A 10-year cohort analysis of routine paediatric ART data in a rural South African setting.
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.
Anova Health Institute,Johannesburg and Tzaneen,South Africa.
R R
RR
Lilian
Anova Health Institute,Johannesburg and Tzaneen,South Africa.
B
B
Mutasa
Anova Health Institute,Johannesburg and Tzaneen,South Africa.
J
J
Railton
Mopani Department of Health,Giyani,South Africa.
W
W
Mongwe
Anova Health Institute,Johannesburg and Tzaneen,South Africa.
J A
JA
McINTYRE
Anova Health Institute,Johannesburg and Tzaneen,South Africa.
H E
HE
Struthers
Anova Health Institute,Johannesburg and Tzaneen,South Africa.
R P H
RP
Peters
D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D015224:Dideoxynucleosides / Q000627:therapeutic use; D001330:Electronic Data Processing; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D059012:Lost to Follow-Up; D008297:Male; D012424:Rural Population; D013019:South Africa; D018119:Stavudine / Q000627:therapeutic use; D000072230:Sustained Virologic Response; D019562:Viral Load; D000099227:Abacavir
D044966:Anti-Retroviral Agents; D015224:Dideoxynucleosides; D018119:Stavudine; D000099227:Abacavir
Analysis of data; HIV/AIDS; paediatrics; public health