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    Jan 19, 2021
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    Monitoring the South African National Antiretroviral Treatment Programme, 2003-2007: the IeDEA Southern Africa collaboration.

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    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
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    Affiliation
    Infectious Disease Epidemiology Unit, School of Public Health and Family Medicine, University of Cape Town. morna@global.co.za
    Issue Date
    2009-09
    
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    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.
    URI
    http://hdl.handle.net/10144/112733
    PubMed ID
    20073292
    Language
    en
    ISSN
    0256-9574
    Collections
    HIV/AIDS

    entitlement

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