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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Patients enrolled in HIV care in mozambique: Baseline characteristics and follow-up outcomes
Journal of Acquired Immune Deficiency Syndromes, Volume 58, No. 3, Year 2011
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Description
Objective: To utilize routinely collected service delivery data from HIV care and treatment clinics in Mozambique to describe the patient population and programmatic outcomes from 2003 to 2009. Methods: Data from patient charts were entered into an electronic database at 28 clinics in 5 Mozambican provinces. Patients' characteristics at enrollment in HIV care and at antiretroviral therapy (ART) initiation were examined. We calculated a corrected 12-month mortality estimate using a recently developed nomogram for sub-Saharan African ART patients. Results: A total of 154,188 HIV-infected individuals (10,164 children <15 years old) were enrolled in HIV care services between 2003 and 2009. Of the 51,269 (36%) adults who started ART, 35% initiated ART with CD4 count <100 cells per microliter and 14.4% with World Health Organization stage IV. Just more than 10% (10.5%) of women were documented to be pregnant at enrollment. One-third of the 3,745 (37%) children who initiated ART were <2 years old, and 53% of those <5 years initiated ART severely immunosuppressed (CD4% <15%). Thirty-five percent of all children and 30% of those initiating ART met the definition of severe malnourishment (weight-for-age Z score <-3). Among those who initiated ART, the median estimated 12-month mortality rate across sites was 13.1% (interquartile range: 11.5%-16.0%) and 13.5% (interquartile range: 11.4%-17.4%) for adults and children, respectively. Conclusions: A substantial number of HIV-infected patients have been enrolled in HIV care and initiated on ART, with many patients having advanced HIV disease. With the release of new guidelines for ART use for adults, pregnant women, and children, extensive efforts are needed to ensure more timely initiation of ART. © 2011 Lippincott Williams & Wilkins.
Authors & Co-Authors
Lahuerta, María
United States, New York
Mailman School of Public Health
Lima, Josué
United States, New York
Mailman School of Public Health
Elul, Batya
United States, New York
Mailman School of Public Health
Okamura, Mie
United States, New York
Mailman School of Public Health
Alvim, Maria Fernanda Sardella
United States, New York
Mailman School of Public Health
Nuwagaba-Biribonwoha, Harriet
United States, New York
Mailman School of Public Health
Horowitz, Deborah
United States, New York
Mailman School of Public Health
Fernandes, Rufino
United States, New York
Mailman School of Public Health
Assan, Américo
Mozambique, Maputo
Ministry of Health Mozambique
Abrams, Elaine J.
United States, New York
Mailman School of Public Health
El-Sadr, W. M.
United States, New York
Mailman School of Public Health
Nash, Denis B.
United States, New York
Mailman School of Public Health
Statistics
Citations: 39
Authors: 12
Affiliations: 2
Identifiers
Doi:
10.1097/QAI.0b013e31822ac0a9
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Mozambique
Participants Gender
Female