Where do HIV-infected adolescents go after transfer? – Tracking transition/transfer of HIV-infected adolescents using linkage of cohort data to a health information system platform

Simple item page
dc.contributor.authorDavies, Mary-Annen_ZA
dc.contributor.authorTsondai, Priscillaen_ZA
dc.contributor.authorTiffin, Nickien_ZA
dc.contributor.authorEley, Brianen_ZA
dc.contributor.authorRabie, Helenaen_ZA
dc.contributor.authorEuvrard, Jonathanen_ZA
dc.contributor.authorOrrell, Catherineen_ZA
dc.contributor.authorProzesky, Hansen_ZA
dc.contributor.authorWood, Robinen_ZA
dc.contributor.authorCogill, Dolphinaen_ZA
dc.contributor.authorHaas, Andreas D.en_ZA
dc.contributor.authorSohn, Annette H.en_ZA
dc.contributor.authorBoulle, Andrewen_ZA
dc.date.accessioned2018-10-23T08:51:41Z
dc.date.available2018-10-23T08:51:41Z
dc.date.issued2017
dc.descriptionCITATION: Davies, M. A., et al. 2017. Where do HIV-infected adolescents go after transfer? – Tracking transition/transfer of HIV-infected adolescents using linkage of cohort data to a health information system platform. Journal of the International AIDS Society, 20(S3):21668, doi:10.7448/IAS.20.4.21668.
dc.descriptionThe original publication is available at https://onlinelibrary.wiley.com
dc.description.abstractIntroduction: To evaluate long-term outcomes in HIV-infected adolescents, it is important to identify ways of tracking outcomes after transfer to a different health facility. The Department of Health (DoH) in the Western Cape Province (WCP) of South Africa uses a single unique identifier for all patients across the health service platform. We examined adolescent outcomes after transfer by linking data from four International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) cohorts in the WCP with DoH data. Methods: We included adolescents on antiretroviral therapy who transferred out of their original cohort from 10 to 19 years of age between 2004 and 2014. The DoH conducted the linkage separately for each cohort and linked anonymized data were then combined. The primary outcome was successful transfer defined as having a patient record at a facility other than the original facility after the transfer date. Secondary outcomes included the proportion of patients retained, with HIV-RNA <400 copies/ml and CD4 > 500 cells/μl at 1, 2 and 3 years post-transfer. Results: Of 460 adolescents transferred out (53% female), 72% transferred at 10–14 years old, and 79% transferred out of tertiary facilities. Overall, 81% of patients transferred successfully at a median (interquartile range) of 56 (27–134) days following transfer date; 95% reached the transfer site <18 months after transfer out. Among those transferring successfully, the proportion retained decreased from 1 to 3 years post-transfer (90–84%). There was no significant difference between transfer and 1–3 years post-transfer in the proportion of retained adolescents with HIV-RNA <400 copies/ml and CD4 > 500 cells/μl except for HIV-RNA <400 copies/ml at 3 years (86% vs. 75%; p = 0.007). The proportion virologically suppressed and with CD4 > 500 cells/μl was significantly lower at 1 and 2 years post-transfer in those transferring at 15–19 vs. 10–14 years of age. Using laboratory data alone over-estimated time to successful transfer. Conclusions: Linking cohort data to health information system data allowed efficient assessment of post-transfer outcomes. Although >80% of adolescents transferred successfully with nearly 85% of them retained for 3 years post-transfer, the decline in the proportion virologically suppressed and poorer outcomes in older adolescents are concerns.en_ZA
dc.description.urihttps://onlinelibrary.wiley.com/doi/full/10.7448/IAS.20.4.21668
dc.description.versionPublisher's version
dc.format.extent9 pages
dc.identifier.citationDavies, M. A., et al. 2017. Where do HIV-infected adolescents go after transfer? – Tracking transition/transfer of HIV-infected adolescents using linkage of cohort data to a health information system platform. Journal of the International AIDS Society, 20(S3):21668, doi:10.7448/IAS.20.4.21668
dc.identifier.issn1758-2652 (online)
dc.identifier.otherdoi:10.7448/IAS.20.4.21668
dc.identifier.urihttp://hdl.handle.net/10019.1/104593
dc.language.isoen_ZAen_ZA
dc.publisherWiley Open Access
dc.rights.holderAuthors retain copyright
dc.subjectHIV-positive childrenen_ZA
dc.titleWhere do HIV-infected adolescents go after transfer? – Tracking transition/transfer of HIV-infected adolescents using linkage of cohort data to a health information system platformen_ZA
dc.typeArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
davies_adolescents_2017.pdf
Size:
324.18 KB
Format:
Adobe Portable Document Format
Description:
Download article
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
1.95 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Research Articles (Paediatrics and Child Health)