title: Patients enrolled in HIV care in Mozambique: baseline characteristics and follow-up outcomes.
abstract: 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.
authors: ICAP-Columbia University, Mailman School of Public Health, New York, NY 10032, USA. ml2842@columbia.edu
authors: Maria
authors: M
authors: Lahuerta
authors: Josue
authors: J
authors: Lima
authors: Batya
authors: B
authors: Elul
authors: Mie
authors: M
authors: Okamura
authors: Maria Fernanda
authors: MF
authors: Alvim
authors: Harriet
authors: H
authors: Nuwagaba-Biribonwoha
authors: Deborah
authors: D
authors: Horowitz
authors: Rufino
authors: R
authors: Fernandes
authors: Americo
authors: A
authors: Assan
authors: Elaine J
authors: EJ
authors: Abrams
authors: Wafaa M
authors: WM
authors: El-Sadr
authors: Denis
authors: D
authors: Nash
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D009073:Mozambique; D011247:Pregnancy; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents