High rate of loss to follow-up and virological non-suppression in HIV-infected children on antiretroviral therapy highlights the need to improve quality of care in South Africa
| Autor: | Rivka R. Lilian, Moya Mabitsi, Remco P. H. Peters, Lucy Ranoto, Helen Struthers, Kate Rees, Geneviève A F S van Liere, James McIntyre, Carol L. Tait, Jackie L. Dunlop |
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| Přispěvatelé: | RS: CAPHRI - R4 - Health Inequities and Societal Participation, MUMC+: DA MMI Staf (9) |
| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Anti-HIV Agents Epidemiology HIV Infections South Africa Risk Factors Hiv infected Humans FAILURE Medicine Treatment Failure Quality of care Lost to follow-up Child Quality of Health Care Retrospective Studies High rate Original Paper business.industry Infant Retrospective cohort study Odds ratio Antiretroviral therapy Confidence interval VIRAL LOAD Infectious Diseases Child Preschool Female Lost to Follow-Up business |
| Zdroj: | Epidemiology and Infection Epidemiology and Infection, 149:88. Cambridge University Press |
| ISSN: | 1469-4409 0950-2688 |
| DOI: | 10.1017/s0950268821000637 |
| Popis: | Provision of high-quality care and ensuring retention of children on antiretroviral therapy (ART) are essential to reduce human immunodeficiency virus (HIV)-associated morbidity and mortality. Virological non-suppression (≥1000 viral copies/ml) is an indication of suboptimal HIV care and support. This retrospective cohort study included ART-naïve children who initiated first-line ART between July 2015 and August 2017 in Johannesburg and rural Mopani district. Of 2739 children started on ART, 29.5% (807/2739) were lost to care at the point of analysis in August 2018. Among retained children, overall virological non-suppression was 30.2% (469/1554). Virological non-suppression was associated with higher loss to care 30.3% (229/755) compared with suppressed children (9.7%, 136/1399, P < 0.001). Receiving treatment in Mopani was associated with virological non-suppression in children under 5 years (adjusted odds ratio (aOR) 1.7 (95% confidence interval (CI) 1.1–2.4), 5–9 years (aOR 1.8 (1.1–3.0)) and 10–14 years (aOR 1.9 (1.2–2.8)). Virological non-suppression was associated with lower CD4 count in children 5–9 years (aOR 2.1 (1.1–4.1)) and 10–14 years (aOR 2.1 (1.2–3.8)). Additional factors included a shorter time on ART ( |
| Databáze: | OpenAIRE |
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