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Decentralising HIV treatment in lower- and middle-income countries

  1. Tamara Kredo1,*,
  2. Nathan Ford2,
  3. Folasade B Adeniyi3,
  4. Paul Garner4

Editorial Group: Cochrane HIV/AIDS Group

Published Online: 27 JUN 2013

Assessed as up-to-date: 26 MAY 2013

DOI: 10.1002/14651858.CD009987.pub2


How to Cite

Kredo T, Ford N, Adeniyi FB, Garner P. Decentralising HIV treatment in lower- and middle-income countries. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD009987. DOI: 10.1002/14651858.CD009987.pub2.

Author Information

  1. 1

    South African Medical Research Council, South African Cochrane Centre, Tygerberg, Western Cape, South Africa

  2. 2

    Médecins Sans Frontières, Geneva, Switzerland

  3. 3

    Stellenbosch University, Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Tygerberg, Cape Town, South Africa

  4. 4

    Liverpool School of Tropical Medicine, Department of Clinical Sciences, Liverpool, Merseyside, UK

*Tamara Kredo, South African Cochrane Centre, South African Medical Research Council, PO Box 19070, Tygerberg, Western Cape, 7505, South Africa. tamara.kredo@mrc.ac.za.

Publication History

  1. Publication Status: New
  2. Published Online: 27 JUN 2013

SEARCH

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Assefa 2012 {published data only}
  • Assefa Y, Kiflie A, Tekle B, Mariam DH, Laga M, Van Damme W. Effectiveness and acceptability of delivery of antiretroviral treatment in health centres by health officers and nurses in Ethiopia. Journal of health services research & policy 2012;17(1):24-9. [PUBMED: 22096081]
Balcha 2010 {published data only}
  • Balcha TT, Jeppsson A. Outcomes of antiretroviral treatment: a comparison between hospitals and health centers in Ethiopia. Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002) 2010;9(5):318-24. [PUBMED: 20923956]
Bedelu 2007 {published data only}
  • Bedelu M, Ford N, Hilderbrand K, Reuter H. Implementing antiretroviral therapy in rural communities: the Lusikisiki model of decentralized HIV/AIDS care. The Journal of infectious diseases 2007;196 Suppl 3:S464-8. [PUBMED: 18181695]
Bock 2008 {published data only}
  • Bock P, Boulle A, White C, Osler M, Eley B. Provision of antiretroviral therapy to children within the public sector of South Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene 2008;102(9):905-11. [PUBMED: 18656217]
Brennan 2011 {published data only}
  • Brennan AT, Long L, Maskew M, Sanne I, Jaffray I, MacPhail P, et al. Outcomes of stable HIV-positive patients down-referred from a doctor-managed antiretroviral therapy clinic to a nurse-managed primary health clinic for monitoring and treatment. AIDS (London, England) 2011;25(16):2027-36. [PUBMED: 21997488]
  • Long L, Brennan A, Fox MP, Ndibongo B, Jaffray I, Sanne I, et al. Treatment outcomes and cost-effectiveness of shifting management of stable ART patients to nurses in South Africa: an observational cohort. PLoS medicine 2011;8(7):e1001055. [PUBMED: 21811402]
Chan 2010 {published data only}
  • Chan AK, Mateyu G, Jahn A, Schouten E, Arora P, Mlotha W, et al. Outcome assessment of decentralization of antiretroviral therapy provision in a rural district of Malawi using an integrated primary care model. Tropical medicine & international health : TM & IH 2010;15 Suppl 1:90-7. [PUBMED: 20586966]
Fatti 2010 {published data only}
  • Fatti G, Grimwood A, Bock P. Better antiretroviral therapy outcomes at primary healthcare facilities: an evaluation of three tiers of ART services in four South African provinces. PloS one 2010;5(9):e12888. [PUBMED: 20877631]
