Risk of death among those awaiting treatment for HIV infection in Zimbabwe: adolescents are at particular risk.

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dc.contributor.authorShroufi, Amir
dc.contributor.authorNdebele, Wedu
dc.contributor.authorNyathi, Mary
dc.contributor.authorGunguwo, Hilary
dc.contributor.authorDixon, Mark
dc.contributor.authorTaziwa, Fabian
dc.date.accessioned2018-11-19T14:13:16Z
dc.date.accessioned2023-06-27T08:51:25Z
dc.date.available2018-11-19T14:13:16Z
dc.date.available2023-06-27T08:51:25Z
dc.date.issued2015-02-23
dc.descriptionOpen access journal articleen_US
dc.description.abstractIntroduction: Mortality among HIV-positive adults awaiting antiretroviral therapy (ART) has previously been found to be high. Here, we compare adolescent pre-ART mortality to that of adults in a public sector HIV care programme in Bulawayo, Zimbabwe. Methods: In this retrospective cohort study, we compared adolescent pre-ART outcomes with those of adults enrolled for HIV care in the same clinic. Adolescents were defined as those aged 1019 at the time of registration. Comparisons of means and proportions were carried out using two-tailed sample t-tests and chi-square tests respectively, for normally distributed data, and the MannWhitney U-tests for non-normally distributed data. Loss to follow-up (LTFU) was defined as missing a scheduled appointment by three or more months. Results: Between 2004 and 2010, 1382 of 1628 adolescents and 7557 of 11,106 adults who registered for HIV care met the eligibility criteria for ART. Adolescents registered at a more advanced disease stage than did adults (83% vs. 73% WHO stage III/ IV, respectively, pB0.001), and the median time to ART initiation was longer for adolescents than for adults [21 (1055) days vs. 15 (742) days, pB0.001]. Among the 138 adolescents and 942 adults who never commenced ART, 39 (28%) of adolescents and 135 (14%) of adults died, the remainder being LTFU. Mortality among treatment-eligible adolescents awaiting ART was significantly higher than among adults (3% vs. 1.8%, respectively, p 0.004). Conclusions: Adolescents present to ART services at a later clinical stage than adults and are at an increased risk of death prior to commencing ART. Improved and innovative HIV case-finding approaches and emphasis on prompt ART initiation in adolescents are urgently needed. Following registration, defaulter tracing should be used, whether or not ART has been commenced.en_US
dc.identifier.citationShroufi A. and Ndebele W. et.al. (2015). Risk of death among those awaiting treatment for HIV infection in Zimbabwe: adolescents are at particular risk. Journal of the International AIDS Society, 18: 19247 p 1-6.en_US
dc.identifier.issn1758-2652
dc.identifier.urihttp://196.220.97.103:4000/handle/123456789/983
dc.language.isoenen_US
dc.publisherWiley Open Accessen_US
dc.subjectHIV/AIDSen_US
dc.subjectARTen_US
dc.subjectAdolescenten_US
dc.subjectpre-Arten_US
dc.subjectAfricaen_US
dc.titleRisk of death among those awaiting treatment for HIV infection in Zimbabwe: adolescents are at particular risk.en_US
dc.typeArticleen_US
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