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14 results on '"Twizere, Christella"'

1. Cervical cancer prevention and care in HIV clinics across sub‐Saharan Africa: results of a facility‐based survey

Author

Asangbeh‐Kerman, Serra Lem, Davidović, Maša, Taghavi, Katayoun, Dhokotera, Tafadzwa, Manasyan, Albert, Sharma, Anjali, Jaquet, Antoine, Musick, Beverly, Twizere, Christella, Chimbetete, Cleophas, Murenzi, Gad, Tweya, Hannock, Muhairwe, Josephine, Wools‐Kaloustian, Kara, Technau, Karl‐Gunter, Anastos, Kathryn, Yotebieng, Marcel, Jousse, Marielle, Ezechi, Oliver, Orang'O, Omenge, Bosomprah, Samuel, Boni, Simon Pierre, Basu, Partha, and Bohlius, Julia

Subjects
HIV (Viruses) -- Prevention, Women -- Health aspects, World health, Vaccination, Medical informatics, Cancer -- Prevention, Cervical cancer -- Prevention, Health, World Health Organization
Abstract

: INTRODUCTION: To eliminate cervical cancer (CC), access to and quality of prevention and care services must be monitored, particularly for women living with HIV (WLHIV). We assessed implementation practices in HIV clinics across sub‐Saharan Africa (SSA) to identify gaps in the care cascade and used aggregated patient data to populate cascades for WLHIV attending HIV clinics. METHODS: Our facility‐based survey was administered between November 2020 and July 2021 in 30 HIV clinics across SSA that participate in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We performed a qualitative site‐level assessment of CC prevention and care services and analysed data from routine care of WLHIV in SSA. RESULTS: Human papillomavirus (HPV) vaccination was offered in 33% of sites. Referral for CC diagnosis (42%) and treatment (70%) was common, but not free at about 50% of sites. Most sites had electronic health information systems (90%), but data to inform indicators to monitor global targets for CC elimination in WLHIV were not routinely collected in these sites. Data were collected routinely in only 36% of sites that offered HPV vaccination, 33% of sites that offered cervical screening and 20% of sites that offered pre‐cancer and CC treatment. CONCLUSIONS: Though CC prevention and care services have long been available in some HIV clinics across SSA, patient and programme monitoring need to be improved. Countries should consider leveraging their existing health information systems and use monitoring tools provided by the World Health Organization to improve CC prevention programmes and access, and to track their progress towards the goal of eliminating CC., INTRODUCTION The World Health Organization (WHO) seeks to eliminate cervical cancer (CC) within this century, and has defined the “90‐70‐90” targets it expects countries to reach by 2030: 90% of [...]

Published
2024
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2. Trends in demographic and clinical characteristics and initiation of antiretroviral therapy among adult patients enrolling in HIV care in the Central Africa International epidemiology Database to Evaluate AIDS (CA-IeDEA) 2004 to 2018

Author

Adedimeji, Adebola A Adedimeji, Hoover, Donald R, Shi, Qiuhu, Kim, Hae-Young, Brazier, Ellen, Ross, Jonathan, Murenzi, Gad, Twizere, Christella, Lelo, Patricia, Nsonde, Dominique, Ajeh, Rogers, Dzudie, Anastase, Nash, Denis, Yotebieng, Marcel, and Anastos, Kathryn

Subjects
Highly active antiretroviral therapy -- Demographic aspects -- Patient outcomes -- Forecasts and trends, HIV infection -- Demographic aspects -- Patient outcomes -- Forecasts and trends -- Drug therapy, Market trend/market analysis, Health
Abstract

Introduction: The Central Africa International epidemiology Database to Evaluate AIDS (CA-IeDEA) is an open observational cohort study investigating impact, progression and long-term outcomes of HIV/AIDS among people living with HIV (PLWH) in Burundi, Cameroon, Democratic Republic of Congo (DRC), Republic of Congo (ROC) and Rwanda. We describe trends in demographic, clinical and immunological characteristics as well as antiretroviral therapy (ART) use of patients aged > 15 years entering into HIV care in the participating CA-IeDEA site. Methods: Information on sociodemographic characteristics, height, weight, body mass index (BMI), CD4 cellcount, WHO staging and ART status at entry into care from 2004 through 2018 were extracted from clinic records of patients aged > 15 years enrolling in HIV care at participating clinics in Burundi, Cameroon, DRC, ROC and Rwanda. We assessed trends in patient characteristics at enrolment in HIV care including ART initiation within the first 30 days after enrolment in care and calculated proportions, means and medians (interquartile ranges) for the main variables of interest. Results: Among 69,176 patients in the CA-IeDEA cohort, 39% were from Rwanda, 24% from ROC, 18% from Cameroon, 14% from Burundi and 5% from DRC. More women (66%) than men enrolled in care and subsequently initiated ART. Women were also younger than men (32 vs. 38 years, P < 0.001) at enrolment and at ART initiation. Trends over time show increases in median CD4 cellcount at enrolment from 190 cells/[micro]L in 2004 to 334 cells/[micro]L in 2018 at enrolment. Among those with complete data on CD4 counts (60%), women had a higher median CD4 cell count at care entry than men (229 vs. 249 cells/[micro]L, P < 0.001). Trends in the proportion of patients using ART within 30 days of enrolment at the participating site show an increase from 16% in 2004 to 75% in 2018. Conclusions: Trends from 2004 to 2018 in the characteristics of patients participating in the CA-IeDEA cohort highlight improvements at entry into care and subsequent ART initiation including after the implementation of Treat All guidelines in the participating sites. Keywords: ARV; Africa; cohort studies; HIV epidemiology; low-and middle-income countries; HIV care continuum, 1 INTRODUCTION In 2018 over 37.9 million people aged >15 years were living with HIV globally, of whom 24.5 million (64.6%) were estimated to be accessing antiretroviral therapy (ART) [1]. [...]

