Treatment and outcome of AIDS-related Kaposi sarcoma in South Africa, Malawi and Zambia: an international comparison
| Autor: | Matthias Egger, Zainab Mohamed, Hannock Tweya, Margaret P Kasaro, Julia Bohlius, Eliane Rohner, Kathryn Stinson, Susan Citonje Msadabwe-Chikuni |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Malawi Pediatrics medicine.medical_specialty Referral Anti-HIV Agents Short Communication Zambia AIDS-Related Kaposi Sarcoma Antineoplastic Agents HIV Infections 610 Medicine & health Kaplan-Meier Estimate Cohort Studies South Africa Young Adult 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) 360 Social problems & social services parasitic diseases Epidemiology Global health Humans Medicine 030212 general & internal medicine Sarcoma Kaposi Retrospective Studies AIDS-Related Opportunistic Infections treatment business.industry Public health Kaposi sarcoma HIV Retrospective cohort study General Medicine medicine.disease 3. Good health 030220 oncology & carcinogenesis Female Electronic data business Follow-Up Studies |
| Zdroj: | Rohner, Eliane; Kasaro, Margaret; Msadabwe-Chikuni, Susan Citonje; Stinson, Kathryn; Mohamed, Zainab; Tweya, Hannock; Egger, Matthias; Bohlius, Julia (2017). Treatment and outcome of AIDS-related Kaposi sarcoma in South Africa, Malawi and Zambia: an international comparison. Pan African Medical Journal, 28, p. 261. African Field Epidemiology Network (A F E N E T) 10.11604/pamj.2017.28.261.11300 The Pan African Medical Journal |
| DOI: | 10.11604/pamj.2017.28.261.11300 |
| Popis: | HIV-related Kaposi sarcoma (KS) is common in sub-Saharan Africa, but optimal treatment strategies in resource-limited settings remain unclear. We did a retrospective cohort study of adults diagnosed with KS before initiating antiretroviral therapy (ART) at three ART programs in South Africa, Malawi and Zambia. We extracted data from medical charts at HIV clinics and oncological referral centers and used electronic data from the International epidemiology Databases to Evaluate AIDS Southern Africa. We used descriptive statistics to assess tumor (T) and systemic illness (S) stage and treatment of AIDS-KS patients. Kaplan-Meier analyses were used to assess survival after KS diagnosis. We analyzed data from 57 patients in total (20 from South Africa, 20 from Zambia, 17 from Malawi). Median age at KS diagnosis was 35 years and similar across sites. The percentage of patients with poor risk AIDS-KS (T1S1) was similar in South Africa (25%) and Malawi (24%) and higher in Zambia (45%). All AIDS-KS patients initiated ART at the HIV clinic. For KS care, in South Africa 18 patients (90%) were referred to an oncology department; in Malawi and Zambia most patients were managed by the HIV clinics. In Malawi and South Africa, most AIDS-KS patients received systemic chemotherapy, in Zambia one patient received chemotherapy at the HIV clinic. A year after KS diagnosis, 15 patients (75%) in South Africa, 10 patients (50%) in Zambia, and 8 patients (47%) in Malawi were still alive; another 3 patients (15%) in South Africa, 8 patients (40%) in Zambia and 4 patients (24%) in Malawi were lost to follow-up. Management of AIDS-KS patients varied considerably across sites in Malawi, South Africa and Zambia. We need more reliable survival data for AIDS-KS patients in sub-Saharan Africa before we can assess which treatments and clinical pathways should be adopted in a specific setting. |
| Databáze: | OpenAIRE |
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