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Treatment Outcomes in a Decentralized Antiretroviral Therapy Program : A Comparison of Two Levels of Care in North Central Nigeria
Joint Authors
Okonkwo, Prosper
Imade, Godwin E.
Oyebode, Tinuade A.
Agbaji, Oche O.
Idoko, John A.
Yohanna, Stephen
Agaba, Patricia A.
Banigbe, Bolanle
Adeola, Juliet
Kanki, Phyllis J.
Sagay, Atiene S.
Source
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-10, 10 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-06-16
Country of Publication
Egypt
No. of Pages
10
Main Subjects
Abstract EN
Background.
Decentralization of antiretroviral therapy (ART) services is a key strategy to achieving universal access to treatment for people living with HIV/AIDS.
Our objective was to assess clinical and laboratory outcomes within a decentralized program in Nigeria.
Methods.
Using a tiered hub-and-spoke model to decentralize services, a tertiary hospital scaled down services to 13 secondary-level hospitals using national and program guidelines.
We obtained sociodemographic, clinical, and immunovirologic data on previously antiretroviral drug naïve patients aged ≥15 years that received HAART for at least 6 months and compared treatment outcomes between the prime and satellite sites.
Results.
Out of 7,747 patients, 3729 (48.1%) were enrolled at the satellites while on HAART, prime site patients achieved better immune reconstitution based on CD4+ cell counts at 12 (P<0.001) and 24 weeks (P<0.001) with similar responses at 48 weeks (P=0.11) and higher rates of viral suppression (<400 c/mL) at 12 (P<0.001) and 48 weeks (P=0.03), but similar responses at 24 weeks (P=0.21).
Mortality was 2.3% versus 5.0% (P<0.001) at prime and satellite sites, while transfer rate was 8.7% versus 5.5% (P=0.001) at prime and satellites.
Conclusion.
ART decentralization is feasible in resource-limited settings, but efforts have to be intensified to maintain good quality of care.
American Psychological Association (APA)
Okonkwo, Prosper& Sagay, Atiene S.& Agaba, Patricia A.& Yohanna, Stephen& Agbaji, Oche O.& Imade, Godwin E.…[et al.]. 2014. Treatment Outcomes in a Decentralized Antiretroviral Therapy Program : A Comparison of Two Levels of Care in North Central Nigeria. AIDS Research and Treatment،Vol. 2014, no. 2014, pp.1-10.
https://search.emarefa.net/detail/BIM-480788
Modern Language Association (MLA)
Okonkwo, Prosper…[et al.]. Treatment Outcomes in a Decentralized Antiretroviral Therapy Program : A Comparison of Two Levels of Care in North Central Nigeria. AIDS Research and Treatment No. 2014 (2014), pp.1-10.
https://search.emarefa.net/detail/BIM-480788
American Medical Association (AMA)
Okonkwo, Prosper& Sagay, Atiene S.& Agaba, Patricia A.& Yohanna, Stephen& Agbaji, Oche O.& Imade, Godwin E.…[et al.]. Treatment Outcomes in a Decentralized Antiretroviral Therapy Program : A Comparison of Two Levels of Care in North Central Nigeria. AIDS Research and Treatment. 2014. Vol. 2014, no. 2014, pp.1-10.
https://search.emarefa.net/detail/BIM-480788
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-480788