Outcomes and Impact of HIV Prevention, ART and TB Programs in Swaziland – Early Evidence from Public Health TriangulationReportar como inadecuado




Outcomes and Impact of HIV Prevention, ART and TB Programs in Swaziland – Early Evidence from Public Health Triangulation - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Introduction

Swaziland’s severe HIV epidemic inspired an early national response since the late 1980s, and regular reporting of program outcomes since the onset of a national antiretroviral treatment ART program in 2004. We assessed effectiveness outcomes and mortality trends in relation to ART, HIV testing and counseling HTC, tuberculosis TB and prevention of mother to child transmission PMTCT.

Methods

Data triangulated include intervention coverage and outcomes according to program registries 2001-2010, hospital admissions and deaths disaggregated by age and sex 2001-2010 and population mortality estimates from the 1997 and 2007 censuses and the 2007 demographic and health survey.

Results

By 2010, ART reached 70% of the estimated number of people living with HIV-AIDS with CD4<350-mm3, with progressively improving patient retention and survival. As of 2010, 88% of health facilities providing antenatal care offered comprehensive PMTCT services. The HTC program recorded a halving in the proportion of adults tested who were HIV-infected; similarly HIV infection rates among HIV-exposed babies halved from 2007 to 2010. Case fatality rates among hospital patients diagnosed with HIV-AIDS started to decrease from 2005–6 in adults and especially in children, contrasting with stable case fatality for other causes including TB. All-cause child in-patient case fatality rates started to decrease from 2005–6. TB case notifications as well as rates of HIV-TB co-infection among notified TB patients continued a steady increase through 2010, while coverage of HIV testing and CPT for co-infected patients increased to above 80%.

Conclusion

Against a background of high, but stable HIV prevalence and decreasing HIV incidence, we documented early evidence of a mortality decline associated with the expanded national HIV response since 2004. Attribution of impact to specific interventions versus natural epidemic dynamics will require additional data from future household surveys, and improved routine program, surveillance, and hospital data at district level.



Autor: Cari van Schalkwyk , Sibongile Mndzebele, Thabo Hlophe, Jesus Maria Garcia Calleja, Eline L. Korenromp, Rand Stoneburner, Cyril P

Fuente: http://plos.srce.hr/



DESCARGAR PDF




Documentos relacionados