Published
2021
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3. Service delivery challenges in HIV care during the first year of the COVID‐19 pandemic: results from a site assessment survey across the global IeDEA consortium

Author

Brazier, Ellen, Ajeh, Rogers, Maruri, Fernanda, Musick, Beverly, Freeman, Aimee, Wester, C. William, Lee, Man?Po, Shamu, Tinei, Ramírez, Brenda Crabtree, D' Almeida, Marcelline, Wools?Kaloustian, Kara, Kumarasamy, N., Althoff, Keri N., Twizere, Christella, Grinsztejn, Beatriz, Tanser, Frank, Messou, Eugène, Byakwaga, Helen, Duda, Stephany N., Nash, Denis, Chansilpa, Chidchon, Dougherty, Trevor, Karminia, Azar, Law, Matthew, Ross, Jeremy, Sohn, Annette, Aguirre, Ivette, Baker, David, Bloch, Mark, Cabot, Safaa, Carr, Andrew, Couldwell, Deborah, Edwards, Sian, Eu, Beng, Farlow, Heather, Finlayson, Robert, Gunathilake, Manoji, Hazlewood, Cherie, Hoy, Jennifer, Langton?Lockton, Julian, Le, Jacqueline, Leprince, Elizabeth, Minc, Ariane, Moore, Richard, O'Sullivan, Maree, Roth, Norm, Rowling, Dianne, Russell, Darren, Ryder, Nathan, Saunders, Craig, Silvers, Julie, Smith, David J., Sowden, David, Sweeney, Grant, Tan, Lynn, Teague, Ricard, Templeton, David, Thng, Caroline, Woolley, Ian, Khol, Vohith, Ly, Penh Sun, Li, Tsz Hei, Po, Lee Man, Kinikar, Aarti, Kumarasamy, Nagalingeswaran, Mundhe, Sanjay, Pujari, Sanjay, Sangle, Shashikala, Nimkar, Smita, Jassin, Madelein, Kurniati, Nia, Merati, Tuti Parwati, Muktiarti, Dina, Amalia, Rizqi, Sukmawati, Ni Made Dewi Dian, Wati, Ketut Dewi Kumara, Yunihastuti, Evy, Tanuma, Junko, Choi, Jun Yong, Azwa, Raja Iskandar Shah Raja, Cheng, Chan Kwai, Gani, Yasmin Mohamed, Mohamed, Thahira Jamal, Moy, Fong Siew, Nallusamy, Revathy, Nor, Mohamad Zulfahami Mohd, Rudi, Nuraini, Shyan, Wong Peng, Yusoff, Nik Khairulddin Nik, Ditangco, Rossana, Chan, Yu?Jiun, Wu, Pei?Chieh, Wu, Ping?Feng, Avihingsanon, Anchalee, Chaiwarith, Romanee, Chokephaibulkit, Kulkanya, Khusuwan, Suwimon, Kiertiburanakul, Sasisopin, Kosalaraksa, Pope, Lumbiganon, Pagakrong, Ounchanam, Pradtana, Puthanakit, Thanyawee, Rungmaitree, Supattra, Solai, Nuttarika, Sudjaritruk, Tavitiya, An, Vu Thien, Cuong, Do Duy, Do, Chau Viet, Huy, Bui Vu, Quy, Tuan, Van Nguyen, Kinh, Nguyen, Luan, Nguyen, Van Lam, Nguyen, Yen Thi, Nong, Vuong Minh, Truong, Huu Khanh, Tuyen, Ngo Thi Thu, Mcgowan, Catherine C., Duda, Stephany, Cahn, Florencia, Cahn, Pedro, Cesar, Carina, Fink, Valeria, Sued, Omar, Coelho, Lara, Machado, Daisy Maria, Pinto, Jorge, Wolff, Marcelo, Rouzier, Vanessa, Padgett, Denis, Gotuzzo, Eduardo, Biziragusenyuka, Jérémie, Gateretse, Patrick, Nimbona, Pelagie, Niyonkuru, Olive, Twizere, Christelle, Anicetus, Surreng, Djenabou, Amadou, Enow, Priscilla, Mbu, Eyongetah, Manga, Martin, Ndobe, Mercy, Nasah, Judith, Ekossono, Elle Nathalie Syntyche, Bouseko, Mireille Teno, Kitetele, Faustin, Lelo, Patricia, Diafouka, Merlin Isidore Justin, Mafoua, Adolphe, Nsonde, Dominique Mahambou, Bihira, Uitonze Aime Maurice, Dusabe, Marie Chantal, Feza, Rosine, Habanabashaka, Jean Claude, Habumuremyi, Viateur, Igizeneza, Ernestine, Kamigisha, Anne Marie, Kubwimana, Gallican, Maniriho, Gilbert, Mbaraga, Gilbert, Muhoza, Benjamin, Mukakarangwa, Jeanne, Mukamana, Joyce, Mukanyirigira, Patricie, Mukeshimana, Yvone Claude, Munyaneza, Athanase, Murenzi, Gad, Musaninyange, Jacqueline, Nyiraneza, Jules Ndumuhire, Ntarambirwa, Fidele, Nyiraneza, Marie Louise, Tuyishime, Josette, Tuyishimire, Yvonne, Ubandutira, Alexis, Umugiraneza, Florance, Umugwaneza, Rosine, Uwamahoro, Olive, Uwamahoro, Pauline, Uwambaje, Marie Victoire, Uwimpuhwe, Clarisse, Uwiragiye, Siphora, Kuhn, Yee Yee, Adera, Felix, Adhiambo, Beatricec, Aggrey, Khaemba, Akadikor, Daniel, Ambulla, Felix, Apiyo, Dorah, Ariya, Patrick, Atemba, Naftal, Ayodi, Fridah, Benard, Chirchir, Bett, Maureen, Birgen, Serafine, Bwalei, Rael, Chebon, Nancy, Chebor, Valentine Jirry, Chebuiywo, Philip, Chemutai, Jacline, Chepkorir, Emily, Chepseba, Carolyne, Chirchir, John, Diero, Lameck, Dukwa, Benard, Elphas, Alice, Etyang, Tom, Idiama, Agnes, Jebichuko, Ann, Jepchumba, Delvine, Juma, Churchill, Juma, Maureen, Juma, Sheila, Kadima, Julie, Karani, Rose, Keitany, Christopher, Keter, Pricilla, Kiavoga, Lucy, Kibet, Harrison, Kimutai, Ruth, Kiplagat, Mutai, Kiprono, Wilfred, Kipruto, Nicholas Kogei, Kirimi, Asenath, Koech, Zeddy, Kosgei, Carolyne, Kutto, Karen, Kweyu, Mildred, Liech, Ephraim Kenneth, Limo, Milka, Maina, Rose, Marumbu, Priscah, Masese, Agnes, Mochotto, Patricia, Molly, Omudeck, Momanyi, Tom, Murutu, John W., Mwanda, Praxidis, Ndakalu, Lillian, Nderitu, Rose N., Obatsa, Sarah, Obiga, Fredrick, Oboya, Moses, Odhiambo, Joseph, Olaya, George, Omanyala, Oscar, Oray, Christine, Otieno, Molly, Otwane, Modesta Toto, Ouma, Paul, Owuor, Charles, Pepela, Doris Tutu, Pessah, Collins, Rotich, Evans, Rotich, Edwin