The evolution and effectiveness of the South African antiretroviral therapy program

 

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dc.contributor.advisor Myer, Landon en_ZA
dc.contributor.author Cornell, Morna Brigit en_ZA
dc.date.accessioned 2015-05-06T14:21:40Z
dc.date.available 2015-05-06T14:21:40Z
dc.date.issued 2014 en_ZA
dc.identifier.citation Cornell, M. 2014. The evolution and effectiveness of the South African antiretroviral therapy program. University of Cape Town. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/12759
dc.description Includes bibliographical references en_ZA
dc.description.abstract Although South Africa has the largest antiretroviral therapy (ART) program worldwide, data on key outcomes like mortality and loss to follow-up (LTF) are limited. A few cohorts have published patient outcomes but there is no national reporting on ART scale-up and its impact on the health of HIV-infected individuals. Yet such monitoring of outcomes is vital to inform and improve service delivery. The International epidemiologic Databases to Evaluate AIDS Southern Africa collaboration (IeDEA-SA) was established in 2005 to collect and analyze individual level data from the larger cohorts of individuals on ART in Southern Africa. Using routine, anonymized data from the South African sites, this thesis aims to describe how the program has evolved over 10 years and to assess its effectiveness .Five quantitative analyses were performed using descriptive statistics and survival analysis methods. The studies used patient-level data on adult patients starting ART to describe characteristics and to explore outcomes and temporal changes in outcomes over time. Patient numbers ranged from 19,481 (limited to cohorts with civil identification numbers) to 83,576 adults, followed for up to 214,400 person years. The results are presented as four published papers and one submitted for publication. The thesis describes a rapid, massive scale-up of services. Despite improvements in baseline immunologic status, late diagnosis and ART initiation especially in men area challenge. en_ZA
dc.language.iso eng en_ZA
dc.subject.other Public Health en_ZA
dc.title The evolution and effectiveness of the South African antiretroviral therapy program en_ZA
dc.type Doctoral Thesis
uct.type.publication Research en_ZA
uct.type.resource Thesis en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Public Health and Family Medicine en_ZA
dc.type.qualificationlevel Doctoral
dc.type.qualificationname PhD en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Cornell, M. B. (2014). <i>The evolution and effectiveness of the South African antiretroviral therapy program</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/12759 en_ZA
dc.identifier.chicagocitation Cornell, Morna Brigit. <i>"The evolution and effectiveness of the South African antiretroviral therapy program."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2014. http://hdl.handle.net/11427/12759 en_ZA
dc.identifier.vancouvercitation Cornell MB. The evolution and effectiveness of the South African antiretroviral therapy program. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2014 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/12759 en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Cornell, Morna Brigit AB - Although South Africa has the largest antiretroviral therapy (ART) program worldwide, data on key outcomes like mortality and loss to follow-up (LTF) are limited. A few cohorts have published patient outcomes but there is no national reporting on ART scale-up and its impact on the health of HIV-infected individuals. Yet such monitoring of outcomes is vital to inform and improve service delivery. The International epidemiologic Databases to Evaluate AIDS Southern Africa collaboration (IeDEA-SA) was established in 2005 to collect and analyze individual level data from the larger cohorts of individuals on ART in Southern Africa. Using routine, anonymized data from the South African sites, this thesis aims to describe how the program has evolved over 10 years and to assess its effectiveness .Five quantitative analyses were performed using descriptive statistics and survival analysis methods. The studies used patient-level data on adult patients starting ART to describe characteristics and to explore outcomes and temporal changes in outcomes over time. Patient numbers ranged from 19,481 (limited to cohorts with civil identification numbers) to 83,576 adults, followed for up to 214,400 person years. The results are presented as four published papers and one submitted for publication. The thesis describes a rapid, massive scale-up of services. Despite improvements in baseline immunologic status, late diagnosis and ART initiation especially in men area challenge. DA - 2014 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - The evolution and effectiveness of the South African antiretroviral therapy program TI - The evolution and effectiveness of the South African antiretroviral therapy program UR - http://hdl.handle.net/11427/12759 ER - en_ZA


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