Fayorsey 2013 {published data only}
  • Fayorsey, R. N, Saito, S, Carter, R. J, et al. Decentralization of pediatric HIV Care and Treatment in Five sub-Saharan African Countries. Journal of Acquired Immune Deficiency Syndrome NLM.
Hansudewechakul 2012 {published data only}
  • Hansudewechakul, R, Naiwatanakul, T, Katana, A, et al. Successful clinical outcomes following decentralization of tertiary paediatric HIV care to a community-based paediatric antiretroviral treatment network, Chiangrai, Thailand, 2002 to 2008. Journal of International AIDS Society NLM.
Humphreys 2010 {published data only}
  • Humphreys CP, Wright J, Walley J, Mamvura CT, Bailey KA, Ntshalintshali SN, et al. Nurse led, primary care based antiretroviral treatment versus hospital care: a controlled prospective study in Swaziland. BMC health services research 2010;10:229. [PUBMED: 20687955]
Jaffar 2009 {published data only}
  • Amuron B, Coutinho A, Grosskurth H, Nabiryo C, Birungi J, Namara G, et al. A cluster-randomised trial to compare home-based with health facility-based antiretroviral treatment in Uganda: study design and baseline findings. The open AIDS journal 2007;1:21-7. [PUBMED: 18923692]
  • Amuron B, Levin J, Birunghi J, Namara G, Coutinho A, Grosskurth H, et al. Mortality in an antiretroviral therapy programme in Jinja, south-east Uganda: a prospective cohort study. AIDS research and therapy 2011;8:39. [PUBMED: 22018282]
  • Jaffar S, Amuron B, Foster S, Birungi J, Levin J, Namara G, et al. Rates of virological failure in patients treated in a home-based versus a facility-based HIV-care model in Jinja, southeast Uganda: a cluster-randomised equivalence trial. Lancet 2009;374(9707):2080-9. [PUBMED: 19939445]
Kipp 2010 {published data only}
  • Kipp W, Konde-Lule J, Rubaale T, Okech-Ojony J, Alibhai A, Saunders DL. Comparing antiretroviral treatment outcomes between a prospective community-based and hospital-based cohort of HIV patients in rural Uganda. BMC international health and human rights 2011;11 Suppl 2:S12. [PUBMED: 22166168]
  • Kipp W, Konde-Lule J, Saunders LD, Alibhai A, Houston S, Rubaale T, et al. Results of a community-based antiretroviral treatment program for HIV-1 infection in Western Uganda. Current HIV research 2010;8(2):179-85. [PUBMED: 20163349]
  • Kipp, W, Konde-Lule, J, Saunders, L. D, et al. Antiretroviral treatment for HIV in rural Uganda: Two-year treatment outcomes of a prospective health centre/community-based and hospital-based cohort. PLoSONE.
Massaquoi 2009 {published data only}
  • Massaquoi M, Zachariah R, Manzi M, Pasulani O, Misindi D, Mwagomba B, et al. Patient retention and attrition on antiretroviral treatment at district level in rural Malawi. Transactions of the Royal Society of Tropical Medicine and Hygiene 2009;103(6):594-600. [PUBMED: 19298993]
McGuire 2012 {published data only}
  • McGuire, M, Pinoges, L, Kanapathipillai, R, et al. Treatment initiation, program attrition and patient treatment outcomes associated with scale-up and decentralization of HIV care in rural Malawi. PLoSONE NLM.
Odafe 2012 {published data only}
  • Odafe, S, Torpey, K, Khamofu, H, et al. The Pattern of Attrition from an Antiretroviral Treatment Program in Nigeria. PLoSONE.
Selke 2010 {published data only}
  • Selke HM, Kimaiyo S, Sidle JE, Vedanthan R, Tierney WM, Shen C, et al. Task-shifting of antiretroviral delivery from health care workers to persons living with HIV/AIDS: clinical outcomes of a community-based program in Kenya. Journal of acquired immune deficiency syndromes (1999) 2010;55(4):483-90. [PUBMED: 20683336]