K., Rutto, Titus C., Shikuku, Monica, Sibweche, Rose Naliaka, Simiyu, Robert Wanyonyi, Siria, Hellen, Some, Michael, Songok, Winnie Cherotich, Tanui, Immaculate, Wafula, Grace, Wambura, Rebecca, Wanjala, Ellah, Wanyama, Carolyne, Wanyonyi, Hellen, Woyakapel, Emmanuel, Zelbabel, Wandera, Gwimo, Dikengela, Kinyota, Ester, Lwali, Jerome, Lyamuya, Rita, Machemba, Richard, Mathias, Julia, Mkombachepa, Lilian, Mokiwa, Athuman, Mushi, Ombeni, Ndunguru, Charles, Ngonyani, Kapella, Nyaga, Charles, Ruta, Happiness, Urassa, Mark, Akanyihayo, James, Arinaitwe, Arnold, Batuuka, Jesca, Birungi, Walusimbi, Bugembe, John Nyanzi, Ddungu, Ahmed, Francis, Kato, Imran, Bangira, Kafuuma, George William, Kalulue, John Bosco, Kanaabi, Grace, Kanyesigye, Michale, Karuhanga, Godfery, Kasozi, Charles, Kasule, Godfrey, Katusime, Assumpta, Kibalama, Donozio, Kimera, Simon Peter, Kulusumu, Namatovu, Lule, Yusuf, Lwanga, Isaac, Mluindwa, Margaret, Moses, Jemba, Mubarak, Sseremba, Muggaga, Daniel, Mukalazi, Evelyn, Muleebwa, Joseph, Mulema, Derick, Musisi, Ivan, Muwawu, John, Muyindike, Winnie, Mwaka, Dick, Naava, Milly, Nabiyki, Immaculate, Nabusulwa, Agnes, Nakabugo, Dorah, Nakamya, Esther, Nakanwagi, Daisy, Nakato, Oliver, Nakayi, Lydian, Nakigozi, Patience, Nakku, Juliet, Nakuya, Juliet, Nakyomu, Justine, Namayanja, Joan, Namirembe, Sarah, Namugumya, Juliet, Namukasa, Ezereth, Namulindwa, Viola, Nankya, Irene, Nannyondo, Grace Mugagga, Nansamba, Harriet, Nansera, Denis, Nanyanzi, Brenda, Nanyonjo, Esther Celina, Nayiga, Irene, Opira, Isaac, Owarwo, Noela C., Resty, Sserunkuma, Semuwemba, Haruna, Senoga, Julius, Sseguya, Gerald, Ssekyewa, John Paul, Ssemakadde, Matthew, Tebajjwa, Jonah, Tugumisirize, Doreen, Tushemerirwe, Robinah, Waliyi, Kawuki, Althoff, Keri, Bishop, Jennifer, Gill, M J., Loutfy, Mona, Smith, Graham, Bamford, Laura, Black, Anthony, Brice, Asia, Brown, Sheldon, Colasanti, Jonathan, Duarte, Piper, Firnhaber, Cynthia, Goetz, Matthew, Grasso, Chris, Gripshover, Barbara, Horberg, Michael, Kelly, Rita, Levine, Ken, Luu, Mitchell, Marconi, Vincent, Maroney, Karen, Mayer, Kenneth, Mayor, Angel, Mcgowan, Catherine, Multani, Ami, Napravnik, Sonia, Nijhawan, Ank, Novak, Richard, Palella, Frank, Rodriguez, Maria C., Scott, Mia, Tedaldi, Ellen, Willig, James, Cornell, Morna, Davies, Mary?Ann, Egger, Matthias, Haas, Andreas, Bereng, Monkoe, Kalake, Maleshoane, Lenela, Keketso, Seretse, Relebohile, Chintenga, Matthews, Chiwoko, Jane, Gumulira, Joe, Huwa, Jacqueline, Maluwa, Rafique, Matanje, Beatrice, Mbewe, Ronald, Mfungwe, Sunshine, Mphande, Zakaliah, Tweya, Hannock, Rafael, Idiovino, Apolles, Patti, Beneke, Eunice, Dlamini, Siphephelo, Edson, Claire, Eley, Brian, Euvrard, Jonathan, Fatti, Geoffrey, Goeieman, Bridgette, Grimwood, Ashraf, Huang, David, Hugo, Susan, Ismail, Zahiera, Jennings, Lauren, Mathenjwa, Thulile, Monteith, Lizette, Mshweshwe, Zamuxolo, Ntuli, Mfundi, Ndlovu, En, Ndlozi, Hloniphile, Noyakaza, Sylvia, Prozesky, Hans, Rabie, Helena, Sipambo, Nosisa, Technau, Karl?Günter, Tembe, Thokozani, Xaba, Nontando, Njobvu, Thandiwe, Munthaly, Mary, Mwetwa, Elly, Kabeba, Gillian, Mwendafilumba, Derrick, Maanguka, Ethel, Manyika, Nelly, Mwansa, Chalwe, Banda, Future, Mwenda, Dickson, Bwalya, Abel, Shapi, Leah, Syame, Kasapo, Sashi, Rita, Mulenga, Chisha, Nanyangwe, Ruth, Chimbetete, Cleophas, Chinofunga, A., Mhike, J., Mubvigwi, E., Nyika, F., Quarter, Kumbirai Pise, Arikawa, Shino Chassagne, Becquet, Renaud, Bernard, Charlotte, Dabis, François, Desmonde, Sophie, Dahourou, Désiré, Ekouevi, Didier Koumavi, Jaquet, Antoine, Jesson, Julie, Leroy, Valeriane, Malateste, Karen, Rabourdin, Elodie, Tiendrebeogo, Thierry, Assogba, Michée, Zannou, Djimon Marcel, Hounhoui, Ghislaine, Bere, Denise, Poda, Armel, Pooda, Gbolo, Traore, Richard, Abauble, Yao, Abby, Ouattara, Acquah, Patrick, Andoble, Valérie, Aude, Yobo N'Dzama, Azani, Jean?Claude, Berete, Oka, Beugre, Jacques Daple, Bohoussou, Caroline Yao, Brou, Simon Boni Emmanuel, Chenal, Henri, Cissé, Abdoulaye, Coulibaly, Nambate, Dainguy, Marie Evelyne, Daligou, Marcelle, D' Aquin, Toni Thomas, Dasse, Claude Desire, Folquet, Madeleine Amorissani, Gnepa, Guy, Gobe, Olivier, Guira, Salif, Hawerlander, Denise, Horo, Apollinaire, Kanga, Guillaume, Messou, Zobo Konan Eugène, Minga, Kla Albert, Moh, Raoul, N'Gbeche, Mariesylvie, Ogbo, Patricia, Oulai, Mathieu, Stéphanie, Se, Eboua, Tanoh, Valère, Itchy Max, Afrane, Adwoa Kumiwa Asare, Akrofi, Esther, Andoh, John Christian, Renner, Lorna, Bagayoko, Awa, Bagayoko, Kadidiatou, Bah, Abdou Salam, Berthe, Alima, Coulibaly, Boureïma, Coulibaly, Fatimata, Coulibaly, Yacouba Aba, Diakité, Aïssata, Bocoum, Fatoumata, Boré, Fatoumata, Dicko, Fatoumata, Koné, Odile, Sylla, Mariam, Tangara, Assitan, Traoré, Mamadou, Seydi, Moussa, Amegatse, Edmond, Djossou, Julienne, Takassi, Elom, and Palanga, Sénam

