Scaling up access to HIV treatment: comparing outcomes among children receiving treatment at mobile and hospital-based HIV clinics in rural Zambia Janneke.

Slides:

Advertisements

Similar presentations

The effect of changes in Kenya HIV guidelines on proportion of patients on ART and patient characteristics at initiation in Lumumba Health Centre, Western.

Advertisements

Risk factors and true outcomes of children lost to follow-up from antiretroviral therapy in Lilongwe, Malawi C. Ardura Gracia, H. Tweya, C Feldacker, S.

Antiretroviral therapy eligibility at enrollment and time to treatment initiation in Ethiopia Chloe A. Teasdale 1, Chunhui Wang 1, Sileshi Lulseged 1,

Urgent need to strengthen active tracing of lost to follow up cases: a prospective cohort study of newly diagnosed HIV clients in rural districts, Zambia.

Retention across the continuum of care in a cohort of HIV infected children in rural India G. Alvarez-Uria RDT Hospital, Department of Infectious Diseases,

Most deaths among children enrolled in two program settings in Cambodia occur within the first 6 months after enrolment. Early mortality rates were more.

Virologic and immunologic response following antiretroviral therapy initiation among pregnant and postpartum women with acute HIV-1 infection: MOPDB0101.

Community adherence support sustains improved three year outcomes for children on ART A. Grimwood 1, G. Fatti 1, E. Mothibi 1, M. Malahlela.

Primary Healthcare Facilities Deliver More Effective Antiretroviral Therapy: An Evaluation in Four Provinces in South Africa Geoffrey Fatti, Ashraf Grimwood.

Effects of patient tracing on estimates of lost to follow-up, mortality and retention in antiretroviral therapy programs in low-middle income countries:

Validating five questions of antiretroviral non-adherence in a decentralized public-sector antiretroviral treatment program in rural South Africa Krisda.

Introduction DCDOH supports HIV test and treat activities - increased number of HIV tests performed, emphasis on earlier linkage to care. Limited data.

Involving the Community in HIV/AIDS Treatment Support Programmes: An Evidence-Based Approach.

Abstract Results Objectives Results Conclusions Background Methods V-1637 Background-At the CORE center in Chicago, despite an on-site hepatitis clinic.

ACCESS TO TREATMENT BY PEOPLE LIVING WITH HIV IN ZAMBIA Presented by: Kunyima Lifumbela Banda Network of Zambian people living with HIV/AIDS (NZP+)

Washington D.C., USA, JULY Rulin C. Hechter 1 MD,PhD Jean Q. Wang 1 PhD Margo A. Sidell 1 ScD William J. Towner 2 MD 1 Dept.

Quality of Care at a Multi-site PEPFAR-funded ART Program: From Measuring to Improvement.

Data from the Collaborative HIV Paediatric Study (CHIPS) Reports up to March 2009* * Numbers are based on reports received rather than children seen to.

The Immunologic Efficacy of Antiretroviral Therapy among HIV-infected Patients in North America and Africa Elvin Geng* 1, Eric Vittinghoff 1, Jean Nachega.

Transition Program of HIV-infected adolescents to Adult HIV care in Buenos Aires, Argentina S. Arazi Caillaud 1, D. Mecikovsky 1, A.Bordato.

Catherine Kober Margaret Johnson Martin Fisher Caroline Sabin On behalf of UK-CHIC BHIVA/BASHH Manchester 2010 Non-uptake of HAART among patients with.

Data from the Collaborative HIV Paediatric Study (CHIPS) Reports up to May 2005.

Impact of Highly Active Antiretroviral Therapy on the Incidence of HIV- encephalopathy among perinatally- infected children and adolescents. Kunjal Patel,

EARLY CHILDHOOD OUTCOMES AT THE BOTSWANA- BAYLOR CHILDREN’S CLINICAL CENTRE OF EXCELLENCE: A REPORT TO THE WHO TECHNICAL REFERENCE GROUP ON PEDIATRIC CARE.

Neurocognitive Impairment in HIV-Infected Subjects on HAART: Prevalence and Associations Kevin Robertson *1, Kunling Wu 2, Thomas Parsons 1, Ron Ellis.

INTRODUCTION Evaluation of Outcomes in Patients Starting Antiretroviral Therapy During Hospitalization Leigh E. Efird, PharmD 1, Manish Patel, PharmD 1,

Data from the Collaborative HIV Paediatric Study (CHIPS) Reports up to March 2010* * Numbers are based on reports received rather than children seen to.

Exploring the potential impact of ART in reducing HIV transmission. Geoff Garnett, Jeff Eaton, Tim Hallett & Ide Cremin Imperial College London.

Factors Associated with Survival in HIV-Infected African Patients on Antiretroviral Therapy: The Impact of a Sampling-Based Approach to Address Losses.

Community-based Adherence Clubs improve outcomes for stable ART patients: Outcomes from Cape Town, South Africa Anna Grimsrud 1, Maia Lesosky 1,2, Cathy.

ZIMBABWE AIDS CARE FOUNDATION NEWLANDS CLINIC Virological Outcomes in Adult Patients on Second Line ART, at Newlands Clinic Dr S. Bote.

Good Three-year Outcomes of Antiretroviral Therapy at Multiple NGO- assisted facilities in Four Provinces in South Africa Geoffrey Fatti, Ashraf Grimwood.

The effect of tuberculosis treatment on virologic and immunologic response to combination antiretroviral therapy among South African children Heidi M.

1 The impact of ongoing illicit drug use on virologic suppression in HIV-infected injection drug users receiving HAART Authors: Harout Tossonian, Jesse.

Failure to Initiate ART, Loss to Follow-up and Mortality among HIV-infected Patients during the pre-ART period in Uganda Elvin H. Geng 1, Winnie Muyindike.

Data from the Collaborative HIV Paediatric Study (CHIPS) Reports up to March 2006* *Numbers are based on reports received rather than children seen to.

INTRODUCTION A previous cohort study from our unit suggested a benefit for the use of efavirenz compared to nevirapine in a group of patients initiating.

Potential Utility of Tipranavir in Current Clinical Practice Daniel R. Kuritzkes, MD Director of AIDS Research Brigham and Woman’s Hospital Division of.

Outcomes of Antiretroviral Treatment Programs in Rural Lesotho: Health Centers and Hospitals Compared Niklaus Labhardt, Motlalepula Sello, Mamokone A.

Mövenpick Royal Palm Hotel Dar es Salaam, Tanzania August 4-6, 2009 The 7th Annual Track 1.0 ART Program Meeting.

1 Adherence to ARV Therapy and Resistance HAIVN Havard Medical School AIDS Initiative in Vietnam.

MDG 6: Combat HIV/AIDS and other diseases. Where are we…  Regionally, “on track” for MDG-6 (only a few countries are progressing slowly or show no progress)

Strategies for Management of Antiretroviral Therapy Study Wafaa El-Sadr and James Neaton for the SMART Study Team.

Can early antiretroviral therapy fully restore health? Workshop on Pathogeneses and Management of Long-Term Complications of ART IAS Conference, Rome July.

Treatment Failure HAIVN Harvard Medical School AIDS Initiative in Vietnam.

Figure 2: Trends in currently prescribed antiretroviral therapy % prescribed HAART increased from 74% to 83% Trends in ART use, HIV viral load, and CD4.

Response to Antiretroviral Treatment In an Ethiopian Hospital Samuel Hailemariam, MD, MPH; J Allen McCutchan, MD, MSc Meaza Demissie, MD, PMH, PHD; Alemayehu.

Successfully enrolled in HIV Care but not linked to timely Treatment: Poor retention and Monitoring of Pre-ART patients who are not yet eligible for ART.

Date of download: 6/23/2016 From: The Anticipated Clinical and Economic Effects of 90–90–90 in South Africa Ann Intern Med. Published online May 31, 2016.

Long-term clinical and viro-immunologic outcomes of post-treatment controllers (PTCs) in the ANRS-VISCONTI study Laurent HOCQUELOUX, MD Orléans’ Regional.

First-Line Treatment of HIV Infection With Either NNRTI- or PI-Based Regimens Effective for Long-term Disease Control Slideset on: MacArthur RD, Novak.