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Babigumira 2009 {published data only}
  • Babigumira JB, Sethi AK, Smyth KA, Singer ME. Cost effectiveness of facility-based care, home-based care and mobile clinics for provision of antiretroviral therapy in Uganda. PharmacoEconomics 2009;27(11):963-73. [PUBMED: 19888795]
Bemelmans 2010 {published data only}
  • Bemelmans M, van den Akker T, Ford N, Philips M, Zachariah R, Harries A, et al. Providing universal access to antiretroviral therapy in Thyolo, Malawi through task shifting and decentralization of HIV/AIDS care. Tropical medicine & international health : TM & IH 2010;15(12):1413-20. [PUBMED: 20958897]
Bolton-Moore 2007 {published data only}
  • Bolton-Moore C, Mubiana-Mbewe M, Cantrell RA, Chintu N, Stringer EM, Chi BH. Clinical outcomes and CD4 cell response in children receiving antiretroviral therapy at primary health care facilities in Zambia. JAMA : the journal of the American Medical Association 2007;298(16):1888-99.
Boyer 2010 {published data only}
  • Boyer S, Eboko F, Camara M, Abe C, Nguini ME, Koulla-Shiro S, et al. Scaling up access to antiretroviral treatment for HIV infection: the impact of decentralization of healthcare delivery in Cameroon. AIDS (London, England) 2010;24 Suppl 1:S5-15. [PUBMED: 20023440]
Boyer 2012 {published data only}
  • Boyer S, Protopopescu C, Marcellin F, Carrieri MP, Koulla-Shiro S, Moatti JP, et al. Performance of HIV care decentralization from the patient's perspective: health-related quality of life and perceived quality of services in Cameroon. Health policy and planning 2012;27(4):301-15. [PUBMED: 21690123]
Chu 2010 {published data only}
  • Chu C, Umanski G, Blank A, Grossberg R, Selwyn PA. HIV-infected patients and treatment outcomes: an equivalence study of community-located, primary care-based HIV treatment vs. hospital-based specialty care in the Bronx, New York. AIDS care 2010;22(12):1522-9. [PUBMED: 20824549]
Cohen 2009 {published data only}
  • Cohen R, Lynch S, Bygrave H, Eggers E, Vlahakis N, Hilderbrand K, et al. Antiretroviral treatment outcomes from a nurse-driven, community-supported HIV/AIDS treatment programme in rural Lesotho: observational cohort assessment at two years. Journal of the International AIDS Society 2009;12:23. [PUBMED: 19814814]
Ingle 2010 {published data only}
  • Ingle SM, May M, Uebel K, Timmerman V, Kotze E, Bachmann M, et al. Differences in access and patient outcomes across antiretroviral treatment clinics in the Free State province: a prospective cohort study. South African Medical Journal 2010;100(10):675-81. [PUBMED: 21080999]
Lambdin 2013 {published data only}
  • Lambdin, B. H, Micek, M. A, Sherr, K, et al. Integration of HIV Care and Treatment in Primary Health Care Centers and Patient Retention in Central Mozambique: A Retrospective Cohort Study. Journal of Acquired Immune Deficiency Syndrome NLM.
Leon 2011 {published data only}
  • Leon A, Caceres C, Fernandez E, Chausa P, Martin M, Codina C, et al. A new multidisciplinary home care telemedicine system to monitor stable chronic human immunodeficiency virus-infected patients: a randomized study. PLoS ONE 2011;6(1):e14515.
Shumbusho 2009 {published data only}
  • Shumbusho F, van Griensven J, Lowrance D, Turate I, Weaver MA, Price J, et al. Task shifting for scale-up of HIV care: evaluation of nurse-centered antiretroviral treatment at rural health centers in Rwanda. PLoS medicine 2009;6(10):e1000163. [PUBMED: 19823569]
Stein 2007 {published data only}
  • Stein J, Lewin S, Fairall L. Hope is the pillar of the universe: health-care providers' experiences of delivering anti-retroviral therapy in primary health-care clinics in the Free State province of South Africa. Social science & medicine (1982) 2007;64(4):954-64. [PUBMED: 17140716]
Tene 2013 {published data only}
  • Tene, G, Lahuerta, M, Teasdale, C, et al. High Retention among HIV-Infected Children in Rwanda during Scale-up and Decentralization of HIV Care and Treatment Programs, 2004-2010. Pediatric Infectious Diseases Journal NLM.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Assefa 2012b {published data only}
  • Assefa AY, Kiflie A, Tesfaye D, Rasschaert F, Lynen L, Van Damme W. Interventions to improve retention in antiretroviral treatment programmes in Ethiopia. XIX INTERNATIONAL AIDS CONFERENCE. Washington DC: International AIDS Society, July 2012. [WEPE727]
Labhart 2012 {unpublished data only}
  • Labhardt N, Sello M, Mohlaba A, Keiser O, Pfeiffer K, Egger M, et al. Outcomes of antiretroviral treatment programs in rural Lesotho: health centres and hospitals compared.. XIX INTERNATIONAL AIDS CONFERENCE. Washington DC: International AIDS Society, JULY 2010. [WEA0205]
Miyano 2012 {published data only}
  • Miyano S, Chipeta V, Sialubanje C, Utsushikawa M, Ishikawa N, Sikazwe I, et al. Decentralization of HIV care services in a rural district in Zambia: a comparative analysis of quality of care between the district hospital and rural health centre. XIX INTERNATIONAL AIDS CONFERENCE. Washington DC: International AIDS Society, JULY 2012. [WEPE722]
Morsheimer (unpublished) {unpublished data only}
  • Morsheimer M, Dramowski A, Myer L, Cotton M, Rabie H. Successful pediatric HIV management within a South African decentralization model of ART delivery. (being submitted for publication) 2012.
Van Dijk 2012 {published data only}
  • Van-dijk JH, Moss WJ, Sinywimaanzi P, Hamangaba F, Sutcliffe CG. Scaling-up access to antiretroviral treatment: a comparison of outcomes among HIV-positive children receiving treatment at mobile and hospital-based HIV clinics in rural Zambia. XIX INTERNATIONAL AIDS CONFERENCE. Washington DC: International AIDS Society, July 2012. [WEPDEO106]