Subjects
HIV (Viruses) -- Care and treatment -- Patient outcomes, Public health administration -- Evaluation, Health
Abstract

: Introduction: Interruptions in treatment pose risks for people with HIV (PWH) and threaten progress in ending the HIV epidemic; however, the COVID‐19 pandemic's impact on HIV service delivery across diverse settings is not broadly documented. Methods: From September 2020 to March 2021, the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium surveyed 238 HIV care sites across seven geographic regions to document constraints in HIV service delivery during the first year of the pandemic and strategies for ensuring care continuity for PWH. Descriptive statistics were stratified by national HIV prevalence ( Results: Questions about pandemic‐related consequences for HIV care were completed by 225 (95%) sites in 42 countries with low (n = 82), medium (n = 86) and high (n = 57) HIV prevalence, including low‐ (n = 57), lower‐middle (n = 79), upper‐middle (n = 39) and high‐ (n = 50) income countries. Most sites reported being subject to pandemic‐related restrictions on travel, service provision or other operations (75%), and experiencing negative impacts (76%) on clinic operations, including decreased hours/days, reduced provider availability, clinic reconfiguration for COVID‐19 services, record‐keeping interruptions and suspension of partner support. Almost all sites in low‐prevalence and high‐income countries reported increased use of telemedicine (85% and 100%, respectively), compared with less than half of sites in high‐prevalence and lower‐income settings. Few sites in high‐prevalence settings (2%) reported suspending antiretroviral therapy (ART) clinic services, and many reported adopting mitigation strategies to support adherence, including multi‐month dispensing of ART (95%) and designating community ART pick‐up points (44%). While few sites (5%) reported stockouts of first‐line ART regimens, 10–11% reported stockouts of second‐ and third‐line regimens, respectively, primarily in high‐prevalence and lower‐income settings. Interruptions in HIV viral load (VL) testing included suspension of testing (22%), longer turnaround times (41%) and supply/reagent stockouts (22%), but did not differ across settings. Conclusions: While many sites in high HIV prevalence settings and lower‐income countries reported introducing or expanding measures to support treatment adherence and continuity of care, the COVID‐19 pandemic resulted in disruptions to VL testing and ART supply chains that may negatively affect the quality of HIV care in these settings., INTRODUCTION The COVID‐19 pandemic has had major direct and indirect impacts on population health globally, through disruptions in the accessibility and quality of basic health services [1], in supply chains [...]

Published
2022
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4. Global HIV prevention, care and treatment services for children: a cross-sectional survey from the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium

Author

Vreeman, Rachel C, primary, Yiannoutsos, Constantin T, additional, Yusoff, Nik Khairulddin Nik, additional, Wester, C William, additional, Edmonds, Andrew, additional, Ofner, Susan, additional, Davies, Mary-Ann, additional, Leroy, Valériane, additional, Lumbiganon, Pagakrong, additional, de Menezes Succi, Regina Célia, additional, Twizere, Christella, additional, Brown, Steven, additional, Bolton-Moore, Carolyn, additional, Takassi, Ounoo Elom, additional, Scanlon, Michael, additional, Martin, Roxanne, additional, and Wools-Kaloustian, Kara, additional

Published
2023
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6. COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic

Author

Rogers, Ajeh, primary, Brazier, Ellen, additional, Dzudie, Anastase, additional, Adedimeji, Adebola, additional, Yotebieng, Marcel, additional, Muhoza, Benjamin, additional, Twizere, Christella, additional, Lelo, Patricia, additional, Nsonde, Dominique, additional, Mafoua, Adolphe, additional, Munyaneza, Athanase, additional, Gateretse, Patrick, additional, Diafouka, Merlin, additional, Murenzi, Gad, additional, Niyongabo, Théodore, additional, Anastos, Kathryn, additional, and Nash, Denis, additional

Published
2022
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7. The impact of WHO’s Treat All guideline on disease progression among people enrolled in HIV care in Central Africa: an observational cohort data by target trial design with multistate modeling

Author

Zhu, Jiaqi, primary, Zhang, Hongbin, additional, Brazier, Ellen, additional, Tymejczyk, Olga, additional, Yotebieng, Marcel, additional, Kimmel, April D., additional, Anastos, Kathryn, additional, Ross, Jonathan, additional, Hoover, Donald R, additional, Shi, Qiuhu, additional, Murenzi, Gad, additional, Nsonde, Dominique, additional, Dzudie, Anastase, additional, Lelo, Patricia, additional, Twizere, Christella, additional, and Nash, Denis, additional

Published
2022
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8. Implementation of 'Treat‐all' at adult HIV care and treatment sites in the Global IeDEA Consortium: results from the Site Assessment Survey

