SidaSubSaharaV1, Pmc, Corpus, bibRecord, 001F11

Incidence of orphanhood before and after implementation of a HIV CARE program in Rakai, Uganda

Identifieur interne : 001F11 ( Pmc/Corpus ); précédent : 001F10; suivant : 001F12

Incidence of orphanhood before and after implementation of a HIV CARE program in Rakai, Uganda

Auteurs : Fredrick E. Makumbi ; Gertrude Nakigozi ; Joseph Sekasanvu ; Ivan Lukabwe ; Joseph Kagaayi ; Tom Lutalo ; Maria Wawer ; Ronald Gray

Source :

Tropical medicine & international health : TM & IH [ 1360-2276 ] ; 2012.

RBID : PMC:4169214

Abstract

Background

Scaling up of HIV care programs in sub-Saharan Africa has resulted in improved survival of HIV-infected adults, but its effect on orphanhood has not been well studied.

Objective

To compare the incidence of orphanhood among children <15 years of age before and after implementing HIV care in Rakai, Uganda.

Methods

Annual household censuses and surveys were conducted January 2001 to September 2009 in a community cohort, where HIV care including antiretroviral therapy (ART) started in June 2004. Data included parental survival of children aged –14 years, and HIV status from consenting adults aged 15–49 years. The incidence of orphanhood was estimated as the number of new orphans divided by person-years, determined during three time periods: Pre-HIVcare roll-out (January 2001–June 2003) 1–3 years before the advent of HIV care in Rakai program, HIVcare-transition from September2003–May2006, and the Expanded HIVcare period from August2006–September2009. Poisson regression was used to estimate incidence rate ratios (IRR) of orphanhood and 95% confidence intervals, and the Population attributable fraction (PAF) of incident orphanhood due to HIV+ parental status was estimated as pd*(RR-1)/RR.

Results

A total of 20 823, 21 770 and 23 700 children aged 0–14 years were censused at the three periods, respectively. The prevalence of orphanhood significantly declined; 17.2% during Pre-HIVcare roll-out, 16.0% at HIVcare-transition, and 12.6% at Expanded HIVcare period (χ² for trend, p<0.0001). The incidence of orphanhood also declined significantly with increasing HIV care from 2.10/100py, 1.57/100py and 1.07/100py (χ² for trend, p<0.0001). The largest declines were observed among children with HIV+ parent(s), 8.2/100pyr, 5.2/100pys and 3.4/100pyr. PAF also declined from 35.3% in the pre-HIVcare to 27.6% in the Expanded HIVcare periods

Conclusion

After the availability of ART there was decline in population attributable fraction of incident orphanhood due to parental HIV+ status, and in the incidence of orphanhood especially among children with HIV-infected parents.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4169214

