A 10-year cohort analysis of routine paediatric ART data in a rural South African setting
Identifieur interne : 002344 ( Pmc/Curation ); précédent : 002343; suivant : 002345A 10-year cohort analysis of routine paediatric ART data in a rural South African setting
Auteurs : R. R. Lilian [Afrique du Sud] ; B. Mutasa [Afrique du Sud] ; J. Railton [Afrique du Sud] ; W. Mongwe [Afrique du Sud] ; J. A. Mcintyre [Afrique du Sud] ; H. E. Struthers [Afrique du Sud] ; R. P. H. Peters [Afrique du Sud]Source :
- Epidemiology and Infection [ 0950-2688 ] ; 2016.
Abstract
South Africa's paediatric antiretroviral therapy (ART) programme is managed using a
monitoring and evaluation tool known as TIER.Net. This electronic system has several
advantages over paper-based systems, allowing profiling of the paediatric ART programme
over time. We analysed anonymized TIER.Net data for HIV-infected children aged <15
years who had initiated ART in a rural district of South Africa between 2005 and 2014. We
performed Kaplan–Meier survival analysis to assess outcomes over time. Records of 5461
children were available for analysis; 3593 (66%) children were retained in care. Losses
from the programme were higher in children initiated on treatment in more recent years
(
Url:
DOI: 10.1017/S0950268816001916
PubMed: 27609130
PubMed Central: 5197927
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<country xml:lang="fr">Afrique du Sud</country>
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<author><name sortKey="Mutasa, B" sort="Mutasa, B" uniqKey="Mutasa B" first="B." last="Mutasa">B. Mutasa</name>
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<affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>School of Public Health and Family Medicine</addr-line>
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,<addr-line>Pretoria</addr-line>
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<author><name sortKey="Mutasa, B" sort="Mutasa, B" uniqKey="Mutasa B" first="B." last="Mutasa">B. Mutasa</name>
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,<addr-line>Johannesburg and Tzaneen</addr-line>
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<country xml:lang="fr">Afrique du Sud</country>
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<author><name sortKey="Railton, J" sort="Railton, J" uniqKey="Railton J" first="J." last="Railton">J. Railton</name>
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<country xml:lang="fr">Afrique du Sud</country>
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<country xml:lang="fr">Afrique du Sud</country>
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<country xml:lang="fr">Afrique du Sud</country>
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,<addr-line>Cape Town</addr-line>
,<country>South Africa</country>
</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
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<author><name sortKey="Peters, R P H" sort="Peters, R P H" uniqKey="Peters R" first="R. P. H." last="Peters">R. P. H. Peters</name>
<affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Anova Health Institute</institution>
,<addr-line>Johannesburg and Tzaneen</addr-line>
,<country>South Africa</country>
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<country xml:lang="fr">Afrique du Sud</country>
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<series><title level="j">Epidemiology and Infection</title>
<idno type="ISSN">0950-2688</idno>
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<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><title>SUMMARY</title>
<p>South Africa's paediatric antiretroviral therapy (ART) programme is managed using a
monitoring and evaluation tool known as TIER.Net. This electronic system has several
advantages over paper-based systems, allowing profiling of the paediatric ART programme
over time. We analysed anonymized TIER.Net data for HIV-infected children aged <15
years who had initiated ART in a rural district of South Africa between 2005 and 2014. We
performed Kaplan–Meier survival analysis to assess outcomes over time. Records of 5461
children were available for analysis; 3593 (66%) children were retained in care. Losses
from the programme were higher in children initiated on treatment in more recent years
(<italic>P</italic>
< 0·0001) and in children aged ≤1 year at treatment
initiation (<italic>P</italic>
< 0·0001). For children aged <3 years,
abacavir was associated with a significantly higher rate of loss from the programme
compared to stavudine (hazard ratio 1·9, <italic>P</italic>
< 0·001). Viral load
was suppressed in 48–52% of the cohort, with no significant change over the years
(<italic>P</italic>
= 0·398). Analysis of TIER.Net data over time provides enhanced
insights into the performance of the paediatric ART programme and highlights interventions
to improve programme performance.</p>
</div>
</front>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Epidemiol Infect</journal-id>
<journal-id journal-id-type="iso-abbrev">Epidemiol. Infect</journal-id>
<journal-id journal-id-type="publisher-id">HYG</journal-id>
<journal-title-group><journal-title>Epidemiology and Infection</journal-title>
</journal-title-group>
<issn pub-type="ppub">0950-2688</issn>
<issn pub-type="epub">1469-4409</issn>
<publisher><publisher-name>Cambridge University Press</publisher-name>
<publisher-loc>Cambridge, UK</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27609130</article-id>
<article-id pub-id-type="pmc">5197927</article-id>