Author

Brazier, Ellen, Maruri, Fernanda, Duda, Stephany N., Tymejczyk, Olga, Wester, C William, Somi, Geoffrey, Ross, Jeremy, Freeman, Aimee, Cornell, Morna, Poda, Armel, Musick, Beverly S., Zhang, Fujie, Althoff, Keri N., Mugglin, Catrina, Kimmel, April D., Yotebieng, Marcel, Nash, Denis, Karminia, Azar, Sohn, Annette H., Allen, Debbie, Bloch, Mark, Boyd, Susan, Brown, Katherine, Costa, Jess, Donohue, William, Gunathilake, Manoji, Hoy, Jennifer, Macrae, Karen, Moore, Richard, Roth, Norman, Rowling, Diane, Silvers, Julie, Smith, David J., Sowden, David, Templeton, David, Varma, Rick, Woolley, Ian, Youds, David, Meng, Somanithd Chhay, Vannary, Bun, Chan, Yun Ting, Lam, Wilson, Lee, Man Po, Ning, Han, Pansy, Yu Po Chu, Kumarasamy, N., Pujari, Sanjay, Kurniati, Nia, Merati, Tuti Parwati, Muktiarti, Dina, Parwata, Wayan Sandhi, Ratni, Made, Sukmawati, Ni Made Dewi Dian, Vedaswari, Dian Sulistya Putu Diah, Wati, Ketut Dewi Kumara, Yunihastuty, Evy, Tanuma, Junko, Mills, Graham, Raymond, Nigel, Ditangco, Rossana, Papa, Ohnmar Seinn, Tek, Ng Oon, Azwa, Raja, Daud, Fauziah, Juin, Wong Ke, Kamarulzaman, Adeeba Binti, Khairulddin, Nik, Li, Chong Meng, Moy, Fong Siew, Shah, Raja Iskandar, Shyan, Wong Peng, Sim, Benedict, Thahira, Jamal Mohamed, Tuang, Koh Mia, Yusoff, Nik, Choi, Jun Yong, Chan, Yu?Jiun, Huang, Chih?Sheng, Wing?Wai, Wong, Avihingsanon, Anchalee, Chokephaibulkit, Kulkanya, Hansudewechakul, Rawiwan, Khumcha, Benjhawan, Khusuwan, Suwimon, Kiertiburanakul, Sasisopin, Lumbiganon, Pagakrong, Maleesatharn, Alan, Praparattanapan, Jutarat, Puthanakit, Thanyawee, Sricharoenchai, Sirintip, Sudjaritruk, Tavitiya, Watanaporn, Suporn, An, Vu Thien, Cuong, Do Duy, H?ng, Bùi Thu, Huy, Bùi V?, Quy, Du Tuan, Van, Lam Nguyen, Baragunzwa, Agathomfue, Gakima, Dévote, Ingabire, Gloria, Kankinoi, Floride, Manyundo, Risase Scholastique, Misago, Celestin, Nahimana, Thierry, Nimbona, Pélagie, Ntirampeba, Felicite, Twizere, Christella, Ajeh, Rogers, Djenabou, Amadou, Dzudie, Anastase, Ewanoge, Alice Ndelle, Tchassem, Edmond, Bampapa, Therese, Lelo, Patricia, Kitetele, Faustin, Paul, Marie, Tytyna, Amida, Akolbout, Maryse, Bitsindou, Parfait, Diafouka, Merlin, Mafoua, Adolphe, Mahinga, Nadine, Moudila, Ella, Moutoula, Antoinette, Ndala, Ulrich, Nsonde, Dominique Mahambou, Ayinkamiye, Josephine, Dusabe, Chantal, Hakizimana, Theogene, Mbaraga, Gilbert, Mukamana, Joyce, Mukantwali, Sandrine, Munyaneza, Athanase, Murangwa, Anthere, Musenguwera, J. Claude, Ngutegure, Marie Immanculee, Ntarambirwa, Fidele, Nyiransabimana, Diane, Sinayobye, Jean D'Amour, Tuyishimire, Yvonne, Uwamahoro, Olive, Viateur, Habumuremyi, Vincent, Sugira, Kuhn, Yee Yee, Musick, Beverly, Rodriguez, Israel, Wools?Kaloustian, Kara, Yiannoutsos, Constantin, Akajoroit, Esinasi, Ariya, Peter, Atsimale, Meshack, Barua, Zeruya, Busaka, Oscar, Bukusi, Elizabeth, Chebor, Valentine, Chemweno, Timothy, Chirchir, John, Esendi, Lameck Diero Sagida, Fwamba, Aisha, Mmella, Anne, Githumbi, Eunice, Hussein, Marcia Nasimiyu, Kandie, Xavier, Kemunto, Martha, Khaemba, Elizabeth, Kipchumba, Mary, Koech, Emily, Kosgei, Caroline, Laundrick, Barasa, Merongo, Ruth, Mochotto, Patricia, Munyisi, Consolata, Ndakalu, Lilian, Ochieng, William