Evidence map›Paper›PMID 30422899›Full record

ArticleJournal of acquired immune deficiency syndromes (1999)2019

Better Outcomes Among HIV-Infected Rwandan Children 18-60 Months of Age After the Implementation of "Treat All".

Stephen Arpadi, Matthew Lamb, Isaie N Nzeyimana, Greet Vandebriel, Gloria Anyalechi, Marcia Wong, Rebecca Smith, Emilia D Rivadeneira, Eugenie Kayirangwa, Samuel S Malamba and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of acquired immune deficiency syndromes (1999), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 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.

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

5 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Review
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

14 authors.

Stephen ArpadiICAP at Columbia, Mailman School of Public Health, Columbia University, New York, NY.
Matthew LambICAP at Columbia, Mailman School of Public Health, Columbia University, New York, NY.
Isaie N NzeyimanaICAP at Columbia, Mailman School of Public Health, Columbia University, New York, NY.
Greet VandebrielICAP at Columbia, Mailman School of Public Health, Columbia University, New York, NY.
Gloria AnyalechiUS Centers for Disease Control and Prevention, Atlanta, GA.
Marcia WongICAP at Columbia, Mailman School of Public Health, Columbia University, New York, NY.
Rebecca SmithICAP at Columbia, Mailman School of Public Health, Columbia University, New York, NY.
Emilia D RivadeneiraUS Centers for Disease Control and Prevention, Atlanta, GA.
Eugenie KayirangwaUS Centers for Disease Control and Prevention, Kigali, Rwanda.
Samuel S MalambaUS Centers for Disease Control and Prevention, Kigali, Rwanda.
Canisious MusoniUS Centers for Disease Control and Prevention, Kigali, Rwanda.
Emilia H KoumansUS Centers for Disease Control and Prevention, Atlanta, GA.
Mollie BraatenICAP at Columbia, Mailman School of Public Health, Columbia University, New York, NY.
Sabin NsanzimanaRwanda Biomedical Center, Kigali, Rwanda.

Funding

CGH CDC HHS U2G GH000994
6 · The paper itself

Abstract

backgroundIn 2012, Rwanda introduced a Treat All approach for HIV-infected children younger than 5 years. We compared antiretroviral therapy (ART) initiation, outcomes, and retention, before and after this change.

methodsWe conducted a retrospective study of children enrolled into care between June 2009 and December 2011 [Before Treat All (BTA) cohort] and between July 2012 and April 2015 [Treat All (TA) cohort].

settingMedical records of a nationally representative sample were abstracted for all eligible aged 18-60 months from 100 Rwandan public health facilities.

resultsWe abstracted 374 medical records: 227 in the BTA and 147 in the TA cohorts. Mean (SD) age at enrollment was [3 years (1.1)]. Among BTA, 59% initiated ART within 1 year, vs. 89% in the TA cohort. Median time to ART initiation was 68 days (interquartile range 14-494) for BTA and 9 days (interquartile range 0-28) for TA (P < 0.0001), with 9 (5%) undergoing same-day initiation in BTA compared with 50 (37%) in TA (P < 0.0001). Before ART initiation, 59% in the BTA reported at least one health condition compared with 35% in the TA cohort (P < 0.0001). Although overall loss to follow-up was similar between cohorts (BTA: 13%, TA: 8%, P = 0.18), loss to follow-up before ART was significantly higher in the BTA (8%) compared with the TA cohort (2%) (P = 0.02).

conclusionsNearly 90% of Rwandan children started on ART within 1 year of enrollment, most within 1 month, with greater than 90% retention after implementation of TA. TA was also associated with fewer morbidities.

Indexed as

National Health ProgramsAnti-HIV AgentsChild, PreschoolFemaleHIV-1HIV InfectionsHumansInfantMaleRetrospective StudiesRwandaViral LoadAnti-HIV Agents

Identifiers

PMID30422899
PMCPMC6392203

What OpenQuestion holds

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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.