Evidence map›Paper›PMID 25706652›Full record

Trial reportPloS one2015

Kericho CLinic-based ART Diagnostic Evaluation (CLADE): design, accrual, and baseline characteristics of a randomized controlled trial conducted in predominately rural, district-level, HIV clinics of Kenya.

Fredrick K Sawe, Eunice Obiero, Peter Yegon, Rither C Langat, Appolonia Aoko, Jemutai Tarus, Ignatius Kiptoo, Raphael K Langat, Jonah Maswai, Margaret Bii and 5 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01791556 (Clinic-based ART Diagnostic Evaluation), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 94% of its field
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.

NCT01791556 nacompletednot on this map

Clinic-based ART Diagnostic Evaluation

TypeinterventionalSponsorWalter Reed Army Institute of Research (WRAIR)Ran2010 to 2012Enrolled820ConditionsAcquired Immunodeficiency Syndrome, HIV Infection, RNA Virus Infections, Virus DiseasesArmsHIV-1 viral load testing
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
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

15 authors at 3 institutions in 2 countries.

Fredrick K SaweKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America; Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD, United States of America.
Eunice ObieroKericho District Hospital, Kenya Ministry of Public Health and Sanitation, Kericho, Kenya.
Peter YegonKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; HJF Medical Research International, Inc., Kericho, Kenya.
Rither C LangatKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; HJF Medical Research International, Inc., Kericho, Kenya.
Appolonia AokoKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; HJF Medical Research International, Inc., Kericho, Kenya.
Jemutai TarusKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; HJF Medical Research International, Inc., Kericho, Kenya.
Ignatius KiptooKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya.
Raphael K LangatKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; HJF Medical Research International, Inc., Kericho, Kenya.
Jonah MaswaiKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; HJF Medical Research International, Inc., Kericho, Kenya.
Margaret BiiKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; HJF Medical Research International, Inc., Kericho, Kenya.
Samoel KhamadiKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; HJF Medical Research International, Inc., Kericho, Kenya.
Kibet P ShikukuKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya.
Nicole CloseEmpiriStat, Mt Airy, MD, United States of America.
Samuel SineiKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; HJF Medical Research International, Inc., Kericho, Kenya.
Douglas N ShafferKenya Medical Research Institute/Walter Reed Project, Kericho, Kenya; U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States of America.
Kenya Medical Research Institute · KEWalter Reed Army Institute of Research · USMinistry of Health · KE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProspective clinical trial data regarding routine HIV-1 viral load (VL) monitoring of antiretroviral therapy (ART) in non-research clinics of Sub-Saharan Africa are needed for policy makers.

methodsCLinic-based ART Diagnostic Evaluation (CLADE) is a randomized, controlled trial (RCT) evaluating feasibility, superiority, and cost-effectiveness of routine VL vs. standard of care (clinical and immunological) monitoring in adults initiating dual nucleoside reverse transcriptase inhibitor (NRTI)+non-NRTI ART. Participants were randomized (1:1) at 7 predominately rural, non-research, district-level clinics of western Kenya. Descriptive statistics present accrual patterns and baseline cohort characteristics.

resultsOver 15 months, 820 adults enrolled at 7 sites with 86-152 enrolled per site. Monthly site enrollment ranged from 2-92 participants. Full (100%) informed consent compliance was independently documented. Half (49.9%) had HIV diagnosed through voluntary counseling and testing. Study arms were similar: mostly females (57.6%) aged 37.6 (SD = 9.0) years with low CD4 (166 [SD = 106]) cells/m3). Notable proportions had WHO Stage III or IV disease (28.7%), BMI <18.5 kg/m2 (23.1%), and a history of tuberculosis (5.6%) or were receiving tuberculosis treatment (8.2%) at ART initiation. In the routine VL arm, 407/409 (99.5%) received baseline VL (234,577 SD = 151,055 copies/ml). All participants received lamivudine; 49.8% started zidovudine followed by 38.4% stavudine and 11.8% tenofovir; and, 64.4% received nevirapine as nNRTI (35.6% efavirenz).

conclusionsA RCT can be enrolled successfully in rural, non-research, resource limited, district-level clinics in western Kenya. Many adults presenting for ART have advanced HIV/AIDS, emphasizing the importance of universal HIV testing and linkage-to-care campaigns.

trial registrationClinicalTrials.gov NCT01791556.

Indexed as

Viral LoadAdultAnti-HIV AgentsCost-Benefit AnalysisFemaleHIV-1HIV InfectionsHumansKenyaMaleMiddle AgedNevirapineProspective StudiesResearch DesignReverse Transcriptase InhibitorsTreatment OutcomeAnti-HIV AgentsNevirapineReverse Transcriptase InhibitorsZidovudine

Identifiers

PMID25706652
PMCPMC4338154
OpenAlexW2051065481

What OpenQuestion holds

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LicenceCC BY
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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.