne : 002A08 ( Pmc/Curation ); précédent : 002A07; suivant : 002A09Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe
Auteurs : Helen Bygrave [Afrique du Sud] ; Judith Mtangirwa [Afrique du Sud] ; Kwenzakwenkosi Ncube [Zimbabwe] ; Nathan Ford [Afrique du Sud] ; Katharina Kranzer [Royaume-Uni] ; Dhodho Munyaradzi [Zimbabwe]Source :
- PLoS ONE [ 1932-6203 ] ; 2012.
Abstract
Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10–30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10–15 (young adolescents) 15.1–19 years (adolescents), 19.1–24 years (young adults) and 24.1–29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17–4.35). Young adults and adolescents had a 2–3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62–4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults.
Url:
DOI: 10.1371/journal.pone.0052856
PubMed: 23285204
PubMed Central: 3527625
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xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town</wicri:regionArea></affiliation></author><author><name sortKey="Ncube, Kwenzakwenkosi" sort="Ncube, Kwenzakwenkosi" uniqKey="Ncube K" first="Kwenzakwenkosi" last="Ncube">Kwenzakwenkosi Ncube</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Ministry of Health and Child Welfare Zimbabwe, Buhera District, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Ministry of Health and Child Welfare Zimbabwe, Buhera District</wicri:regionArea></affiliation></author><author><name sortKey="Ford, Nathan" sort="Ford, Nathan" uniqKey="Ford N" first="Nathan" last="Ford">Nathan Ford</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Southern Africa 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sortKey="Munyaradzi, Dhodho" sort="Munyaradzi, Dhodho" uniqKey="Munyaradzi D" first="Dhodho" last="Munyaradzi">Dhodho Munyaradzi</name><affiliation wicri:level="1"><nlm:aff id="aff5"><addr-line>Medical Unit, Médecins Sans Frontières, Harare, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Medical Unit, Médecins Sans Frontières, Harare</wicri:regionArea></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10–30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10–15 (young adolescents) 15.1–19 years (adolescents), 19.1–24 years (young adults) and 24.1–29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17–4.35). Young adults and adolescents had a 2–3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62–4.52). 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Dowdy</name></author><author><name sortKey="Chaisson, Re" uniqKey="Chaisson R">RE Chaisson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Charles, M" uniqKey="Charles M">M Charles</name></author><author><name sortKey="Noel, F" uniqKey="Noel F">F Noel</name></author><author><name sortKey="Leger, P" uniqKey="Leger P">P Leger</name></author><author><name sortKey="Severe, P" uniqKey="Severe P">P Severe</name></author><author><name sortKey="Riviere, C" uniqKey="Riviere C">C Riviere</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ryscavage, P" uniqKey="Ryscavage P">P Ryscavage</name></author><author><name sortKey="Anderson, Ej" uniqKey="Anderson E">EJ Anderson</name></author><author><name sortKey="Sutton, Sh" uniqKey="Sutton S">SH Sutton</name></author><author><name sortKey="Reddy, S" uniqKey="Reddy S">S Reddy</name></author><author><name sortKey="Taiwo, B" uniqKey="Taiwo B">B Taiwo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khan, M" uniqKey="Khan M">M Khan</name></author><author><name sortKey="Song, X" uniqKey="Song X">X Song</name></author><author><name sortKey="Williams, K" uniqKey="Williams K">K Williams</name></author><author><name sortKey="Bright, K" uniqKey="Bright K">K Bright</name></author><author><name sortKey="Sill, A" uniqKey="Sill A">A Sill</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Maturo, D" uniqKey="Maturo D">D Maturo</name></author><author><name sortKey="Powell, A" uniqKey="Powell A">A Powell</name></author><author><name sortKey="Major Wilson, H" uniqKey="Major Wilson H">H Major-Wilson</name></author><author><name sortKey="Sanchez, K" uniqKey="Sanchez K">K Sanchez</name></author><author><name sortKey="De Santis, Jp" uniqKey="De Santis J">JP De Santis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bakanda, C" uniqKey="Bakanda 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sortKey="Aka, Ae" uniqKey="Aka A">AE Aka</name></author><author><name sortKey="Dior, H" uniqKey="Dior H">H Dior</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moodley, K" uniqKey="Moodley K">K Moodley</name></author><author><name sortKey="Myer, L" uniqKey="Myer L">L Myer</name></author><author><name sortKey="Michaels, D" uniqKey="Michaels D">D Michaels</name></author><author><name sortKey="Cotton, M" uniqKey="Cotton M">M Cotton</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nachega, Jb" uniqKey="Nachega J">JB Nachega</name></author><author><name sortKey="Mugavero, Mj" uniqKey="Mugavero M">MJ Mugavero</name></author><author><name sortKey="Zeier, M" uniqKey="Zeier M">M Zeier</name></author><author><name sortKey="Vit Ria, M" uniqKey="Vit Ria M">M Vitória</name></author><author><name sortKey="Gallant, Je" uniqKey="Gallant J">JE Gallant</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cremin, I" uniqKey="Cremin I">I Cremin</name></author><author><name sortKey="Mushati, P" uniqKey="Mushati P">P Mushati</name></author><author><name sortKey="Hallett, T" uniqKey="Hallett T">T Hallett</name></author><author><name sortKey="Mupambireyi, Z" uniqKey="Mupambireyi Z">Z Mupambireyi</name></author><author><name sortKey="Nyamukapa, C" uniqKey="Nyamukapa C">C Nyamukapa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Knol, Mj" uniqKey="Knol M">MJ Knol</name></author><author><name sortKey="Janssen, Kj" uniqKey="Janssen K">KJ Janssen</name></author><author><name