The Impact of HIV Care and Support Interventions on Key Outcomes in Low- and Middle-Income Countries

Kaplan, Jonathan E.; Hamm, Tiffany E.; Forhan, Sara E.; Hassani, Ahmed Saadani; Bang, Gail; Weyant, Emily; Tchuenche, Jean M.; Langley, Carol; Lapidos‐Salaiz, Ilana; Bateganya, Moses

doi:10.1097/qai.0000000000000495

Cited by 21 publications

(26 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A detailed description of the search terms applied and the geographic filters used in the literature search can be found in the introductory article of this supplement. 7 Search terms related specifically to CTX prophylaxis included “CTX,” “cotrimoxazole,” “trimethoprim–sulfamethoxazole,” and “trimethoprim sulfamethoxazole combination.”…”

Section: Methodsmentioning

confidence: 99%

“…The overall quality of evidence for each study was rated as “strong,” “medium,” or “weak.” Further information on the rating of quality of evidence can be found in the abovementioned introductory article. 7 …”

Section: Methodsmentioning

confidence: 99%

“…Articles that reported CE were rated separately by a health economist and rated as level 1—full economic evaluation (includes CE analysis, cost-utility analysis, or cost–benefit analysis); level 2—partial economic evaluations (ie, cost analyses, cost-description studies, cost-outcome descriptions); or level 3—randomized trials and studies (reporting more limited information, such as estimates of resource use or costs associated with the intervention(s) and comparator(s)). 7 …”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of the Impact of Cotrimoxazole Prophylaxis on Key Outcomes Among HIV-Infected Adults in Low- and Middle-Income Countries

Hassani

Marston

Kaplan³

2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

Background Cotrimoxazole (CTX) prophylaxis is among the key interventions provided to HIV-infected individuals in resource-limited settings. We conducted a systematic review of the available evidence. Methods MEDLINE, Embase, Global Health, CINAHL, SOCA, and African Index Medicus (AIM) were used to identify articles relevant to the CTX prophylaxis intervention from 1995 to 2014. Included articles addressed impact of CTX prophylaxis on the outcomes of mortality, morbidity, retention in care, quality of life, and/or prevention of ongoing HIV transmission. We rated the quality of evidence in individual articles and assessed the overall quality of the body of evidence, the expected impact, and the cost effectiveness (CE) for each outcome. Results Of the initial 1418 identified articles, 42 met all inclusion criteria. These included 9 randomized controlled trials, 26 observational studies, 2 systematic reviews with meta-analysis, 1 other systematic review, and 4 CE studies. The overall quality of evidence was rated as “good” and the expected impact “high” for both mortality and morbidity. The overall quality of evidence from the 4 studies addressing retention in care was rated as “poor,” and the expected impact on retention was rated as “uncertain.” The 4 assessed CE studies showed that provision of CTX prophylaxis is cost effective and sometimes cost saving. No studies addressed impact on quality of life or HIV transmission. Conclusions CTX prophylaxis is a cost-effective intervention with expected high impact on morbidity and mortality reduction in HIV-infected adults in resource-limited settings. Benefits are seen in both pre-antiretroviral therapy and antiretroviral therapy populations.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of the Impact of Cotrimoxazole Prophylaxis on Key Outcomes Among HIV-Infected Adults in Low- and Middle-Income Countries

Hassani

Marston

Kaplan³

2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

show abstract

“…A more detailed description of the search terms applied and the geographic filters used can be found in “Evaluation of evidence for impact of HIV care and support interventions in resource-limited countries: Introduction” in this Supplement. 16 Specific additional search terms were used (“MALARIA” or “MALARIAE” or “MALARIAL” or “MALARIALS” or “MALARIOUS” or “MALARI”).…”

Section: Methodsmentioning

confidence: 99%

“…Those that satisfied criteria for inclusion were abstracted and summarized on the basis of study design [eg, randomized control trial (RCT) and cohort study], comparison group(s), number of participants, and assessment of impact on the outcome(s) of interest [expressed as hazard ratios (HR), odds ratios (OR), incidence rate ratios (IRR), or relative risk (RR) and the respective 95% confidence intervals (CIs) if available]. An assessment of the quality of each study was made on the basis of study design, number of participants, and internal and external validity and rated as “strong,” “medium,” or “weak.” More details of the assessment of quality are described in “Evaluation of evidence for impact of HIV care and support interventions in resource-limited countries: Introduction.” 16 Health economic studies were assessed based on an agreed-upon set of categories as follows: level 1 full economic evaluation (includes either cost-effectiveness analysis, cost–utility analysis, cost–benefit analysis), level 2 partial economic evaluations (ie, cost analysis, cost-description studies, cost–outcome descriptions), or level 3 randomized trials and studies reporting more limited information, such as estimates of resource use or costs associated with intervention(s) and comparator(s).…”

