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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Adult HIV care resources, management practices and patient characteristics in the Phase 1 IeDEA Central Africa cohort
Journal of the International AIDS Society, Volume 15, No. 2, Article 17422, Year 2012
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Description
Introduction: Despite recent advances in the management of HIV infection and increased access to treatment, prevention, care and support, the HIV/AIDS epidemic continues to be a major global health problem, with sub-Saharan Africa suffering by far the greatest humanitarian, demographic and socio-economic burden of the epidemic. Information on HIV/AIDS clinical care and established cohorts' characteristics in the Central Africa region are sparse. Methods: A survey of clinical care resources, management practices and patient characteristics was undertaken among 12 adult HIV care sites in four countries of the International Epidemiologic Databases to Evaluate AIDS Central Africa (IeDEA-CA) Phase 1 regional network in October 2009. These facilities served predominantly urban populations and offered primary care in the Democratic Republic of Congo (DRC; six sites), secondary care in Rwanda (two sites) and tertiary care in Cameroon (three sites) and Burundi (one site). Results: Despite some variation in facility characteristics, sites reported high levels of monitoring resources, including electronic databases, as well as linkages to prevention of mother-to-child HIV transmission programs. At the time of the survey, there were 21,599 HIV-positive adults (median age 37 years) enrolled in the clinical cohort. Though two-thirds were women, few adults (6.5%) entered HIV care through prevention of mother-to-child transmission services, whereas 55% of the cohort entered care through voluntary counselling and testing. Two-thirds of patients at sites in Cameroon and DRC were in WHO Stage III and IV at baseline, whereas nearly all patients in the Rwanda facilities with clinical stage information available were in Stage I and II. WHO criteria were used for antiretroviral therapy initiation. The most common treatment regimen was stavudine/lamivudine/ nevirapine (64%), followed by zidovudine/lamivudine/ nevirapine (19%). Conclusions: Our findings demonstrate the feasibility of establishing large clinical cohorts of HIV-positive individuals in a relatively short amount of time in spite of challenges experienced by clinics in resource-limited settings such as those in this region. Country differences in the cohort's site and patient characteristics were noted. This information sets the stage for the development of research initiatives and additional programs to enhance adult HIV care and treatment in Central Africa. © 2012 Divaris K et al; licensee International AIDS Society.
Authors & Co-Authors
Divaris, Kimon
United States, Chapel Hill
Unc-ch Adams School of Dentistry
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Newman, Jamie E.
United States, Research Triangle Park
Rti International
Hemingway-Foday, Jennifer J.
United States, Research Triangle Park
Rti International
Akam, Wilfred
Cameroon
Limbe Provincial Hopital
Balimba, Ashu
Cameroon, Yaounde
Hôpital Militaire
Dusengamungu, Cyrille
Rwanda
Kibuye District Hospital
Kalenga, Lucien
Unknown Affiliation
Mbaya, Marcel
Unknown Affiliation
Molu, Brigitte Mfangam
Cameroon, Yaounde
Yaounde General Hospital
Mugisha, Veronicah
United States, New York
Mailman School of Public Health
Mukumbi, Henry
Unknown Affiliation
Mushingantahe, Jules
Rwanda, Kigali
Muhima Hospital
Nash, Denis B.
United States, New York
Columbia University
Niyongabo, Théodore
Burundi, Bujumbura
Centre Hospitalo-universitaire de Kamenge
Atibu, Joseph
Democratic Republic Congo
Faculté de Médecine
Azinyue, Innocent
Cameroon, Yaounde
Vindata Solutions
Kiumbu, Modeste
Democratic Republic Congo
Faculté de Médecine
Woelk, Godfrey B.
United States, Research Triangle Park
Rti International
Statistics
Citations: 18
Authors: 18
Affiliations: 13
Identifiers
Doi:
10.7448/IAS.15.2.17422
e-ISSN:
17582652
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Burundi
Cameroon
Congo
Rwanda
Participants Gender
Female