Okoth, Odalo, Paul, Okumu, Wicklife, Omari, Lilian, Omondi, Alphoce, Osia, Lydia, Owino, Magret, Oyoo, Maureen, Pepela, Doris, Rono, Millicent, Simon, Omar, Tenge, Angie, Too, Mary, Toto, Modesta, Towett, Cathrine, Wawire, Kennedy, Kimambo, Mensaria, Kinyota, Ester, Lyamuya, Rita, Mathias, Julia, Mfuko, Athuman Ramadhan, Michael, Denna, Ngonyani, Kapella Zacharia, Nyaga, Charles, Somi, G.R., Urassa, Mark S., Batte, James, Bwana, Mwebesa Bosco, Castelnuovo, Barbara, Kanyesigye, Michael, Kisakye, Alice, Nalugoda, Fred, Semuwemba, Haruna, Ssali, John, Ssemakadde, Matthew, Castilho, Jessica, Cesar, Carina, De Alencastro, Paulo Ricardo, Barbosa, Eduardo Luiz, Brites, Carlos, Caricol, Renata, Carmo, Fabiana Bononi Do, Coelho, Lara Esteves, Escuder, Maria Mercedes, Estevam, Denize Lotufo, Ferreira, Flavia Gomes Faleiro, Gonçalves, Alexandre, Gouvêa, Aída Barbosa, Ikeda, Maria Leticia Rodrigues, Kalichman, Artur O., Machado, Daisy Maria, Queiroz, Simone, Souza, Rosa, Succi, Regina Célia, Trindade, Kátia Valeska, Tupinambás, Unai, Wolff, Marcelo, Rouzier, Vanessa, Padgett, Denis, Crabtree, Brenda, Martin, Carlos Eduardo Verne, Mejia, Fernando, Chang, Benny, Done, Brenda, Gabe, Larry, Gill, John, Gough, Kevin, Howlett, Gail, Klein, Marin, Latendre?Paquette, Judy, Leung, Victor, Macphee, Paul, Macpherson, P., Maharaj, Raj, Medina, Lorna Carrasco, Page, Suzanne, Pexos, Costas, Rachlis, Anita, Salters, Kate, Sterling, Sherine, Boswell, Stephen, Burkholder, Greer, Cesteros, Gisela, Chagaris, Kalliope, Franklin, Rosa, Fuhrer, Jack, Gilbert, Cynthia L., Goetz, Matthew, Grasso, Chris, Horberg, Michael, Hunter?Mellado, Robert F., Kell, Rita, Kitahata, Mari, Klein, Daniel, Levine, Ken, Marconi, Vincent, Mathews, Christopher, Mayor, Angel M., Mcgowan, Catherine, Napravnik, Sonia, Novak, Richard, Oursler, Kris Ann, Ramos, Shellier, Rodriguez, Benigno, Rodriguez, Maria C., Silverberg, Michael, Simberkoff, Michael S., Varshney, Mohit, Ward, Douglas, Widick, Barb, Yangco, Bienvenido G., Davies, Mary?Ann, Smith, Lilian, Von Groote, Per Maximilian, Muhairwe, Josephine, Balakasi, Steve, Banda, Quietus, Kalepa, Getrude, Bello, Andrew, Bulla, J.W., Chigeda, Maria, Chikaphupha, Joyce, Chikwekwere, Flora, Kachoka, Jack, Kapito, Allan, Katondo, Alinafe Nathan, Kumwenda, Molly, Labein, Felix Phewa, Magombo, Ronald, Malumbe, Bridget, Makuwira, I., Marico, Patricia, Masangale, Betha, Mchiela, Angella, Midian, Dan, Phiri, Kezia, Tambe, Mary, Thomas, Baid, Thomson, Charles, Hector, Jonas, Cross, Anna, Dlamini, Siphephelo, Eley, Brian, Euvrard, Jonathan, Fatti, Geoffrey, Hilderbrand, Katherine, Hsiao, Marvin, Mpye, Michael, Prozesky, Hans, Reubenson, Gary, Rose, Lesley, Sawry, Shobna, Sibambo, Nosisa, Technau, Karl, Vinikoor, Michael, Chimbetete, Cleophas, Kamenova, Kamelia, Balestre, Eric, Leroy, Valeriane, Malasteste, Karen, Djimon, Marcel Zannou, D' Almeida, Marcelline, Hounhoui, Ghislaine, Assogba, Michee, Zoungrana, Jacques, Yaméogo, Issouf, Tapsoba, Achille, Abdelh, Sidibé, Bosse, Clarisse Amani, Diabaté, Mamoudou, Eboua, Tanoh Kassi François, Folquet, Madeleine Amorissani, Hawelander, Denise, Konaté, Mamadou, Kouakou, Kouadio, Lambert, Dohoun, Minga, Albert Kla, N'Gbeche, Marie Sylvie, Tanon, Aristophane, Yao, Abo, Renner, Lorna, N'Diaye, Clémentine, Berthé, Mme Alima, Seydi, Moussa, Tine, Judicaël, Elom, Takassi Ounoo, Kariylare, Benjamin, and Patassi, Akessiwe

