Trends in all-cause mortality during the scale-up of an antiretroviral therapy programme: a cross-sectional study in Lusaka, Zambia.
Objective To follow the trends in all-cause mortality in Lusaka, Zambia, during the scale-up of a national programme of antiretroviral therapy (ART). Methods Between November 2004 and September 2011, we conducted 12 survey rounds as part of a cross-sectional study in Lusaka, with independent samplin...
| Publicado en: | Bulletin of the World Health Organization Vol. 92; no. 10; pp. 734 - 742 |
|---|---|
| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
World Health Organization
Oct2014
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103903224&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103903224 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00429686 BUW jtl: Bulletin of the World Health Organization issn: 00429686 maglogo: N pubinfo: dt: Oct2014 vid: 92 iid: 10 pid: 437 pub: World Health Organization artinfo: ui: 103903224 98737226 10.2471/BLT.13.134239 103903224 ppf: 734 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Trends in all-cause mortality during the scale-up of an antiretroviral therapy programme: a cross-sectional study in Lusaka, Zambia. aug: au: Rathod, Sujit D. Chi, Benjamin H. Kusanthan, Thankian Chilopa, Batista Levy, Jens Sikazwe, Izukanji Mwaba, Peter Stringer, Jeffrey S. A. affil: Department of Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, England sug: subj: Mortality Trends Antiretroviral Therapy, Highly Active Evaluation Anti-HIV Agents Funding Source Human Male Female Cross Sectional Studies Zambia Surveys Descriptive Statistics Confidence Intervals P-Value Random Sample Interviews Data Analysis, Statistical Data Analysis Software Poisson Distribution Infant Child, Preschool Child Adolescence Adult Middle Age Aged Infant: 1-23 months Child, Preschool: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Objective To follow the trends in all-cause mortality in Lusaka, Zambia, during the scale-up of a national programme of antiretroviral therapy (ART). Methods Between November 2004 and September 2011, we conducted 12 survey rounds as part of a cross-sectional study in Lusaka, with independent sampling in each round. In each survey, we asked the heads of 3600 households to state the number of deaths in their households in the previous 12 months and the number of orphans aged less than 16 years in their households and investigated the heads’ knowledge, attitudes and practices related to human immunodeficiency virus (HIV). Findings The number of deaths we recorded--per 100 person–years--in each survey ranged from 0.92 (95% confidence interval, CI: 0.78-1.09) in September 2011, to 1.94 (95% CI: 1.60-2.35) in March 2007. We found that mortality decreased only modestly each year (mortality rate ratio: 0.98; 95% CI: 0.95-1.00; P = 0.093). The proportion of households with orphans under the age of 16 years decreased from 17% in 2004 to 7% in 2011. The proportions of respondents who had ever been tested for HIV, had a comprehensive knowledge of HIV, knew where to obtain free ART and reported that a non-pregnant household member was receiving ART gradually increased. Conclusion The expansion of ART services in Lusaka was not associated with a reduction in all-cause mortality. Coverage, patient adherence and retention may all have to be increased if ART is to have a robust and lasting impact at population level in Lusaka. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|