Le SIDA en Afrique subsaharienne (serveur d'exploration)

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A 10-year cohort analysis of routine paediatric ART data in a rural South African setting

Identifieur interne : 002344 ( Pmc/Curation ); précédent : 002343; suivant : 002345

A 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 :

RBID : PMC:5197927

Abstract

SUMMARY

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 (P < 0·0001) and in children aged ≤1 year at treatment initiation (P < 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, P < 0·001). Viral load was suppressed in 48–52% of the cohort, with no significant change over the years (P = 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.


Url:
DOI: 10.1017/S0950268816001916
PubMed: 27609130
PubMed Central: 5197927

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PMC:5197927

Le document en format XML

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<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 (
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<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>
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<name>
<surname>LILIAN</surname>
<given-names>R. R.</given-names>
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<surname>MUTASA</surname>
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<name>
<surname>RAILTON</surname>
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<name>
<surname>MONGWE</surname>
<given-names>W.</given-names>
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<xref ref-type="aff" rid="aff2">2</xref>
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<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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