<article-id pub-id-type="doi">10.1017/S0950268816001916</article-id>
<article-id pub-id-type="pii">S0950268816001916</article-id>
<article-id pub-id-type="publisher-id">00191</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Papers</subject>
</subj-group>
<subj-group subj-group-type="section"><subject>HIV</subject>
</subj-group>
</article-categories>
<title-group><article-title>A 10-year cohort analysis of routine paediatric ART data in a rural South
African setting</article-title>
<alt-title alt-title-type="left-running">R. R. Lilian and others</alt-title>
<alt-title alt-title-type="right-running">Ten-year analysis of paediatric ART
data</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>LILIAN</surname>
<given-names>R. R.</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>MUTASA</surname>
<given-names>B.</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>RAILTON</surname>
<given-names>J.</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>MONGWE</surname>
<given-names>W.</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>McINTYRE</surname>
<given-names>J. A.</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>STRUTHERS</surname>
<given-names>H. E.</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>PETERS</surname>
<given-names>R. P. H.</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff5">5</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<institution>Anova Health Institute</institution>
,<addr-line>Johannesburg and Tzaneen</addr-line>
,<country>South Africa</country>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>Mopani Department of Health</addr-line>
,<addr-line>Giyani</addr-line>
,<country>South Africa</country>
</aff>
<aff id="aff3"><label>3</label>
<addr-line>School of Public Health and Family Medicine</addr-line>
,<institution>University of Cape Town</institution>
,<addr-line>Cape Town</addr-line>
,<country>South Africa</country>
</aff>
<aff id="aff4"><label>4</label>
<addr-line>Department of Medicine</addr-line>
,<institution>University of Cape Town</institution>
,<addr-line>Cape Town</addr-line>
,<country>South Africa</country>
</aff>
<aff id="aff5"><label>5</label>
<addr-line>Department of Microbiology</addr-line>
,<institution>University of Pretoria</institution>
,<addr-line>Pretoria</addr-line>
,<country>South Africa</country>
</aff>
<author-notes><corresp id="cor1"><label>*</label>
Author for correspondence: Dr R. P. H. Peters,
<addr-line>12 Sherborne Road</addr-line>
, <addr-line>Johannesburg</addr-line>
,
<addr-line>2193</addr-line>
, <country>South Africa</country>
. (Email: <email>peters@anovahealth.co.za</email>
)</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>1</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub"><day>09</day>
<month>9</month>
<year>2016</year>
</pub-date>
<volume>145</volume>
<issue>1</issue>
<fpage>170</fpage>
<lpage>180</lpage>
<history><date date-type="received"><day>26</day>
<month>2</month>
<year>2016</year>
</date>
<date date-type="rev-recd"><day>14</day>
<month>7</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>02</day>
<month>8</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© Cambridge University Press 2016</copyright-statement>
<copyright-year>2016</copyright-year>
<copyright-holder>Cambridge University Press</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p><pmc-comment>CREATIVE COMMONS</pmc-comment>
This is an Open Access article, distributed under the terms of the Creative
Commons Attribution licence (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits
unrestricted re-use, distribution, and reproduction in any medium, provided the original
work is properly cited.</license-p>
</license>
</permissions>
<self-uri xlink:title="pdf" xlink:href="S0950268816001916a.pdf"></self-uri>
<abstract abstract-type="normal"><title>SUMMARY</title>
<p>South Africa's paediatric antiretroviral therapy (ART) programme is managed using a
monitoring and evaluation tool known as TIER.Net. This electronic system has several
advantages over paper-based systems, allowing profiling of the paediatric ART programme
over time. We analysed anonymized TIER.Net data for HIV-infected children aged <15
years who had initiated ART in a rural district of South Africa between 2005 and 2014. We
performed Kaplan–Meier survival analysis to assess outcomes over time. Records of 5461
children were available for analysis; 3593 (66%) children were retained in care. Losses
from the programme were higher in children initiated on treatment in more recent years
(<italic>P</italic>
< 0·0001) and in children aged ≤1 year at treatment
initiation (<italic>P</italic>
< 0·0001). For children aged <3 years,
abacavir was associated with a significantly higher rate of loss from the programme
compared to stavudine (hazard ratio 1·9, <italic>P</italic>
< 0·001). Viral load
was suppressed in 48–52% of the cohort, with no significant change over the years
(<italic>P</italic>
= 0·398). Analysis of TIER.Net data over time provides enhanced
insights into the performance of the paediatric ART programme and highlights interventions
to improve programme performance.</p>
</abstract>
<kwd-group><title>Key words</title>
<kwd>Analysis of data</kwd>
<kwd>HIV/AIDS</kwd>
<kwd>paediatrics</kwd>
<kwd>public health</kwd>
</kwd-group>
<counts><fig-count count="2"></fig-count>
<table-count count="3"></table-count>
<ref-count count="41"></ref-count>
<page-count count="11"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>
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