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Home >> Publications >> Adult HIV care resources, management practices and patient characteristics in the Phase 1 IeDEA Central Africa cohort.

Publication

Author(s):

Divaris K, Newman J, Hemingway-Foday J, Akam W, Balimba A, Dusengamungu C, Kalenga L, Mbaya M, Molu BM, Mugisha V, Mukumbi H, Mushingantahe J, Nash D, Niyongabo T, Atibu J, Azinyue I, Kiumbu M, Woelk G.

Pub Title:

Adult HIV care resources, management practices and patient characteristics in the Phase 1 IeDEA Central Africa cohort.

Pub Date:

Nov 21 2012

Pub Region(s):

Central Africa

Journal Issue:

15

Page Number:
17422

Journal:

Title: 
JIAS- Journal of the International AIDS Society
Link: 
http://www.jiasociety.org/index.php/jias/article/view/17422

PubMed: 23199800
Pub PDF: PDF icon 23199800.pdf

Abstract

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.

PMID: 23199800 [PubMed - indexed for MEDLINE]

PMCID: PMC3504932

 

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Citation:

Divaris K, Newman J, Hemingway-Foday J, Akam W, Balimba A, Dusengamungu C, Kalenga L, Mbaya M, Molu BM, Mugisha V, Mukumbi H, Mushingantahe J, Nash D, Niyongabo T, Atibu J, Azinyue I, Kiumbu M, Woelk G. Adult HIV care resources, management practices and patient characteristics in the Phase 1 IeDEA Central Africa cohort. J Int AIDS Soc. 2012 Nov 21;15(2):17422. doi: 10.7448/IAS.15.2.17422. PubMed PMID: 23199800; PubMed Central PMCID: PMC3504932.