Section: Methodsmentioning

confidence: 99%

Impact of Cotrimoxazole and Insecticide-Treated Nets for Malaria Prevention on Key Outcomes Among HIV-Infected Adults in Low- and Middle-Income Countries

Hassani

Marston

2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

Background HIV-infected adults are at increased risk of severe malaria and death. Malaria prevention in people living with HIV (PLHIV) consists of several interventions, including cotrimoxazole (CTX) prophylaxis and insecticide-treated nets (ITNs). We conducted a systematic review of the available evidence. Methods MEDLINE, EmBase, Global Health, CINAHL, SOCA, and African Index Medicus were used to identify articles relevant to the CTX prophylaxis and ITNs interventions from 1995 to July 2014. For each individual study, we assessed the quality of evidence and the impact of the 2 interventions on the outcomes of mortality, morbidity, retention in care, quality of life, and/or prevention of ongoing HIV transmission. For each outcome, we summarized the quality of the overall body of evidence, the expected impact, and costing and cost-effectiveness (CE). Findings The overall quality of evidence regarding malaria-related morbidity was rated as “good” for CTX prophylaxis and “fair” for ITN use; the expected “impact” of these interventions on morbidity was rated “high” and “uncertain,” respectively. Three studies that addressed the costing and CE of ITN provision for malaria prevention in PLHIV consisted of 2 full “level 1” and 1 partial “level 2” economic evaluations. Conclusions CTX prophylaxis is effective in reducing malaria-related morbidity among PLHIV. Limited evidence is available with respect to the impact and the CE of ITN use and/or provision in this population.

show abstract

Effectiveness of an SMS-based maternal mHealth intervention to improve clinical outcomes of HIV-positive pregnant women

et al. 2017

View full text Add to dashboard Cite

We conducted a retrospective study to investigate the effectiveness of an mHealth messaging intervention aiming to improve maternal health and HIV outcomes. Maternal health SMSs were sent to 235 HIV-infected pregnant women twice per week in pregnancy and continued until the infant's first birthday. The messages were timed to the stage of the pregnancy/infant age and covered maternal health and HIV-support information. Outcomes, measured as antenatal care (ANC) visits, birth outcomes and infant HIV testing, were compared to a control group of 586 HIV-infected pregnant women who received no SMS intervention. Results showed that intervention participants attended more ANC visits (5.16 vs. 3.95, p < 0.01) and were more likely to attend at least the recommended four ANC visits (relative risk (RR): 1.41, 95% confidence interval (CI): 1.15-1.72). Birth outcomes of intervention participants improved as they had an increased chance of a normal vaginal delivery (RR: 1.10, 95% CI: 1.02-1.19) and a lower risk of delivering a low-birth weight infant (<2500 g) (RR: 0.14, 95% CI: 0.02-1.07). In the intervention group, there was a trend towards higher attendance to infant polymerase chain reaction (PCR) testing within six weeks after birth (81.3% vs. 75.4%, p = 0.06) and a lower mean infant age in weeks at HIV PCR testing (9.5 weeks vs. 11.1 weeks, p = 0.14). These results add to the growing evidence that mHealth interventions can have a positive impact on health outcomes and should be scaled nationally following comprehensive evaluation.

show abstract

The Impact of HIV Care and Support Interventions on Key Outcomes in Low- and Middle-Income Countries

Cited by 21 publications

References 1 publication

Assessment of the Impact of Cotrimoxazole Prophylaxis on Key Outcomes Among HIV-Infected Adults in Low- and Middle-Income Countries

Assessment of the Impact of Cotrimoxazole Prophylaxis on Key Outcomes Among HIV-Infected Adults in Low- and Middle-Income Countries

Impact of Cotrimoxazole and Insecticide-Treated Nets for Malaria Prevention on Key Outcomes Among HIV-Infected Adults in Low- and Middle-Income Countries

Effectiveness of an SMS-based maternal mHealth intervention to improve clinical outcomes of HIV-positive pregnant women

Contact Info

Product

Resources

About