Subjects
Public health administration -- Evaluation, HIV infection -- Diagnosis -- Drug therapy, Health
Abstract

: Introduction: Since 2015, the World Health Organization (WHO) has recommended that all people living with HIV (PLHIV) initiate antiretroviral treatment (ART), irrespective of CD4+ count or clinical stage. National adoption of universal treatment has accelerated since WHO's 2015 “Treat All” recommendation; however, little is known about the translation of this guidance into practice. This study aimed to assess the status of Treat All implementation across regions, countries, and levels of the health care delivery system. Methods: Between June and December 2017, 201/221 (91%) adult HIV treatment sites that participate in the global IeDEA research consortium completed a survey on capacity and practices related to HIV care. Located in 41 countries across seven geographic regions, sites provided information on the status and timing of site‐level introduction of Treat All, as well as site‐level practices related to ART initiation. Results: Almost all sites (93%) reported that they had begun implementing Treat All, and there were no statistically significant differences in site‐level Treat All introduction by health facility type, urban/rural location, sector (public/private) or country income level. The median time between national policy adoption and site‐level introduction was one month. In countries where Treat All was not yet adopted in national guidelines, 69% of sites reported initiating all patients on ART, regardless of clinical criteria, and these sites had been implementing Treat All for a median period of seven months at the time of the survey. The majority of sites (77%) reported typically initiating patients on ART within 14 days of confirming diagnosis, with 60% to 62% of sites implementing Treat All in East, Southern and West Africa reporting same‐day ART initiation for most patients. Conclusions: By mid‐ to late‐2017, the Treat All strategy was the standard of care at almost all IeDEA sites, including rural, primary‐level health facilities in low‐resource settings. While further assessments of site‐level capacity to provide high‐quality HIV care under Treat All and to support sustained viral suppression after ART initiation are needed, the widespread introduction of Treat All at the service delivery level is a critical step towards global targets for ending the HIV epidemic as a public health threat., Introduction WHO's 2015 recommendation for immediate treatment of all PLHIV, regardless of CD4+ cell count, represented a paradigm shift in HIV care and treatment. By preventing morbidity and mortality among [...]

