A 10-year cohort analysis of routine paediatric ART data in a rural South African setting

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Authors

Lilian, R.P.
Mutasa, B.
Railton, J.
Mongwe, W.
McIntyre, J.A.
Struthers, H.E.
Peters, Remco P.H.

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Cambridge University Press

Abstract

South Africa’s paediatric antiretroviral therapy (ART) programme is managed using a monitoring and evaluation tool known as TIER.Net. This electronic system has several advantages over paper-based systems, allowing profiling of the paediatric ART programme over time. We analysed anonymized TIER.Net data for HIV-infected children aged <15 years who had initiated ART in a rural district of South Africa between 2005 and 2014. We performed Kaplan–Meier survival analysis to assess outcomes over time. Records of 5461 children were available for analysis; 3593 (66%) children were retained in care. Losses from the programme were higher in children initiated on treatment in more recent years (P < 0·0001) and in children aged ≤1 year at treatment initiation (P < 0·0001). For children aged <3 years, abacavir was associated with a significantly higher rate of loss from the programme compared to stavudine (hazard ratio 1·9, P < 0·001). Viral load was suppressed in 48–52% of the cohort, with no significant change over the years (P = 0·398). Analysis of TIER.Net data over time provides enhanced insights into the performance of the paediatric ART programme and highlights interventions to improve programme performance.

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Keywords

Analysis of data, HIV/AIDS, Paediatrics, Public health, Human immunodeficiency virus (HIV), Acquired immune deficiency syndrome (AIDS), Antiretroviral therapy (ART)

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Citation

Lilian, RR, Mutasa, B, Railton, J, Mongwe, W, McIntyre, JA, Struthers, HE & Peters, RPH 2016, 'A 10-year cohort analysis of routine paediatric ART data in a rural South African setting', Epidemiology and Infection, vol. 145, no. 1, pp. 170-180.