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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A public health approach to rapid scale-up of antiretroviral treatment in Malawi during 2004-2006
Journal of Acquired Immune Deficiency Syndromes, Volume 49, No. 3, Year 2008
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Description
Background: Approximately 1 million people are infected with HV in Malawi, where AIDS is the leading cause of death in adults. By December 31, 2007, more than 141,000 patients were initiated on antiretroviral treatment (ART) by use of a public health approach to scale up HIV services. Methods: We analyzed national quarterly and longitudinal cohort data from October 2004 to December 2006 to examine trends in characteristics of patients initiating ART, end-of-quarter clinical outcomes, and 6- and 12-month survival probability. Findings: During a 27-month period, 72,666 patients were initiated on ART, of whom about two-thirds were women. The percentage of patients initiated on ART who were children and farmers increased from 5.5% to 9.0% and 23% to 32%, respectively (P < 0.001 for trends). Estimated survival probability ranged from 85% to 88% at 6 months and 81% to 84% at 12 months on ART. Interpretation: In Malawi, a public health approach to ART increased treatment access and maintained high 6- and 12-month survival. Resource-limited countries scaling up ART programs may benefit from this approach of simplified clinical decision making, standardized ART regimens, nonphysician care, limited laboratory support, and centralized monitoring and evaluation. Copyright © 2008 Lippincott Williams & Wilkins.
Authors & Co-Authors
Lowrance, David W.
Unknown Affiliation
Makombe, Simon D.
Unknown Affiliation
Harries, Anthony David
Unknown Affiliation
Shiraishi, Ray W.
Unknown Affiliation
Hochgesang, Mindy
Unknown Affiliation
Aberle-Grasse, John M.
Unknown Affiliation
Libamba, Edwin
Unknown Affiliation
Schouten, Erik J.
Unknown Affiliation
Eilerbrock, Tedd
Unknown Affiliation
Kamoto, Kelita
Unknown Affiliation
Statistics
Citations: 58
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1097/QAI.0b013e3181893ef0
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Malawi
Participants Gender
Female