Monitoring the South African National Antireteoviral Treatment Programme, 2003-2007: The IeDEA Southern Africa Collaboration

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dc.contributor.authorCornell, Morna
dc.contributor.authorTechnau, Karl
dc.contributor.authorFairall, Lara
dc.contributor.authorWood, Robin
dc.contributor.authorMoultrie, Harry
dc.contributor.authorVan Cutsem, Gilles
dc.contributor.authorGiddy, Janet
dc.contributor.authorMohapi, Lerato
dc.contributor.authorEley, Brian
dc.contributor.authorMacPhail, Patrick
dc.contributor.authorProzesky, Hans
dc.contributor.authorRabie, Helena
dc.contributor.authorDavies, Mary-Ann
dc.contributor.authorMaxwell, Nicola
dc.contributor.authorBoulle, Andrew
dc.date.accessioned2017-04-10T08:14:02Z
dc.date.available2017-04-10T08:14:02Z
dc.date.issued2009
dc.date.updated2016-01-07T08:49:34Z
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 characterize patients accessing these services; and to describe changes in services and patients 2003-2007. Design & setting Multi-cohort study of 11 ART programmes in Gauteng, Western Cape, Free State and KwaZulu-Natal. Subjects ART-naïve adults and children (<16 years old) who initiated ART with ≥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 (IQR) range was 35.0 years (29.8-41.4) and 42.5 months (14.7-82.5) respectively. Of adults, 68% were female. Median CD4 cell count was 102 cells/µL (44-164) and was lower among males than females (86, 34-150 vs 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/µL, p<0.001) and for those in Stage IV (39-89 cells/µL, 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 increasing enrolment. Late presentation, especially of men and children, remains a concern. Investment in sentinel sites ensures good individual-level data while freeing most sites to continue with simplified reporting.
dc.identifierhttp://dx.doi.org/10.7196/SAMJ.3437
dc.identifier.apacitationCornell, M., Technau, K., Fairall, L., Wood, R., Moultrie, H., Van Cutsem, G., ... Boulle, A. (2009). Monitoring the South African National Antireteoviral Treatment Programme, 2003-2007: The IeDEA Southern Africa Collaboration. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/24172en_ZA
dc.identifier.chicagocitationCornell, Morna, Karl Technau, Lara Fairall, Robin Wood, Harry Moultrie, Gilles Van Cutsem, Janet Giddy, et al "Monitoring the South African National Antireteoviral Treatment Programme, 2003-2007: The IeDEA Southern Africa Collaboration." <i>South African Medical Journal</i> (2009) http://hdl.handle.net/11427/24172en_ZA
dc.identifier.citationCornell, M., Technau, K., Fairall, L., Wood, R., Moultrie, H., Van Cutsem, G., Giddy, J., Mohapi, L., Eley, B., MacPhail, P., Prozesky, H., Rabie, H., Davies, M., Maxwell, N., & Boulle, A. (2009). Monitoring the South African antiretroviral programme 2003-2007: The IeDEA Southern Africa collaboration. South African Medical Journal, 99(9), 653.
dc.identifier.ris TY - Journal Article AU - Cornell, Morna AU - Technau, Karl AU - Fairall, Lara AU - Wood, Robin AU - Moultrie, Harry AU - Van Cutsem, Gilles AU - Giddy, Janet AU - Mohapi, Lerato AU - Eley, Brian AU - MacPhail, Patrick AU - Prozesky, Hans AU - Rabie, Helena AU - Davies, Mary-Ann AU - Maxwell, Nicola AU - Boulle, Andrew AB - 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 characterize patients accessing these services; and to describe changes in services and patients 2003-2007. Design & setting Multi-cohort study of 11 ART programmes in Gauteng, Western Cape, Free State and KwaZulu-Natal. Subjects ART-naïve adults and children (<16 years old) who initiated ART with ≥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 (IQR) range was 35.0 years (29.8-41.4) and 42.5 months (14.7-82.5) respectively. Of adults, 68% were female. Median CD4 cell count was 102 cells/µL (44-164) and was lower among males than females (86, 34-150 vs 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/µL, p<0.001) and for those in Stage IV (39-89 cells/µL, 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 increasing enrolment. Late presentation, especially of men and children, remains a concern. Investment in sentinel sites ensures good individual-level data while freeing most sites to continue with simplified reporting. DA - 2009 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Monitoring the South African National Antireteoviral Treatment Programme, 2003-2007: The IeDEA Southern Africa Collaboration TI - Monitoring the South African National Antireteoviral Treatment Programme, 2003-2007: The IeDEA Southern Africa Collaboration UR - http://hdl.handle.net/11427/24172 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/24172
dc.identifier.vancouvercitationCornell M, Technau K, Fairall L, Wood R, Moultrie H, Van Cutsem G, et al. Monitoring the South African National Antireteoviral Treatment Programme, 2003-2007: The IeDEA Southern Africa Collaboration. South African Medical Journal. 2009; http://hdl.handle.net/11427/24172.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceSouth African Medical Journal
dc.source.urihttp://www.samj.org.za/index.php/samj
dc.titleMonitoring the South African National Antireteoviral Treatment Programme, 2003-2007: The IeDEA Southern Africa Collaboration
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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