Outcomes of the Botswana national HIV/AIDS treatment programme from 2002 to 2010: a longitudinal analysis

Farahani, Mansour; Vable, Anusha M.; Lebelonyane, Refeletswe; Seipone, Khumo; Anderson, M.; Avalos, Ava; Chadborn, Tim; Hailu, Tilahun; Roumis, Danae; Moeti, Themba; Musuka, Godfrey; Busang, Lesego; Gaolathe, Tendani; Malefho, Kolaatamo C S; Marlink, Richard

doi:10.1016/s2214-109x(13)70149-9

Cited by 66 publications

(57 citation statements)

References 28 publications

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“…Why do mortality rates vary among districts? The attrition rate (retention and survival) has been increasingly used as a yardstick to assess the long‐term success of large‐scale ART programmes . The fact that this study found significant attrition inequality across districts suggests that the expanding ART programme might not have effective management and sufficient resources in some districts to adequately support adherence and retention.…”

Section: Discussionmentioning

confidence: 85%

Variation in attrition at subnational level: review of the Botswana National HIV/AIDS Treatment (Masa) programme data (2002–2013)

Farahani

Price

El-Halabi

et al. 2015

Tropical Med Int Health

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Objective To evaluate the variation in all-cause attrition (mortality and loss to follow-up (LTFU)) among HIV-infected individuals in Botswana by health district during the rapid and massive scale-up of the National Treatment Program. Methods Analysis of routinely collected longitudinal data from 226,030 patients who received ART through the Botswana National HIV/AIDS Treatment Program across all 24 health districts from 2002 to 2013. A time-to-event analysis was used to measure crude mortality and loss to follow-up rates (LTFU). A marginal structural model was used to evaluate mortality and LTFU rates by district over time, adjusted for individual-level risk factors (e.g., age, gender, baseline CD4, year of treatment initiation, and antiretroviral regimen). Results Mortality rates in the districts ranged from the lowest 1.0 (95% CI 0.9–1.1) in Selibe-Phikwe, to the highest 5.0 (95% CI 4.0–6.1), in Mabutsane. There was a wide range of overall LTFU across districts, including rates as low as 4.6 (95% CI 4.4–4.9) losses per 100 person-years in Ngamiland, and 5.9 (95% CI 5.6–6.2) losses per 100 person-years in South East, to rates as high as 25.4 (95% CI 23.08–27.89) losses per 100 person-years in Mabutsane and 46.3 (95% CI 43.48–49.23) losses per 100 person-years in Okavango. Even when known risk factors for mortality and LTFU were adjusted for, district was a significant predictor of both mortality and LTFU rates Conclusion We found statistically significant variation in attrition (mortality and LTFU) and data quality among districts. These findings suggest that district-level contextual factors affect retention in treatment. Further research needs to investigate factors that can potentially cause this variation.

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Section: Discussionmentioning

confidence: 85%

Variation in attrition at subnational level: review of the Botswana National HIV/AIDS Treatment (Masa) programme data (2002–2013)

Farahani

Price

El-Halabi

et al. 2015

Tropical Med Int Health

Self Cite

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“…Botswana was the first country in Africa to establish a national ART program and began providing treatment free-of-charge to its HIV-infected population in early 2002 [1].…”

Section: Introductionmentioning

confidence: 99%

Advanced Human Immunodeficiency Virus Disease in Botswana Following Successful Antiretroviral Therapy Rollout: Incidence of and Temporal Trends in Cryptococcal Meningitis

Tenforde

Mokomane²,

Leeme³

et al. 2017

Clinical Infectious Diseases

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“…Widespread access to effective antiretroviral therapy (ART) has led to increased survival in persons living with the human immunodeficiency virus (HIV) [1,2]. In several parts of the world, non-communicable diseases (NCDs) have replaced AIDS as the leading causes of morbidity and mortality in HIV patients, a trend that is accentuated by aging of the HIV population [3,4].…”

Section: Introductionmentioning

confidence: 99%

HIV Associated Chronic Obstructive Pulmonary Disease in Nigeria

et al. 2015

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Objective To determine the prevalence and risk factors for chronic obstructive pulmonary disease (COPD) among HIV-infected adults in Nigeria. Design Cross-sectional study. Methods HIV-infected adults aged ≥ 30 years with no acute ailments accessing care at the antiretroviral therapy clinic of Jos University Teaching Hospital were enrolled consecutively. Participants were interviewed to obtain pertinent demographic and clinical information, including exposure to risk factors for COPD. Post-bronchodilator spirometry was carried out. HIV related information was retrieved from the clinic medical records. COPD case-definition was based on the Global Initiative for Obstructive Lung Disease (GOLD) criteria using post-bronchodilator FEV1/FVC <0.7. COPD prevalence was also calculated using the lower limit of normal for FEV1/FVC criteria (LLN) from the European Respiratory Society normative equation. Factors associated with COPD were determined using logistic regression models Results Study population comprised 356 HIV infected adults with mean age of 44.5 (standard deviation, 7.1) years and 59% were female. The mean time elapsed since HIV diagnosis was 7.0 (SD, 2.6) years and 97.5% of the respondents were on stable ART with virologic suppression present in 67.2%. Prevalence of COPD were 15.4% (95% confidence interval [CI] 11.7-19.2), 12.07% (95% CI 8.67-15.48), 22.19% (95% CI 18.16-26.83) using GOLD, ERS LLN and GLI LLN diagnostic criteria respectively. In multivariate analyses adjusting for gender, exposure to cigarette smoke or biomass, history of pulmonary tuberculosis, use of antiretroviral therapy, current CD4 T-cell count and HIV RNA, only age > 50 years was independently associated with COPD with OR 3.4; 95% CI 1.42-8.17 when compared to ages 30-40 years. Conclusion HIV-associated COPD is common in our population of HIV patients.

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Outcomes of the Botswana national HIV/AIDS treatment programme from 2002 to 2010: a longitudinal analysis

Abstract: The African Comprehensive HIV/AIDS Partnerships.

Cited by 66 publications

References 28 publications

Variation in attrition at subnational level: review of the Botswana National HIV/AIDS Treatment (Masa) programme data (2002–2013)

Variation in attrition at subnational level: review of the Botswana National HIV/AIDS Treatment (Masa) programme data (2002–2013)

Advanced Human Immunodeficiency Virus Disease in Botswana Following Successful Antiretroviral Therapy Rollout: Incidence of and Temporal Trends in Cryptococcal Meningitis

HIV Associated Chronic Obstructive Pulmonary Disease in Nigeria

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