ArticleGlobal health action2013
Decentralised paediatric HIV care in Ethiopia: a comparison between outcomes of patients managed in health centres and in a hospital clinic.
Article in Global health action, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 4 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- The effects of decentralising antiretroviral therapy care delivery on health outcomes for adolescents and young adults in low- and middle-income countries: a systematic review.Global health action · 2019Pooled it
- Decentralization of health systems in low and middle income countries: a systematic review.International journal of public health · 2017Pooled it
- Pooled it
- Growth reconstitution following antiretroviral therapy and nutritional supplementation: systematic review and meta-analysis.AIDS (London, England) · 2015Pooled it
- Article
- Level of Attrition from Antiretroviral Therapy Among Human Immune Deficiency Virus-Infected Children: The Cases of Sidama Zone, Southern Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Incidence and Predictors of Loss to Follow-Up Among Children Attending ART Clinics in Northeast Ethiopia: A Retrospective Cohort Study.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Lessons for test and treat in an antiretroviral programme after decentralisation in Uganda: a retrospective analysis of outcomes in public healthcare facilities within the Lablite project.International health · 2020Article
- Article
- Rates and predictors of attrition among children on antiretroviral therapy in Ethiopia: A prospective cohort study.PloS one · 2018Article
- High risk of loss to follow-up among South African children on ART during transfer, a retrospective cohort analysis with community tracing.Journal of the International AIDS Society · 2017Article
- Outcomes among HIV-infected children initiating HIV care and antiretroviral treatment in Ethiopia.Tropical medicine & international health : TM & IH · 2017Article
- Retention in care among HIV-positive patients initiating second-line antiretroviral therapy: a retrospective study from an Ethiopian public hospital clinic.Global health action · 2016Article
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4 authors.
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Abstract
backgroundIn order to increase access to antiretroviral therapy (ART) in HIV-infected children, paediatric HIV care has been introduced in health centres in Ethiopia, where patients are managed by health professionals with limited training.
objectiveTo compare outcomes of paediatric HIV care in hospital and health centre clinics and to determine risk factors for death and loss to follow-up (LTFU).
designRetrospective comparison of patient characteristics and outcomes among children managed in a public hospital and all five public health centres in the uptake area.
resultsAmong 1,960 patients (health centres 572, hospital clinic 1,388), 34% were lost to follow-up, 2% died, 14% were transferred out, and 46% remained in care. Children initiating ART in the hospital clinic had lower median CD4 cell counts (age <1 year: 575 vs. 1,183 cells/mm³, p=0.024; age 1-5 years: 370 vs. 598 cells/mm³, p<0.001; age >5 years: 186 vs. 259 cells/mm³, p<0.001), and a higher proportion were <1 year of age (22% vs. 15%, p=0.025). ART initiation rates and retention in care were similar between children managed in health centres and in the hospital clinic (36% vs. 37% and 47% vs. 46%, respectively). Among patients starting ART, mortality was associated with age <1 year [hazard ratio (HR) 12.0; 95% confidence interval (CI): 3.5, 41]. LTFU was associated with CD4 cell counts <350 cells/mm³ (HR 1.8; 95% CI: 1.2, 3.0), weight-for-age z-scores below -4 (HR 2.8; 95% CI: 1.4, 5.6), and age <5 years (1-5 years: HR 1.6; 95% CI: 1.0, 2.5; <1 year: HR 3.3; 95% CI: 1.6, 6.6).
conclusionsOutcomes of HIV care were similar for Ethiopian children managed in a hospital clinic or in health centres. However, patients treated at the hospital clinic had characteristics of more advanced disease. Rates of LTFU were high in both types of health facility.
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