Evidence map›Paper›PMID 22815862›Full record

Trial reportPloS one2012

Antiretroviral treatment for HIV in rural Uganda: two-year treatment outcomes of a prospective health centre/community-based and hospital-based cohort.

Walter Kipp, Joseph Konde-Lule, L Duncan Saunders, Arif Alibhai, Stan Houston, Tom Rubaale, Ambikaipakan Senthilselvan, Joa Okech-Ojony

Registry-linked trialAbstract readClinical TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02776254 (Community ART for Retention in Zambia), which is not on this map. Cited by 32 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02776254 nacompletednot on this mapstarted 2016, after this paper: background citation

Community ART for Retention in Zambia: Evaluating the Feasibility, Effectiveness, and Efficiency of Decentralized and Streamlined Antiretroviral Therapy Care Models

TypeinterventionalSponsorCentre for Infectious Disease Research in ZambiaRan2016 to 2017Enrolled3,100ConditionsHIVArmsSTART, CAG, UAG, FAST-TRACK
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  10. Decentralising HIV treatment in lower- and middle-income countries.The Cochrane database of systematic reviews · 2013
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Walter KippDepartment of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Canada. walter.kipp@ualberta.ca
Joseph Konde-Lule
L Duncan Saunders
Arif Alibhai
Stan Houston
Tom Rubaale
Ambikaipakan Senthilselvan
Joa Okech-Ojony

Funding

Canadian Institutes of Health Research MOP-74586
6 · The paper itself

Abstract

backgroundIn sub-Saharan Africa, a shortage of trained health professionals and limited geographical access to health facilities present major barriers to the expansion of antiretroviral therapy (ART). We tested the utility of a health centre (HC)/community-based approach in the provision of ART to persons living with HIV in a rural area in western Uganda.

methodsThe HIV treatment outcomes of the HC/community-based ART program were evaluated and compared with those of an ART program at a best-practice regional hospital. The HC/community-based cohort comprised 185 treatment-naïve patients enrolled in 2006. The hospital cohort comprised of 200 patients enrolled in the same time period. The HC/community-based program involved weekly home visits to patients by community volunteers who were trained to deliver antiretroviral drugs to monitor and support adherence to treatment, and to identify and report adverse reactions and other clinical symptoms. Treatment supporters in the homes also had the responsibility to remind patients to take their drugs regularly. ART treatment outcomes were measured by HIV-1 RNA viral load (VL) after two years of treatment. Adherence was determined through weekly pill counts.

resultsSuccessful ART treatment outcomes in the HC/community-based cohort were equivalent to those in the hospital-based cohort after two years of treatment in on-treatment analysis (VL≤400 copies/mL, 93.0% vs. 87.3%, p = 0.12), and in intention-to-treat analysis (VL≤400 copies/mL, 64.9% and 62.0%, p = 0.560). In multivariate analysis patients in the HC/community-based cohort were more likely to have virologic suppression compared to hospital-based patients (adjusted OR = 2.47, 95% CI 1.01-6.04).

conclusionAcceptable rates of virologic suppression were achieved using existing rural clinic and community resources in a HC/community-based ART program run by clinical officers and supported by lay volunteers and treatment supporters. The results were equivalent to those of a hospital-based ART program run primarily by doctors.

Indexed as

Antiretroviral Therapy, Highly ActiveCommunity Health CentersHospitalsRural PopulationAdultAnti-HIV AgentsConfidence IntervalsDemographyFemaleFollow-Up StudiesHIV InfectionsHumansKaplan-Meier EstimateMaleOdds RatioPatient ComplianceAnti-HIV Agents

Identifiers

PMID22815862
PMCPMC3398945

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.