DOI: 10.1111/j.1365-3156.2012.03031.x
PubMed: 22716203
PubMed Central: 4169214

Links to Exploration step

PMC:4169214

Le document en format XML

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<author><name sortKey="Makumbi, Fredrick E" sort="Makumbi, Fredrick E" uniqKey="Makumbi F" first="Fredrick E" last="Makumbi">Fredrick E. Makumbi</name>
<affiliation><nlm:aff id="A3">Rakai Health Sciences Program, Kalisizo, Uganda</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">Makerere University School of Public Health, Kampala, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nakigozi, Gertrude" sort="Nakigozi, Gertrude" uniqKey="Nakigozi G" first="Gertrude" last="Nakigozi">Gertrude Nakigozi</name>
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<author><name sortKey="Sekasanvu, Joseph" sort="Sekasanvu, Joseph" uniqKey="Sekasanvu J" first="Joseph" last="Sekasanvu">Joseph Sekasanvu</name>
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<author><name sortKey="Lukabwe, Ivan" sort="Lukabwe, Ivan" uniqKey="Lukabwe I" first="Ivan" last="Lukabwe">Ivan Lukabwe</name>
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<author><name sortKey="Kagaayi, Joseph" sort="Kagaayi, Joseph" uniqKey="Kagaayi J" first="Joseph" last="Kagaayi">Joseph Kagaayi</name>
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<author><name sortKey="Lutalo, Tom" sort="Lutalo, Tom" uniqKey="Lutalo T" first="Tom" last="Lutalo">Tom Lutalo</name>
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<author><name sortKey="Wawer, Maria" sort="Wawer, Maria" uniqKey="Wawer M" first="Maria" last="Wawer">Maria Wawer</name>
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<author><name sortKey="Gray, Ronald" sort="Gray, Ronald" uniqKey="Gray R" first="Ronald" last="Gray">Ronald Gray</name>
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<author><name sortKey="Makumbi, Fredrick E" sort="Makumbi, Fredrick E" uniqKey="Makumbi F" first="Fredrick E" last="Makumbi">Fredrick E. Makumbi</name>
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</affiliation>
<affiliation><nlm:aff id="A2">Makerere University School of Public Health, Kampala, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Nakigozi, Gertrude" sort="Nakigozi, Gertrude" uniqKey="Nakigozi G" first="Gertrude" last="Nakigozi">Gertrude Nakigozi</name>
<affiliation><nlm:aff id="A3">Rakai Health Sciences Program, Kalisizo, Uganda</nlm:aff>
</affiliation>
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<author><name sortKey="Sekasanvu, Joseph" sort="Sekasanvu, Joseph" uniqKey="Sekasanvu J" first="Joseph" last="Sekasanvu">Joseph Sekasanvu</name>
<affiliation><nlm:aff id="A3">Rakai Health Sciences Program, Kalisizo, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lukabwe, Ivan" sort="Lukabwe, Ivan" uniqKey="Lukabwe I" first="Ivan" last="Lukabwe">Ivan Lukabwe</name>
<affiliation><nlm:aff id="A3">Rakai Health Sciences Program, Kalisizo, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kagaayi, Joseph" sort="Kagaayi, Joseph" uniqKey="Kagaayi J" first="Joseph" last="Kagaayi">Joseph Kagaayi</name>
<affiliation><nlm:aff id="A3">Rakai Health Sciences Program, Kalisizo, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Lutalo, Tom" sort="Lutalo, Tom" uniqKey="Lutalo T" first="Tom" last="Lutalo">Tom Lutalo</name>
<affiliation><nlm:aff id="A3">Rakai Health Sciences Program, Kalisizo, Uganda</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wawer, Maria" sort="Wawer, Maria" uniqKey="Wawer M" first="Maria" last="Wawer">Maria Wawer</name>
<affiliation><nlm:aff id="A1">Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gray, Ronald" sort="Gray, Ronald" uniqKey="Gray R" first="Ronald" last="Gray">Ronald Gray</name>
<affiliation><nlm:aff id="A1">Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA</nlm:aff>
</affiliation>
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<series><title level="j">Tropical medicine & international health : TM & IH</title>
<idno type="ISSN">1360-2276</idno>
<idno type="eISSN">1365-3156</idno>
<imprint><date when="2012">2012</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Scaling up of HIV care programs in sub-Saharan Africa has resulted in improved survival of HIV-infected adults, but its effect on orphanhood has not been well studied.</p>
</sec>
<sec id="S2"><title>Objective</title>
<p id="P2">To compare the incidence of orphanhood among children <15 years of age before and after implementing HIV care in Rakai, Uganda.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">Annual household censuses and surveys were conducted January 2001 to September 2009 in a community cohort, where HIV care including antiretroviral therapy (ART) started in June 2004. Data included parental survival of children aged –14 years, and HIV status from consenting adults aged 15–49 years. The incidence of orphanhood was estimated as the number of new orphans divided by person-years, determined during three time periods: <italic>Pre-HIVcare</italic>
 roll-out (January 2001–June 2003) 1–3 years before the advent of HIV care in Rakai program, <italic>HIVcare-transition from</italic>
 September2003–May2006, and the <italic>Expanded HIVcare</italic>
 period from August2006–September2009. Poisson regression was used to estimate incidence rate ratios (IRR) of orphanhood and 95% confidence intervals, and the Population attributable fraction (PAF) of incident orphanhood due to HIV+ parental status was estimated as pd*(RR-1)/RR.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">A total of 20 823, 21 770 and 23 700 children aged 0–14 years were censused at the three <italic>periods</italic>
, respectively. The prevalence of orphanhood significantly declined; 17.2% during <italic>Pre-HIVcare roll-out</italic>
, 16.0% at <italic>HIVcare-transition</italic>
, and 12.6% at <italic>Expanded HIVcare </italic>
period (χ<sup>2</sup>
 for trend, p<0.0001). The incidence of orphanhood also declined significantly with increasing HIV care from 2.10/100py, 1.57/100py and 1.07/100py (χ<sup>2</sup>
 for trend, p<0.0001). The largest declines were observed among children with HIV+ parent(s), 8.2/100pyr, 5.2/100pys and 3.4/100pyr. PAF also declined from 35.3% in the <italic>pre-HIVcare</italic>
 to 27.6% in the <italic>Expanded HIVcare</italic>
