Monitoring the South African National Antiretroviral Treatment Programme, 2003-2007: the IeDEA Southern Africa collaboration.

Hdl Handle:
http://hdl.handle.net/10144/112733
Title:
Monitoring the South African National Antiretroviral Treatment Programme, 2003-2007: the IeDEA Southern Africa collaboration.
Authors:
Cornell, Morna; Technau, Karl; Fairall, Lara; Wood, Robin; Moultrie, Harry; van Cutsem, Gilles; Giddy, Janet; Mohapi, Lerato; Eley, Brian; MacPhail, Patrick; Prozesky, Hans; Rabie, Helena; Davies, Mary-Ann; Maxwell, Nicola; Boulle, Andrew
Journal:
South African Medical Journal = Suid-Afrikaanse tydskrif vir geneeskunde
Abstract:
OBJECTIVES: To introduce the combined South African cohorts of the International epidemiologic Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration as reflecting the South African national antiretroviral treatment (ART) programme; to characterise patients accessing these services; and to describe changes in services and patients from 2003 to 2007. DESIGN AND SETTING: Multi-cohort study of 11 ART programmes in Gauteng, Western Cape, Free State and KwaZulu-Natal. SUBJECTS: Adults and children (<16 years old) who initiated ART with > or =3 antiretroviral drugs before 2008. RESULTS: Most sites were offering free treatment to adults and children in the public sector, ranging from 264 to 17,835 patients per site. Among 45,383 adults and 6,198 children combined, median age (interquartile range) was 35.0 years (29.8-41.4) and 42.5 months (14.7-82.5), respectively. Of adults, 68% were female. The median CD4 cell count was 102 cells/microl (44-164) and was lower among males than females (86, 34-150 v. 110, 50-169, p<0.001). Median CD4% among children was 12% (7-17.7). Between 2003 and 2007, enrolment increased 11-fold in adults and 3-fold in children. Median CD4 count at enrolment increased for all adults (67-111 cells/microl, p<0.001) and for those in stage IV (39-89 cells/microl, p<0.001). Among children <5 years, baseline CD4% increased over time (11.5-16.0%, p<0.001). CONCLUSIONS: IeDEA-SA provides a unique opportunity to report on the national ART programme. The study describes dramatically increased enrolment over time. Late diagnosis and ART initiation, especially of men and children, need attention. Investment in sentinel sites will ensure good individual-level data while freeing most sites to continue with simplified reporting.
Affiliation:
Infectious Disease Epidemiology Unit, School of Public Health and Family Medicine, University of Cape Town. morna@global.co.za
Issue Date:
Sep-2009
URI:
http://hdl.handle.net/10144/112733
PubMed ID:
20073292
Language:
en
ISSN:
0256-9574
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorCornell, Mornaen
dc.contributor.authorTechnau, Karlen
dc.contributor.authorFairall, Laraen
dc.contributor.authorWood, Robinen
dc.contributor.authorMoultrie, Harryen
dc.contributor.authorvan Cutsem, Gillesen
dc.contributor.authorGiddy, Janeten
dc.contributor.authorMohapi, Leratoen
dc.contributor.authorEley, Brianen
dc.contributor.authorMacPhail, Patricken
dc.contributor.authorProzesky, Hansen
dc.contributor.authorRabie, Helenaen
dc.contributor.authorDavies, Mary-Annen
dc.contributor.authorMaxwell, Nicolaen
dc.contributor.authorBoulle, Andrewen
dc.date.accessioned2010-10-08T22:22:50Z-
dc.date.available2010-10-08T22:22:50Z-
dc.date.issued2009-09-
dc.identifier.citationMonitoring the South African National Antiretroviral Treatment Programme, 2003-2007: the IeDEA Southern Africa collaboration. 2009, 99 (9):653-60 S. Afr. Med. J.en
dc.identifier.issn0256-9574-
dc.identifier.pmid20073292-
dc.identifier.urihttp://hdl.handle.net/10144/112733-
dc.description.abstractOBJECTIVES: To introduce the combined South African cohorts of the International epidemiologic Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration as reflecting the South African national antiretroviral treatment (ART) programme; to characterise patients accessing these services; and to describe changes in services and patients from 2003 to 2007. DESIGN AND SETTING: Multi-cohort study of 11 ART programmes in Gauteng, Western Cape, Free State and KwaZulu-Natal. SUBJECTS: Adults and children (<16 years old) who initiated ART with > or =3 antiretroviral drugs before 2008. RESULTS: Most sites were offering free treatment to adults and children in the public sector, ranging from 264 to 17,835 patients per site. Among 45,383 adults and 6,198 children combined, median age (interquartile range) was 35.0 years (29.8-41.4) and 42.5 months (14.7-82.5), respectively. Of adults, 68% were female. The median CD4 cell count was 102 cells/microl (44-164) and was lower among males than females (86, 34-150 v. 110, 50-169, p<0.001). Median CD4% among children was 12% (7-17.7). Between 2003 and 2007, enrolment increased 11-fold in adults and 3-fold in children. Median CD4 count at enrolment increased for all adults (67-111 cells/microl, p<0.001) and for those in stage IV (39-89 cells/microl, p<0.001). Among children <5 years, baseline CD4% increased over time (11.5-16.0%, p<0.001). CONCLUSIONS: IeDEA-SA provides a unique opportunity to report on the national ART programme. The study describes dramatically increased enrolment over time. Late diagnosis and ART initiation, especially of men and children, need attention. Investment in sentinel sites will ensure good individual-level data while freeing most sites to continue with simplified reporting.en
dc.language.isoenen
dc.rightsArchived with thanks to South African Medical Journal = Suid-Afrikaanse tydskrif vir geneeskundeen
dc.subject.meshAdulten
dc.subject.meshAnti-Retroviral Agentsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshCohort Studiesen
dc.subject.meshCommunity Health Servicesen
dc.subject.meshDatabases, Factualen
dc.subject.meshFemaleen
dc.subject.meshHIV Infectionsen
dc.subject.meshHealth Promotionen
dc.subject.meshHealth Services Accessibilityen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshPopulation Surveillanceen
dc.subject.meshPractice Guidelines as Topicen
dc.subject.meshProgram Evaluationen
dc.subject.meshSouth Africaen
dc.subject.meshYoung Adulten
dc.titleMonitoring the South African National Antiretroviral Treatment Programme, 2003-2007: the IeDEA Southern Africa collaboration.en
dc.contributor.departmentInfectious Disease Epidemiology Unit, School of Public Health and Family Medicine, University of Cape Town. morna@global.co.zaen
dc.identifier.journalSouth African Medical Journal = Suid-Afrikaanse tydskrif vir geneeskundeen

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