title: The MANGUA Project: A Population-Based HIV Cohort in Guatemala.
abstract: Introduction. The MANGUA cohort is an ongoing multicenter, observational study of people living with HIV/AIDS in Guatemala. The cohort is based on the MANGUA application which is an electronic database to capture essential data from the medical records of HIV patients in care. Methods. The cohort enrolls HIV-positive adults ≥16 years of age. A predefined set of sociodemographic, behavioral, clinical, and laboratory data are registered at entry to the cohort study. Results. As of October 1st, 2012, 21 697 patients had been included in the MANGUA cohort (median age: 33 years, 40.3% female). At enrollment 74.1% had signs of advanced HIV infection and only 56.3% had baseline CD4 cell counts. In the first 12 months after starting antiretroviral treatment 26.9% (n = 3938) of the patients were lost to the program. Conclusions. The implementation of a cohort of HIV-positive patients in care in Guatemala is feasible and has provided national HIV indicators to monitor and evaluate the HIV epidemic. The identified percentages of late presenters and high rates of LTFU will help the Ministry to target their current efforts in improving access to diagnosis and care.
authors.affiliation: Fundació Sida i Societat, Technical Advisor Unit (UAT), Escuintla National Hospital, 5001 Escuintla, Guatemala ; PhD Programme in Methodology of Biomedical Research and Public Health, Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08193 Catalonia, Spain.
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: García
authors.affiliation: Clínica Familiar Luis Ángel García, San Juan de Dios Hospital, Asociación de Salud Integral, 1001 Guatemala City, Guatemala.
authors.forename: Blanca
authors.initials: B
authors.lastname: Samayoa
authors.affiliation: Fundació Sida i Societat, Technical Advisor Unit (UAT), Escuintla National Hospital, 5001 Escuintla, Guatemala ; TransLab, Department of Medical Sciences, University of Girona, Girona, 17004 Catalonia, Spain.
authors.forename: Meritxell
authors.initials: M
authors.lastname: Sabidó
authors.affiliation: Fundació Sida i Societat, Technical Advisor Unit (UAT), Escuintla National Hospital, 5001 Escuintla, Guatemala.
authors.forename: Luis Alberto
authors.initials: LA
authors.lastname: Prieto
authors.affiliation: Fundació Sida i Societat, Technical Advisor Unit (UAT), Escuintla National Hospital, 5001 Escuintla, Guatemala.
authors.forename: Mikhail
authors.initials: M
authors.lastname: Nikiforov
authors.affiliation: Infectious Diseases Clinic, Roosevelt Hospital, 1011 Guatemala City, Guatemala.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Pinzón
authors.affiliation: Juan José Ortega de Coatepeque National Hospital, Coatepeque, 09020 Quetzaltenango, Guatemala.
authors.forename: Luis Roberto
authors.initials: LR
authors.lastname: Santa Marina de León
authors.affiliation: Hospital del Instituto Guatemalteco de Seguridad Social (IGSS), 1009 Guatemala City, Guatemala.
authors.forename: José Fernando
authors.initials: JF
authors.lastname: Ortiz
authors.affiliation: National Programme for Prevention and Control of STI and HIV/AIDS (PNS), 1011 Guatemala City, Guatemala.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Ponce
authors.affiliation: Infectious Diseases Clinic, Roosevelt Hospital, 1011 Guatemala City, Guatemala.
authors.forename: Carlos Rodolfo
authors.initials: CR
authors.lastname: Mejía
authors.affiliation: Clínica Familiar Luis Ángel García, San Juan de Dios Hospital, Asociación de Salud Integral, 1001 Guatemala City, Guatemala.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Arathoon
authors.affiliation: Fundació Sida i Societat, Technical Advisor Unit (UAT), Escuintla National Hospital, 5001 Escuintla, Guatemala ; PhD Programme in Methodology of Biomedical Research and Public Health, Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08193 Catalonia, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain ; Center for Epidemiological Studies on HIV/AIDS and STI of Catalonia (CEEISCAT), Institut Català d'Oncologia, Generalitat de Catalunya, Badalona, 08916 Catalonia, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Casabona
authors.affiliation: Fundació Sida i Societat, Technical Advisor Unit (UAT), Escuintla National Hospital, 5001 Escuintla, Guatemala.
authors.forename: The Mangua Cohort
authors.initials: TM
authors.lastname: Study Group