scholarly journals Antiretroviral treatment Long-Term (ALT) cohort: a prospective cohort of 10 years of ART-experienced patients in Uganda

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e015490 ◽  
Author(s):  
Barbara Castelnuovo ◽  
Frank Mubiru ◽  
Agnes N Kiragga ◽  
Rachel Musomba ◽  
Olive Mbabazi ◽  
...  
Keyword(s):  
Antiretroviral Treatment ◽  
Sub Saharan Africa ◽  
Mineral Density ◽  
Hiv Rna ◽  
Observational Cohort ◽  
Sub Saharan ◽  
Set Up ◽  
Future Plans

PurposeLittle information is available on patients on antiretroviral treatment (ART) after a long-term period from sub-Saharan Africa, with the longest follow-up and related outcomes being after 10 years on ART. At the Infectious Diseases Institute (IDI) (Kampala, Uganda), we set up a cohort of patients already on ART for 10 years at the time of enrolment, who will be followed up for additional 10 years.ParticipantsA prospective observational cohort of 1000 adult patients previously on ART for 10 years was enrolled between May 2014 and September 2015. Patients were eligible for enrolment if they were in their consecutive 10th year of ART regardless of the combination of drugs for both first- and second-line ART. Data were collected at enrolment and all annual study visits. Follow-up visits are scheduled once a year for 10 years. Biological samples (packed cells, plasma and serum) are stored at enrolment and follow-up visits.Findings to dateOut of 1000 patients enrolled, 345 (34.5%) originate from a pre-existing research cohort at IDI, while 655 (65.5%) were enrolled from the routine clinic. Overall, 81% of the patients were on first line at the time of the enrolment in the ART long-term cohort, with the more frequent regimen being zidovudine plus lamivudine plus nevirapine (44% of the cohort), followed by zidovudine plus lamivudine plus efavirenz (22%) and tenofovir plus lamivudine or emtricitabine plus efavirenz (10%). At cohort enrolment, viral suppression was defined as HIV-RNA <400 copies/mL was 95.8%.Future plansThrough collaboration with other institutions, we are planning several substudies, including the evaluation of the risk for cardiovascular diseases, the assessment of bone mineral density, screening for liver cirrhosis using fibroscan technology and investigation of drug–drug interactions between ART and common drugs used for non-communicable diseases.

Virological follow-up of adult patients in antiretroviral treatment programmes in sub-Saharan Africa: a systematic review

2010 ◽  
Vol 10 (3) ◽  
pp. 155-166 ◽  
Author(s):  
Roos E Barth ◽  
Maarten F Schim van der Loeff ◽  
Rob Schuurman ◽  
Andy IM Hoepelman ◽  
Annemarie MJ Wensing
Keyword(s):  
Systematic Review ◽  
Antiretroviral Treatment ◽  
Adult Patients ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Child Marriage: A Discussion Paper

2015 ◽  
Vol 6 (2) ◽  
pp. 8-14 ◽  
Author(s):  
Tahera Ahmed
Keyword(s):  
Developing Countries ◽  
Literature Review ◽  
South Asia ◽  
Sub Saharan Africa ◽  
Child Marriage ◽  
Discussion Paper ◽  
Life Threatening ◽  
Sub Saharan ◽  
Set Up

Child marriage is still a massive problem in many developing countries. The issue is more concentrated in countries of Sub Saharan Africa and South Asia. This paper, through literature review attempts to assess the situation, the consequences, various programmes and recommendations on the reduction of child marriage. In this article it is reinforced that, consequences of child marriage put the girls at risk of early pregnancies with life-threatening conditions. This paper suggests that each country should set up its own mid-term and long-term goals to bring about significant reduction in child marriages.

scholarly journals The multi-country PROMOTE HIV antiretroviral treatment observational cohort in Sub-Saharan Africa: Objectives, design, and baseline findings

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0208805 ◽  
Author(s):  
Taha E. Taha ◽  
Nonhlanhla Yende-Zuma ◽  
Jim Aizire ◽  
Tsungai Chipato ◽  
Lillian Wambuzi Ogwang ◽  
...  
Keyword(s):  
Antiretroviral Treatment ◽  
Sub Saharan Africa ◽  
Observational Cohort ◽  
Sub Saharan

scholarly journals Correcting Mortality for Loss to Follow-Up: A Nomogram Applied to Antiretroviral Treatment Programmes in Sub-Saharan Africa

PLoS Medicine ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. e1000390 ◽  
Author(s):  
Matthias Egger ◽  
Ben D. Spycher ◽  
John Sidle ◽  
Ralf Weigel ◽  
Elvin H. Geng ◽  
...  
Keyword(s):  
Antiretroviral Treatment ◽  
Sub Saharan Africa ◽  
Loss To Follow Up ◽  
Sub Saharan

scholarly journals Outcomes of ventriculoperitoneal shunt insertion in Sub-Saharan Africa

2010 ◽  
Vol 6 (4) ◽  
pp. 329-335 ◽  
Author(s):  
Esther Gathura ◽  
Dan Poenaru ◽  
Richard Bransford ◽  
A. Leland Albright
Keyword(s):  
Sub Saharan Africa ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Shunt Insertion ◽  
Vp Shunt ◽  
Good Outcome ◽  
Sub Saharan ◽  
Poor Outcomes

