Characteristics of HIV-Infected Children at Enrollment into Care and at Antiretroviral Therapy Initiation in Central Africa
Publication Date
January 12, 2017
Journal
PLOS ONE
Authors
Adebola Adedimeji, Andrew Edmonds, Donald Hoover, Qiuhu Shi, et al
Volume
12
Issue
1
Pages
e0169871
DOI
https://dx.plos.org/10.1371/journal.pone.0169871
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0169871
Scopus
85009266809
Mendeley
http://www.mendeley.com/research/characteristics-hivinfected-children-enrollment-care-antiretroviral-therapy-initiation-central-afric
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Mendeley | Further Information

{"title"=>"Characteristics of HIV-Infected Children at Enrollment into Care and at Antiretroviral Therapy Initiation in Central Africa", "type"=>"journal", "authors"=>[{"first_name"=>"Adebola", "last_name"=>"Adedimeji", "scopus_author_id"=>"6507660033"}, {"first_name"=>"Andrew", "last_name"=>"Edmonds", "scopus_author_id"=>"26634992800"}, {"first_name"=>"Donald", "last_name"=>"Hoover", "scopus_author_id"=>"7202318191"}, {"first_name"=>"Qiuhu", "last_name"=>"Shi", "scopus_author_id"=>"35312175500"}, {"first_name"=>"Jean D.Amour", "last_name"=>"Sinayobye", "scopus_author_id"=>"56203719900"}, {"first_name"=>"Martin", "last_name"=>"Nduwimana", "scopus_author_id"=>"6507532627"}, {"first_name"=>"Patricia", "last_name"=>"Lelo", "scopus_author_id"=>"13002731400"}, {"first_name"=>"Denis", "last_name"=>"Nash", "scopus_author_id"=>"8882895800"}, {"first_name"=>"Kathryn", "last_name"=>"Anastos", "scopus_author_id"=>"7003935425"}, {"first_name"=>"Marcel", "last_name"=>"Yotebieng", "scopus_author_id"=>"26325950800"}], "year"=>2017, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"28081230", "doi"=>"10.1371/journal.pone.0169871", "sgr"=>"85009266809", "isbn"=>"1111111111", "scopus"=>"2-s2.0-85009266809", "issn"=>"19326203", "pui"=>"614055582"}, "id"=>"b05e1b58-3a12-3965-9856-ea8566b1b493", "abstract"=>"BACKGROUND: Despite the World Health Organization (WHO) regularly updating guidelines to recommend earlier initiation of antiretroviral therapy (ART) in children, timely enrollment into care and initiation of ART in sub-Saharan Africa in children lags behind that of adults. The impact of implementing increasingly less restrictive ART guidelines on ART initiation in Central Africa has not been described., MATERIALS AND METHODS: Data are from the Central Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) pediatric cohort of 3,426 children (0-15 years) entering HIV care at 15 sites in Burundi, DRC, and Rwanda. Measures include CD4 count, WHO clinical stage, age, and weight-for-age Z score (WAZ), each at enrollment into HIV care and at ART initiation. Changes in the medians or proportions of each measure by year of enrollment and year of ART initiation were assessed to capture potential impacts of changing ART guidelines., RESULTS: Median age at care enrollment decreased from 77.2 months in 2004-05 to 30.3 months in 2012-13. The median age at ART initiation (n = 2058) decreased from 83.0 months in 2004-05 to 66.9 months in 2012-13. The proportion of children <=24 months of age at enrollment increased from 12.7% in 2004-05 to 46.7% in 2012-13, and from 9.6% in 2004-05 to 24.2% in 2012-13 for ART initiation. The median CD4 count at enrollment into care increased from 563 (IQR: 275, 901) in 2004-05 to 660 (IQR: 339, 1071) cells/mul in 2012-13, and the median CD4 count at ART initiation increased from 310 (IQR:167, 600) in 2004-05 to 589 (IQR: 315, 1113) cells/mul in 2012-13. From 2004-05 to 2012-13, median WAZ improved from -2 (IQR: -3.4, -1.1) to -1 (IQR: -2.5, -0.2) at enrollment in care and from -2 (IQR: -3.8, -1.6) to -1 (IQR: -2.6, -0.4) at ART initiation., DISCUSSION AND CONCLUSION: Although HIV-infected children <=24 months of age accounted for half of all children enrolling in care in our cohort during 2012-13, they represented less than a quarter of all those who were initiated on ART during the same period. Further research is needed to identify barriers to timely diagnosis, linkage to care, and initiation of ART among children with HIV infection.", "link"=>"http://www.mendeley.com/research/characteristics-hivinfected-children-enrollment-care-antiretroviral-therapy-initiation-central-afric", "reader_count"=>11, "reader_count_by_academic_status"=>{"Researcher"=>3, "Student > Doctoral Student"=>1, "Student > Master"=>4, "Other"=>1, "Student > Bachelor"=>1, "Lecturer"=>1}, "reader_count_by_user_role"=>{"Researcher"=>3, "Student > Doctoral Student"=>1, "Student > Master"=>4, "Other"=>1, "Student > Bachelor"=>1, "Lecturer"=>1}, "reader_count_by_subject_area"=>{"Nursing and Health Professions"=>3, "Medicine and Dentistry"=>7, "Psychology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>7}, "Psychology"=>{"Psychology"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}}, "group_count"=>2}

Scopus | Further Information

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