sortKey="Donders, Ar" uniqKey="Donders A">AR Donders</name></author><author><name sortKey="Egberts, Ac" uniqKey="Egberts A">AC Egberts</name></author><author><name sortKey="Heerdink, Er" uniqKey="Heerdink E">ER Heerdink</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Demissie, S" uniqKey="Demissie S">S Demissie</name></author><author><name sortKey="Lavalley, Mp" uniqKey="Lavalley M">MP LaValley</name></author><author><name sortKey="Horton, Nj" uniqKey="Horton N">NJ Horton</name></author><author><name sortKey="Glynn, Rj" uniqKey="Glynn R">RJ Glynn</name></author><author><name sortKey="Cupples, La" uniqKey="Cupples L">LA Cupples</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Greenland, S" uniqKey="Greenland S">S Greenland</name></author><author><name sortKey="Finkle, Wd" uniqKey="Finkle W">WD Finkle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Cutsem, G" uniqKey="Van Cutsem G">G Van Cutsem</name></author><author><name sortKey="Ford, N" uniqKey="Ford N">N Ford</name></author><author><name sortKey="Hilderbrand, K" uniqKey="Hilderbrand K">K Hilderbrand</name></author><author><name sortKey="Goemaere, E" uniqKey="Goemaere E">E Goemaere</name></author><author><name sortKey="Mathee, S" uniqKey="Mathee S">S Mathee</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23285204</article-id><article-id pub-id-type="pmc">3527625</article-id><article-id pub-id-type="publisher-id">PONE-D-12-24034</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0052856</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject><subj-group><subject>Epidemiology</subject></subj-group><subj-group><subject>Global Health</subject></subj-group><subj-group><subject>Infectious Diseases</subject><subj-group><subject>Viral Diseases</subject><subj-group><subject>HIV</subject><subj-group><subject>HIV diagnosis and management</subject></subj-group></subj-group></subj-group></subj-group><subj-group><subject>Pediatrics</subject><subj-group><subject>Adolescent Medicine</subject></subj-group></subj-group><subj-group><subject>Public Health</subject><subj-group><subject>Child Health</subject></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Social and Behavioral Sciences</subject><subj-group><subject>Sociology</subject><subj-group><subject>Demography</subject><subj-group><subject>Death Rate</subject></subj-group></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Antiretroviral Therapy Outcomes among Adolescents and Youth in Rural Zimbabwe</article-title><alt-title alt-title-type="running-head">Adolescents and Youth ART Outcomes in Zimbabwe</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Bygrave</surname><given-names>Helen</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Mtangirwa</surname><given-names>Judith</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ncube</surname><given-names>Kwenzakwenkosi</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ford</surname><given-names>Nathan</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kranzer</surname><given-names>Katharina</given-names></name><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Munyaradzi</surname><given-names>Dhodho</given-names></name><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa</addr-line></aff><aff id="aff2"><label>2</label><addr-line>Ministry of Health and Child Welfare Zimbabwe, Buhera District, Zimbabwe</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa</addr-line></aff><aff id="aff4"><label>4</label><addr-line>Clinical Research Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line></aff><aff id="aff5"><label>5</label><addr-line>Medical Unit, Médecins Sans Frontières, Harare, Zimbabwe</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Braitstein</surname><given-names>Paula</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>Indiana University and Moi University, United States of America</addr-line></aff><author-notes><corresp id="cor1">* E-mail: <email>Helen.bygrave@joburg.msf.org</email></corresp><fn fn-type="conflict"><p><bold>Competing Interests: </bold>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con"><p>Conceived and designed the experiments: HB DM. Performed the statistical analysis: KK HB. Prepared the first draft of the manuscript: HB. Provided critical input to subsequent drafts of the manuscript: HB JM KN NF KK DM. Approved the final version of the manuscript: HB JM KN NF KK DM.</p></fn></author-notes><pub-date pub-type="collection"><year>2012</year></pub-date><pub-date pub-type="epub"><day>20</day><month>12</month><year>2012</year></pub-date><volume>7</volume><issue>12</issue><elocation-id>e52856</elocation-id><history><date date-type="received"><day>30</day><month>7</month><year>2012</year></date><date date-type="accepted"><day>23</day><month>11</month><year>2012</year></date></history><permissions><copyright-year>2012</copyright-year><copyright-holder>Bygrave et al</copyright-holder><license><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><abstract><p>Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10–30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10–15 (young adolescents) 15.1–19 years (adolescents), 19.1–24 years (young adults) and 24.1–29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17–4.35). Young adults and adolescents had a 2–3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62–4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults.</p></abstract><funding-group><funding-statement>The authors have no support or funding to report.</funding-statement></funding-group><counts><page-count count="5"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Curation/RBID.i -Sk "pubmed:23285204" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd \
| NlmPubMed2Wicri -a SidaSubSaharaV1
| This area was generated with Dilib version V0.6.32. |  |