Object Ventriculoperitoneal (VP) shunts in Sub-Saharan Africa are traditionally associated with high complication rates and poor outcomes. The aim of this study was to review one large institutional experience with VP shunts, to evaluate the feasibility of shunt insertion procedures with acceptable long-term outcomes in Africa, and to identify factors correlated with good and/or poor outcomes. Methods A retrospective study was conducted by reviewing the charts of all children who underwent primary (93%) or subsequent VP shunt insertions at the Kijabe Hospital between November 2004 and March 2007. Epidemiological data, clinical investigations, etiology of the hydrocephalus, details of the VP shunt insertion, outcome at follow-up, and morbidity and mortality data were collected. Outcomes were graded as good, fair, or poor, according to visual, motor, and seizure criteria. Results The authors analyzed 593 VP shunt insertions in 574 patients. The sex distribution was 53% male and 47% female. The mean age at shunt insertion was 8.5 months (range 0–309 months). The commonest etiologies for hydrocephalus were spina bifida (43.4%) and postinfectious (27.7%). Follow-up was available in 76% of children, with a mean follow-up period of 8.9 months (range 2–30.5 months). The median patient age was 3.3 months. The overall shunt function rate at 2 years was 65%, and the complication rate per procedure was 20%, with infection encountered in 9.1% and shunt malfunction in 11%. Complications were significantly related to hydrocephalus etiology and to sex (p = 0.03 and p = 0.01, respectively). Overall outcomes were good in 40.2% and poor in 59.8%. Overall mortality in the group was 7.1%. Younger patients who survived had an overall good outcome (p = 0.0001). Only 10% of patients with a head circumference greater than 60 cm had a good outcome. Conclusions Despite limited resources, VP shunt procedures can be carried out in Sub-Saharan Africa with acceptable complication rates and fair long-term outcomes.

scholarly journals Long-term outcomes of early initiated antiretroviral therapy in sub-Saharan children: a Cameroonian cohort study (ANRS-12140 Pediacam study, 2008–2013, Cameroon)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Francis Ateba Ndongo ◽  
Mathurin Cyrille Tejiokem ◽  
Calixte Ida Penda ◽  
Suzie Tetang Ndiang ◽  
Jean-Audrey Ndongo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Virologic Response ◽  
Sub Saharan Africa ◽  
Factors Associated ◽  
Sub Saharan

Abstract Background In most studies, the virological response is assessed during the first two years of antiretroviral treatment initiated in HIV-infected infants. However, early initiation of antiretroviral therapy exposes infants to very long-lasting treatment. Moreover, maintaining viral suppression in children is difficult. We aimed to assess the virologic response and mortality in HIV-infected children after five years of early initiated antiretroviral treatment (ART) and identify factors associated with virologic success in Cameroon. Methods In the ANRS-12140 Pediacam cohort study, 2008–2013, Cameroon, we included all the 149 children who were still alive after two years of early ART. Virologic response was assessed after 5 years of treatment. The probability of maintaining virologic success between two and five years of ART was estimated using Kaplan-Meier curve. The immune status and mortality were also studied at five years after ART initiation. Factors associated with a viral load < 400 copies/mL in children still alive at five years of ART were studied using logistic regressions. Results The viral load after five years of early ART was suppressed in 66.8% (60.1–73.5) of the 144 children still alive and in care. Among the children with viral suppression after two years of ART, the probability of maintaining viral suppression after five years of ART was 64.0% (54.0–74.0). The only factor associated with viral suppression after five years of ART was achievement of confirmed virological success within the first two years of ART (OR = 2.7 (1.1–6.8); p = 0.033). Conclusions The probability of maintaining viral suppression between two and five years of early initiated ART which was quite low highlights the difficulty of parents to administer drugs daily to their children in sub-Saharan Africa. It also stressed the importance of initial viral suppression for achieving and maintaining virologic success in the long-term. Further studies should focus on identifying strategies that would enhance better retention in care and improved adherence to treatment within the first two years of ART early initiated in Sub-Saharan HIV-infected children.

scholarly journals Paediatric HIV - Looking beyond CD4 Counts

2013 ◽  
Vol 69 (4) ◽  
Author(s):  
J. Potterton ◽  
N. Hiburn ◽  
A. Stewart ◽  
C. Humphries
Keyword(s):  
Sub Saharan Africa ◽  
Paediatric Hiv ◽  
Life Challenges ◽  
Social Challenge ◽  
Sub Saharan ◽  
The University ◽  
Significant Health

Paediatric HIV remains a significant health and social challenge in sub-Saharan Africa despite many countries gaining improved access to antiretroviral treatment. Paediatric HIV affects multiple body systems and has the potential to cause wide ranging impairments as well as activity and participation limitations. The aim of this paper is to highlight some of the impairments that remain, despite the children having access to better medical care, in order to establish a possible role for physiotherapists. Nine studies conducted through the department of physiotherapy at the University of the Witwatersrand, South Africa are presented. The results of these studies demonstrate the neurodevelopmental, musculoskeletal, respiratory and quality of life challenges which children infected with HIV as well as their caregivers continue to face. The need for long term, multidisciplinary follow up of children infected with HIV is emphasized.

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