 periods</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P5">After the availability of ART there was decline in population attributable fraction of incident orphanhood due to parental HIV+ status, and in the incidence of orphanhood especially among children with HIV-infected parents.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">9610576</journal-id>
<journal-id journal-id-type="pubmed-jr-id">20323</journal-id>
<journal-id journal-id-type="nlm-ta">Trop Med Int Health</journal-id>
<journal-id journal-id-type="iso-abbrev">Trop. Med. Int. Health</journal-id>
<journal-title-group><journal-title>Tropical medicine & international health : TM & IH</journal-title>
</journal-title-group>
<issn pub-type="ppub">1360-2276</issn>
<issn pub-type="epub">1365-3156</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22716203</article-id>
<article-id pub-id-type="pmc">4169214</article-id>
<article-id pub-id-type="doi">10.1111/j.1365-3156.2012.03031.x</article-id>
<article-id pub-id-type="manuscript">NIHMS624075</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Incidence of orphanhood before and after implementation of a HIV CARE program in Rakai, Uganda</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Makumbi</surname>
<given-names>Fredrick E</given-names>
</name>
<degrees>PhD</degrees>
<email>fmakumbi@musph.ac.ug</email>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nakigozi</surname>
<given-names>Gertrude</given-names>
</name>
<degrees>MBChB MPH</degrees>
<email>gnakigozi@rhsp.org</email>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sekasanvu</surname>
<given-names>Joseph</given-names>
</name>
<degrees>BSC</degrees>
<email>joesseka@rhsp.org</email>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lukabwe</surname>
<given-names>Ivan</given-names>
</name>
<degrees>Bstat</degrees>
<email>luanzag@gmail.com</email>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kagaayi</surname>
<given-names>Joseph</given-names>
</name>
<degrees>MBChB MPH</degrees>
<email>jkagaayi@rhsp.org</email>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lutalo</surname>
<given-names>Tom</given-names>
</name>
<degrees>MSC</degrees>
<email>tlutalo@rhsp.org</email>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wawer</surname>
<given-names>Maria</given-names>
</name>
<degrees>MD</degrees>
<email>mwawer@jhsph.edu</email>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gray</surname>
<given-names>Ronald</given-names>
</name>
<degrees>MD</degrees>
<email>rgray@jhsph.edu</email>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA</aff>
<aff id="A2"><label>2</label>
Makerere University School of Public Health, Kampala, Uganda</aff>
<aff id="A3"><label>3</label>
Rakai Health Sciences Program, Kalisizo, Uganda</aff>
<author-notes><corresp id="cor1"><bold>Corresponding author</bold>
, Fredrick E Makumbi, <email>fmakumbi@musph.ac.ug</email>
, Makerere University, College of Health Sciences, School of Public Health, Rm 221, P.O.Box 7072 Kampala, Mobile: 256-772-318387</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>12</day>
<month>9</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>21</day>
<month>6</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="ppub"><month>8</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>19</day>
<month>9</month>
<year>2014</year>
</pub-date>
<volume>17</volume>
<issue>8</issue>
<fpage>e94</fpage>
<lpage>102</lpage>
<pmc-comment>elocation-id from pubmed: 10.1111/j.1365-3156.2012.03031.x</pmc-comment>
      <abstract><sec id="S1"><title>Background</title>
<p id="P1">Scaling up of HIV care programs in sub-Saharan Africa has resulted in improved survival of HIV-infected adults, but its effect on orphanhood has not been well studied.</p>
</sec>
<sec id="S2"><title>Objective</title>
<p id="P2">To compare the incidence of orphanhood among children <15 years of age before and after implementing HIV care in Rakai, Uganda.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">Annual household censuses and surveys were conducted January 2001 to September 2009 in a community cohort, where HIV care including antiretroviral therapy (ART) started in June 2004. Data included parental survival of children aged –14 years, and HIV status from consenting adults aged 15–49 years. The incidence of orphanhood was estimated as the number of new orphans divided by person-years, determined during three time periods: <italic>Pre-HIVcare</italic>
 roll-out (January 2001–June 2003) 1–3 years before the advent of HIV care in Rakai program, <italic>HIVcare-transition from</italic>
 September2003–May2006, and the <italic>Expanded HIVcare</italic>
 period from August2006–September2009. Poisson regression was used to estimate incidence rate ratios (IRR) of orphanhood and 95% confidence intervals, and the Population attributable fraction (PAF) of incident orphanhood due to HIV+ parental status was estimated as pd*(RR-1)/RR.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">A total of 20 823, 21 770 and 23 700 children aged 0–14 years were censused at the three <italic>periods</italic>
, respectively. The prevalence of orphanhood significantly declined; 17.2% during <italic>Pre-HIVcare roll-out</italic>
, 16.0% at <italic>HIVcare-transition</italic>
, and 12.6% at <italic>Expanded HIVcare </italic>
period (χ<sup>2</sup>
 for trend, p<0.0001). The incidence of orphanhood also declined significantly with increasing HIV care from 2.10/100py, 1.57/100py and 1.07/100py (χ<sup>2</sup>
 for trend, p<0.0001). The largest declines were observed among children with HIV+ parent(s), 8.2/100pyr, 5.2/100pys and 3.4/100pyr. PAF also declined from 35.3% in the <italic>pre-HIVcare</italic>
 to 27.6% in the <italic>Expanded HIVcare</italic>
 periods</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P5">After the availability of ART there was decline in population attributable fraction of incident orphanhood due to parental HIV+ status, and in the incidence of orphanhood especially among children with HIV-infected parents.</p>
</sec>
</abstract>
<kwd-group><kwd>Incidence</kwd>
<kwd>orphanhood</kwd>
<kwd>HIV care</kwd>
<kwd>ART</kwd>
<kwd>PAF</kwd>
<kwd>Uganda</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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Incidence of orphanhood before and after implementation of a HIV CARE program in Rakai, Uganda

Incidence of orphanhood before and after implementation of a HIV CARE program in Rakai, Uganda

Source :

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki