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A 10-year cohort analysis of routine paediatric ART data in a rural South African setting.

A 10-year cohort analysis of routine paediatric ART data in a rural South African setting.
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Lilian RR, Mutasa B, Railton J, Mongwe W, McINTYRE JA, Struthers HE, Peters RP,


Lilian RR, Mutasa B, Railton J, Mongwe W, McINTYRE JA, Struthers HE, Peters RP, (click to view)

Lilian RR, Mutasa B, Railton J, Mongwe W, McINTYRE JA, Struthers HE, Peters RP,

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Epidemiology and infection 2016 9 9() 1-11

Abstract

South Africa’s paediatric antiretroviral therapy (ART) programme is managed using a monitoring and evaluation tool known as TIER.Net. This electronic system has several advantages over paper-based systems, allowing profiling of the paediatric ART programme over time. We analysed anonymized TIER.Net data for HIV-infected children aged <15 years who had initiated ART in a rural district of South Africa between 2005 and 2014. We performed Kaplan-Meier survival analysis to assess outcomes over time. Records of 5461 children were available for analysis; 3593 (66%) children were retained in care. Losses from the programme were higher in children initiated on treatment in more recent years (P < 0·0001) and in children aged ≤1 year at treatment initiation (P < 0·0001). For children aged <3 years, abacavir was associated with a significantly higher rate of loss from the programme compared to stavudine (hazard ratio 1·9, P < 0·001). Viral load was suppressed in 48-52% of the cohort, with no significant change over the years (P = 0·398). Analysis of TIER.Net data over time provides enhanced insights into the performance of the paediatric ART programme and highlights interventions to improve programme performance.

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