Evidence map›Paper›PMID 25822098›Full record

Observational studyPathogens and global health2015

Enrolment trends in a comprehensive HIV programme in rural north-central Nigeria: improved care indices, but declining quality of clinical data over time.

Muktar H Aliyu, Meridith Blevins, Folasade Arinze, Karen M Megazzini, Scottie Bussell, Julie Dunlap, Chisom Odoh, Usman I Gebi, Mukhtar Y Muhammad, Bryan E Shepherd and 3 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Pathogens and global health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. 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

13 authors.

Muktar H Aliyu
Meridith Blevins
Folasade Arinze
Karen M Megazzini
Scottie Bussell
Julie Dunlap
Chisom Odoh
Usman I Gebi
Mukhtar Y Muhammad
Bryan E Shepherd
Carolyn M Audet
Sten H Vermund
C William Wester

Funding

The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Tennessee CFAR: Implementation of Culturally Responsive Trauma-Informed Care with Youth with HIV in Memphis, TNP30AI110527 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Stephany Norah Duda · 2015 to 2026
$27.5M
VIROLOGY COREP30AI054999 · NIAID · VANDERBILT UNIVERSITY · PI D'AQUILA, RICHARD · 2003 to 2011
$10.3M
Optimizing integrated PMTCT services in rural North-Central NigeriaR01HD075075 · NICHD · VANDERBILT UNIVERSITY · PI ALIYU, MUKTAR HASSAN · 2012 to 2013
$895k
NCATS NIH HHS KL2TR000445NIAID NIH HHS P30 AI054999NIAID NIH HHS P30 AI110527NICHD NIH HHS NIHR01HD075075NICHD NIH HHS R01 HD075075NICHD NIH HHS R01HD075075
6 · The paper itself

Abstract

backgroundVanderbilt University affiliate Friends in Global Health was funded in 2008 to support comprehensive HIV/AIDS services in north-central Nigeria. We summarise programme characteristics and trends in enrolment and quality of data collection in this rural, resource-limited environment.

methodsWe used routinely collected programme data in supported sites from June 1 2009 to September 30, 2013.Baseline characteristics were defined as those collected closest to a 90-day window period before and after enrolment. Summary characteristics were compared by site and enrolment year.

resultsWe enrolled 3,960 HIV-infected patients into care (68% women), median age of 32 years [interquartile range (IQR): 27-40]. Most clients were married (79%) and unemployed (60%). At enrolment, median CD4+ cell count was 230 cells/μL (IQR: 114-390) and haemoglobin was 10.7 g/dL (IQR: 9.3-11.9). Advanced clinical disease [World Health Organization (WHO) clinical stage III/IV] at enrolment was documented in 29% of clients. Cumulative enrolment increased from 377 patients in 2009 to 3,960 patients by 2013.With each successive year, more clients were enrolled at earlier stages of disease; in 2009, 37% of patients were identified as WHO clinical stage I, while in 2013, 55% of patients were so classified. While documentation of clinical staging remained stable, the completeness of CD4+ cell count and haemoglobin data declined with time.

conclusionExpanded testing in a comprehensive HIV programme in rural Nigeria brought persons to care at earlier stages of illness. Yet, as clinical services expanded, data collection quality declined. The paradox of successful scaling up HIV services but deteriorating quality of data underscores the importance of data management training and quality improvement efforts.

Indexed as

Health Services ResearchAdultAnti-HIV AgentsAntiretroviral Therapy, Highly ActiveCD4 Lymphocyte CountFemaleHIV InfectionsHumansMaleNigeriaProgram EvaluationRural PopulationSurvival AnalysisTime FactorsAnti-HIV Agentsdata quality,enrolment,HIV/AIDS,PEPFAR,rural Nigeriatrends,

Identifiers

PMID25822098
PMCPMC4571821

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Registered trials

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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.