Published
2019
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9. Comparison of cohort characteristics in Central Africa International Epidemiology Databases to Evaluate AIDS and Demographic Health Surveys: Rwanda and Burundi

Author

Mageras, Anna, primary, Brazier, Ellen, additional, Niyongabo, Théodore, additional, Murenzi, Gad, additional, D’Amour Sinayobye, Jean, additional, Adedimeji, Adebola A, additional, Twizere, Christella, additional, Kelvin, Elizabeth A, additional, Anastos, Kathryn, additional, Nash, Denis, additional, and Jones, Heidi E, additional

Published
2021
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10. Impact of universal antiretroviral treatment eligibility on rapid treatment initiation among young adolescents with HIV in sub-Saharan Africa

Author

Tymejczyk, Olga, Brazier, Ellen, Wools-Kaloustian, Kara, Davies, Mary-Ann, DiLorenzo, Madeline, Edmonds, Andrew, Vreeman, Rachel, Bolton, Carolyn, Twizere, Christella, Okoko, Nicollate, Phiri, Sam, Nakigozi, Gertrude, Lelo, Patricia, Von Groote, Per, Sohn, Annette H, and Nash, Denis

Subjects
610 Medicine & health, 360 Social problems & social services
Abstract

BACKGROUND Young adolescents with perinatally-acquired HIV are at risk for poor care outcomes. We examined whether universal antiretroviral treatment (ART) eligibility policies (Treat All) improved rapid ART initiation following care enrollment among 10-14-year-olds in seven sub-Saharan African countries. METHODS Regression discontinuity analysis and data for 6,912 10-14-year-old patients were used to estimate changes in rapid ART initiation (within 30 days of care enrollment) following adoption of Treat All policies in two groups of countries: Uganda and Zambia (policy adopted in 2013) and Burundi, Democratic Republic of the Congo, Kenya, Malawi, and Rwanda (policy adopted in 2016). RESULTS There were immediate increases in rapid ART initiation among young adolescents after national adoption of Treat All. Increases were greater in countries adopting the policy in 2016, compared with those adopting it in 2013: 23.4 percentage points (pp) (95%CI: 13.9-32.8) vs. 11.2pp (95%CI: 2.5-19.9). However, the rate of increase in rapid ART initiation among 10-14-year-olds rose appreciably in countries with earlier treatment expansions, from 1.5pp per year before Treat All to 7.7pp afterwards. CONCLUSIONS Universal ART eligibility has increased rapid treatment initiation among young adolescents enrolling in HIV care. Further research should assess their retention in care and viral suppression under Treat All.

Published
2020
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13. Impact of Universal Antiretroviral Treatment Eligibility on Rapid Treatment Initiation Among Young Adolescents with Human Immunodeficiency Virus in Sub-Saharan Africa

Author

Tymejczyk, Olga, primary, Brazier, Ellen, additional, Wools-Kaloustian, Kara, additional, Davies, Mary-Ann, additional, Dilorenzo, Madeline, additional, Edmonds, Andrew, additional, Vreeman, Rachel, additional, Bolton, Carolyn, additional, Twizere, Christella, additional, Okoko, Nicollate, additional, Phiri, Sam, additional, Nakigozi, Gertrude, additional, Lelo, Patricia, additional, von Groote, Per, additional, Sohn, Annette H, additional, and Nash, Denis, additional

Published
2019
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14. Impact of Universal Antiretroviral Treatment Eligibility on Rapid Treatment Initiation Among Young Adolescents with Human Immunodeficiency Virus in Sub-Saharan Africa.

Author

Tymejczyk, Olga, Brazier, Ellen, Wools-Kaloustian, Kara, Davies, Mary-Ann, Dilorenzo, Madeline, Edmonds, Andrew, Vreeman, Rachel, Bolton, Carolyn, Twizere, Christella, Okoko, Nicollate, Phiri, Sam, Nakigozi, Gertrude, Lelo, Patricia, Groote, Per von, Sohn, Annette H, Nash, Denis, and von Groote, Per

Subjects
HIV, TEENAGERS
Abstract

Background: Young adolescents with perinatally acquired human immunodeficiency virus (HIV) are at risk for poor care outcomes. We examined whether universal antiretroviral treatment (ART) eligibility policies (Treat All) improved rapid ART initiation after care enrollment among 10-14-year-olds in 7 sub-Saharan African countries.Methods: Regression discontinuity analysis and data for 6912 patients aged 10-14-years were used to estimate changes in rapid ART initiation (within 30 days of care enrollment) after adoption of Treat All policies in 2 groups of countries: Uganda and Zambia (policy adopted in 2013) and Burundi, Democratic Republic of the Congo, Kenya, Malawi, and Rwanda (policy adopted in 2016).Results: There were immediate increases in rapid ART initiation among young adolescents after national adoption of Treat All. Increases were greater in countries adopting the policy in 2016 than in those adopting it in 2013: 23.4 percentage points (pp) (95% confidence interval, 13.9-32.8) versus 11.2pp (2.5-19.9). However, the rate of increase in rapid ART initiation among 10-14-year-olds rose appreciably in countries with earlier treatment expansions, from 1.5pp per year before Treat All to 7.7pp per year afterward.Conclusions: Universal ART eligibility has increased rapid treatment initiation among young adolescents enrolling in HIV care. Further research should assess their retention in care and viral suppression under Treat All. [ABSTRACT FROM AUTHOR]

Published
2020
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