Browsing by Author "Bolton-Moore, Carolyn"

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    Global HIV prevention, care and treatment services for children: a cross-sectional survey from the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium
    (BMJ, 2023-03-13) Vreeman, Rachel C.; Yiannoutsos, Constantin T.; Yusoff, Nik Khairulddin Nik; Wester, C. William; Edmonds, Andrew; Ofner, Susan; Davies, Mary-Ann; Leroy, Valériane; Lumbiganon, Pagakrong; de Menezes Succi, Regina Célia; Twizere, Christella; Brown, Steven; Bolton-Moore, Carolyn; Takassi, Ounoo Elom; Scanlon, Michael; Martin, Roxanne; Wools-Kaloustian, Kara; IeDEA; Biostatistics and Health Data Science, School of Medicine
    Objectives: To assess access children with HIV have to comprehensive HIV care services, to longitudinally evaluate the implementation and scale-up of services, and to use site services and clinical cohort data to explore whether access to these services influences retention in care. Methods: A cross-sectional standardised survey was completed in 2014-2015 by sites providing paediatric HIV care across regions of the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We developed a comprehensiveness score based on the WHO's nine categories of essential services to categorise sites as 'low' (0-5), 'medium', (6-7) or 'high' (8-9). When available, comprehensiveness scores were compared with scores from a 2009 survey. We used patient-level data with site services to investigate the relationship between the comprehensiveness of services and retention. Results: Survey data from 174 IeDEA sites in 32 countries were analysed. Of the WHO essential services, sites were most likely to offer antiretroviral therapy (ART) provision and counselling (n=173; 99%), co-trimoxazole prophylaxis (168; 97%), prevention of perinatal transmission services (167; 96%), outreach for patient engagement and follow-up (166; 95%), CD4 cell count testing (126; 88%), tuberculosis screening (151; 87%) and select immunisation services (126; 72%). Sites were less likely to offer nutrition/food support (97; 56%), viral load testing (99; 69%) and HIV counselling and testing (69; 40%). 10% of sites rated 'low', 59% 'medium' and 31% 'high' in the comprehensiveness score. The mean comprehensiveness of services score increased significantly from 5.6 in 2009 to 7.3 in 2014 (p<0.001; n=30). Patient-level analysis of lost to follow-up after ART initiation estimated the hazard was highest in sites rated 'low' and lowest in sites rated 'high'. Conclusion: This global assessment suggests the potential care impact of scaling-up and sustaining comprehensive paediatric HIV services. Meeting recommendations for comprehensive HIV services should remain a global priority.
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    The Tuberculosis Sentinel Research Network (TB-SRN) of the International epidemiology Databases to Evaluate AIDS (IeDEA): protocol for a prospective cohort study in Africa, Southeast Asia and Latin America
    (BMJ, 2024-01-09) Enane, Leslie A.; Duda, Stephany N.; Chanyachukul, Thida; Bolton-Moore, Carolyn; Navuluri, Neelima; Messou, Eugène; Mbonze, Nana; McDade, LaQuita R.; Figueiredo, Marina Cruvinel; Ross, Jeremy; Evans, Denise; Diero, Lameck; Akpata, Robert; Zotova, Natalia; Freeman, Aimee; Pierre, Marie Flore; Rupasinghe, Dhanushi; Ballif, Marie; Byakwaga, Helen; de Castro, Nathalie; Tabala, Martine; Sterling, Timothy R.; Sohn, Annette H.; Fenner, Lukas; Wools-Kaloustian, Kara; Poda, Armel; Yotebieng, Marcel; Huebner, Robin; Marcy, Olivier; International epidemiology Databases to Evaluate AIDS; Pediatrics, School of Medicine
    Introduction: Tuberculosis (TB) is a leading infectious cause of death globally. It is the most common opportunistic infection in people living with HIV, and the most common cause of their morbidity and mortality. Following TB treatment, surviving individuals may be at risk for post-TB lung disease. The TB Sentinel Research Network (TB-SRN) provides a platform for coordinated observational TB research within the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. Methods and analysis: This prospective, observational cohort study will assess treatment and post-treatment outcomes of pulmonary TB (microbiologically confirmed or clinically diagnosed) among 2600 people aged ≥15 years, with and without HIV coinfection, consecutively enrolled at 16 sites in 11 countries, across 6 of IeDEA's global regions. Data regarding clinical and sociodemographic factors, mental health, health-related quality of life, pulmonary function, and laboratory and radiographic findings will be collected using standardised questionnaires and data collection tools, beginning from the initiation of TB treatment and through 12 months after the end of treatment. Data will be aggregated for proposed analyses. Ethics and dissemination: Ethics approval was obtained at all implementing study sites, including the Vanderbilt University Medical Center Human Research Protections Programme. Participants will provide informed consent; for minors, this includes both adolescent assent and the consent of their parent or primary caregiver. Protections for vulnerable groups are included, in alignment with local standards and considerations at sites. Procedures for requesting use and analysis of TB-SRN data are publicly available. Findings from TB-SRN analyses will be shared with national TB programmes to inform TB programming and policy, and disseminated at regional and global conferences and other venues.