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
NCT 01414413 {published data only}
  • Home Assessment and Initiation of Antiretroviral Therapy for HIV in Malawi (CONDA-YAPA). International AIDS Society Conference.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
Brinkhof 2009
  • Brinkhof M W, Pujades-Rodriguez M, Egger M. Mortality of patients lost to follow-up in antiretroviral treatment programmes in resource-limited settings: systematic review and meta-analysis. PLoS One 2009;4:e5790.
Decroo 2009
  • Decroo T, Panunzi I, das Dores C, Maldonado F, Biot M, Ford N, et al. Lessons learned during down referral of antiretroviral treatment in Tete, Mozambique. Journal of the International AIDS Society 2009;12(1):6. [PUBMED: 19419543]
Deeks 2008
  • Deeks JJ, Higgins JPT, Altman DG. Chapter 9: Analysing data and undertaking meta-analyses. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Chichester: John Wiley & Sons, 2008:276-82.
Ford 2011
  • Ford N, Calmy A, Mills EJ. The first decade of antiretroviral therapy in Africa. Globalization and Health 2011; Vol. 7:33. [PUBMED: 21958478]
Fox 2010
GRADEpro 2008 [Computer program]
  • Schünemann H, Brozek J, Oxman A. GRADEpro. GRADE Working Group, 2008.
Guyatt 2011
  • Guyatt GH, Oxman AD, Schunemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. Journal of Clinical Epidemiology 2011;64(4):380-2. [PUBMED: 21185693]
Higgins 2008
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from: http://www.cochrane-handbook.org, (Accessed 20 February 2012).
Higgins 2008a
  • Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Chichester: John Wiley & Sons, 2008:187-241.
Kagee 2011
  • Kagee A, Remien RH, Berkman A, Hoffman S, Campos L, Swartz L. Structural barriers to ART adherence in Southern Africa: Challenges and potential ways forward. Global Public Health 2011;6(1):83-97. [PUBMED: 20509066]
Kredo 2012
  • Kredo T, Bateganya M, Pienaar ED, Adeniyi FB. Task shifting from doctors to non-doctors for initiation and maintenance of HIV/AIDS treatment. Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd, 2012, issue 9. [DOI: 10.1002/14651858.CD007331.pub2; CD007331]
Miller 2010
Newcastle-Ottawa Scale
  • Wells GA, Shea B, O'Connell D, Petersen J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomised studies in meta-analyses. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (Accessed 20 February 2012).
Review Manager 2011 [Computer program]
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan) Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
UNAIDS 2011
  • Global HIV/AIDS response: epidemic update and health sector progress towards Universal Access. Available from: http://www.who.int/hiv/pub/progress_report2011/hiv_full_report_2011.pdf (Accessed 22 February 2012). Geneva, Switzerland: WHO/UNAIDS. UNICEF.
Ware 2009
  • Ware NC, Idoko J, Kaaya S, Biraro IA, Wyatt MA, Agbaji O, et al. Explaining adherence success in sub-Saharan Africa: an ethnographic study. PLoS Medicine 2009;6(1):e11. [PUBMED: 19175285]
WHO 2008
  • World Health Organization (WHO). Task shifting : rational redistribution of tasks among health workforce teams : global recommendations and guidelines (2008). Available from: http://www.who.int/healthsystems/task_shifting/en (Accessed 22 February 2012). WHO Press.