Effectiveness of Antiretroviral Treatment in a South African Program<subtitle>A Cohort Study</subtitle>

Abstract

HAART provided through these South African government health services seems as effective as that provided in high-income countries. Delays starting HAART contributed to high mortality rates. Faster expansion and timely commencement of HAART are needed.

Effect of cotrimoxazole on mortality in HIV-infected adults on antiretroviral therapy: a systematic review and meta-analysis

“…Of the nine, seven reported an estimate for the effect of cotrimoxazole on mortality, [28][29][30][31][32][33][34] whereas three reported an estimate for the effect on morbidity. 28,35,36 Two studies also reported the preventive effect on malaria.…”

“…28,35,36 Two studies also reported the preventive effect on malaria. 28,36 Assessment of publication bias indicated that three studies [28][29][30] were of high methodological quality, while the other six [31][32][33][34][35][36] were of moderate methodological quality (Table 4, available at: http://www.who. int/bulletin/volumes/90/2/11-093260).…”

Tuberculosis among adults starting antiretroviral therapy in South Africa: the need for routine case finding

“…Our prevalence is similar to recent data from Western Cape (32%), 12 but higher than generally reported among ART-eligible adults in Africa (3%-19%). 10,11,16,[18][19][20] This reflects systematic screening of our patients using multiple modalities, and a broad case definition allowing diagnosis based on radiological and clinical features highlighting the 'real life' burden, and recognising that sputum culture misses some cases of disseminated tuberculosis. 21 Our 18% prevalence of cultureconfirmed pulmonary tuberculosis accords with studies from Cambodia (17%), 22 KwaZulu-Natal (19%), 16 and Western Cape (17%).…”

Provision of Antiretroviral Therapy in South Africa: The Nuts and Bolts

“…Outcome data have been available from selected sites, either individually [62,63] or as part of collaborative analyses [65,118], substantiating the perceived clinical benefits of treatment, while at the same time demonstrating how scale-up resulted in inevitable difficulties to retain or confirm that patients were in care. Outcomes from routine government reporting were initially only available from monitoring systems in the Western Cape and Free State Provinces, based on a mix of paper-based systems and electronic capture [119,120]. The adaptation of the routine paper-based cohort monitoring later evolved into a flexible three-tier system comprising paper-based, electronic register and full electronic medical record systems.…”