A decade of HIV care in rural Tanzania: Trends in clinical outcomes and impact of clinic optimisation in an open, prospective cohort.

Fiona Vanobberghen
Emilio Letang
Anna Gamell
Dorcas K Mnzava
Diana Faini
Lameck B Luwanda
Herry Mapesi
Kim Mwamelo
George Sikalengo
Marcel Tanner
Christoph Hatz
Hansjakob Furrer
Manuel Battegay
Tracy R Glass
KIULARCO Study Group

Open link

Publication date

January 2017

DOI

10.1371/journal.pone.0180983

Publisher

Public Library of Science (PLoS)

Journal

PLoS ONE

Abstract

Our objectives were to describe trends in enrolment and clinical outcomes in the open, prospective Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) in the Morogoro region of southern Tanzania, and identify strengths and areas for improvement in the care of HIV-positive individuals in rural Tanzania.We included adults (≥15 years) and children (<15 years) enrolled in the cohort in 2005-2014. The cohort underwent significant changes from autumn 2012 to optimise care. We evaluated mortality and loss to follow-up (LTFU) using competing risks methods, ART usage, opportunistic infections (OI), co-infections and laboratory abnormalities.Overall, 7010 adults and 680 children were enrolled; enrolment peaked in 2008 but has increased steadily sin...