Priscilla Tsondai, Lynne Wilkinson, Anna Grimsrud, Angelina Trivino,

HIV System Assessment with Longitudinal Treatment Cascade in KwaZulu-Natal, South Africa Noah Haber,1 Frank Tanser,2 Kevindra Naidu,2 Tinofa Mutevedzi,2.

Earlier treatment and lower mortality in infants Initiating ART at

Title Factors associated with viral suppression among adolescents living with HIV in Cambodia “No conflicts of interest to declare”

Factors affecting virological failure in patients receiving antiretroviral therapy: a prospective HIV Clinical cohort in rural Uganda. Patrick Kazooba1,

L.F. Jefferys1, J. Hector1, M.A. Hobbins2, J. Ehmer2, N. Anderegg3

Validating Definitions of Antiretroviral Treatment Failure in Malawi

The Effect of Family Social Intervention on Treatment Response in Children with HIV Infection Francine Cheng DO, Janak Patel MD, Debbie Konopik SWA, and.

Better Retention Rates Observed in Patients on Lopinavir than Atazanavir in Uganda

Utilizing research as an opportunity to strengthen

MHEALTH to Improve Health: Effectiveness of a weekly text messaging intervention to improve ART adherence and HIV Viral Load: WelTel OAKTREE. M.C.M. Murray1,2,3,

A COLLABORATIVE APPROACH TO ESTABLISH PREDICTORS

Immunologic and virological response to ART among HIV infected individuals at a tertiary hospital in Ghana ¹Obiri-Yeboah Dorcas, School of Medical Sciences,

SDC 3: Time until virologic suppression and failure

Dorina Onoya1, Tembeka Sineke1, Alana Brennan1,2, Matt Fox1,2

Mortality and cause of death among HIV patients in London in 2016

Experiences & outcomes of group psychotherapy as an antiretroviral adherence support intervention among young people failing ART at Newlands Clinic, Harare,

Andreas D. Haas, PhD Postdoctoral fellow, ICAP at Columbia University

Treatment Outcome among patients on ART in Southern Tanzania: Does Time of ART initiation Matter?

Presentation transcript:

Scaling up access to HIV treatment: comparing outcomes among children receiving treatment at mobile and hospital-based HIV clinics in rural Zambia Janneke H. van Dijk 1,2, William J. Moss 3, Pamela Sinywimaanzi 1, Francis Hamangaba 1, Catherine G. Sutcliffe 3 1 Macha Research Trust, Zambia 1,, Erasmus University Rotterdam, the Netherlands 2, Johns Hopkins University, USA 3 Travel time and distance are barriers to care for HIV- infected children in resource-poor settings Decentralization is one of the keys to scaling-up access to antiretroviral treatment (ART) Study design: Ongoing pediatric cohort study at Macha Hospital since 2007 Analysis Population: Outreach group and hospital group

Results Comparison before and after transfer to mobileoutreach clinic Cost of travel Lower transportation costs after transfer (p< ) Quality of care reported to be the same by the majority, although reports of better waiting times but poorer counseling services and physical examinations by some in outreach group. Travel time After transfer travel time was significantly shorter (>25% travelled ≥5 hrs vs. 4.5% ≥ 5 hrs after transfer, p<0.0001), Fewer use of public transportation (>40% vs. 4.6% public transport use, before and after transfer respectively)

Results Comparison of children receiving ART at Macha hospital and at outreach clinics Mean CD4% since ART initiation for Macha Hospital and outreach groups Hospital (n=41)Outreach (n=68)P-value Median age (yr, IQR)4.9 (2.2, 9.4)2.9 (1.6, 7.5)0.07 Male Gender19 (46.3%)22 (53.7%)0.41 Death0 (0.0%)1 (1.5%)0.44 LTFU0 (0.0%)7 (10.3%)0.03

Conclusion: Children in outreach group less likely to achieve virologic suppression, potentially due to lower adherence Continuous emphasis on the importance of adherence is critical for the success of decentralized care 11 children, of which 10 in outreach group (18.2% vs. 3.5%; p=0.06), experienced virologic failure Median % of visits with good adherence was significantly lower in the outreach group (69.2% vs. 79.3%; p<0.05) P=0.02 Proportion of children with undetectable viral load over time