A national survey of teachers on antiretroviral therapy in Malawi: access, retention in therapy and survival.

BACKGROUND: HIV/AIDS is having a devastating effect on the education sector in sub-Saharan Africa. A national survey was conducted in all public sector and private sector facilities in Malawi providing antiretroviral therapy (ART) to determine the uptake of ART by teachers and their outcomes while o...

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Main Authors: Simon D Makombe, Andreas Jahn, Hannock Tweya, Stuart Chuka, Joseph Kwong-Leung Yu, Mindy Hochgesang, John Aberle-Grasse, Lameck Thambo, Erik J Schouten, Kelita Kamoto, Anthony D Harries
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2007-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC1905945?pdf=render
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author Simon D Makombe
Andreas Jahn
Hannock Tweya
Stuart Chuka
Joseph Kwong-Leung Yu
Mindy Hochgesang
John Aberle-Grasse
Lameck Thambo
Erik J Schouten
Kelita Kamoto
Anthony D Harries
author_facet Simon D Makombe
Andreas Jahn
Hannock Tweya
Stuart Chuka
Joseph Kwong-Leung Yu
Mindy Hochgesang
John Aberle-Grasse
Lameck Thambo
Erik J Schouten
Kelita Kamoto
Anthony D Harries
author_sort Simon D Makombe
collection DOAJ
description BACKGROUND: HIV/AIDS is having a devastating effect on the education sector in sub-Saharan Africa. A national survey was conducted in all public sector and private sector facilities in Malawi providing antiretroviral therapy (ART) to determine the uptake of ART by teachers and their outcomes while on treatment. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective cohort study was carried out based on patient follow-up records from ART Registers and treatment master cards in all 138 ART clinics in Malawi; observations were censored on September 30(th) 2006. By this date, Malawi's 102 public sector and 36 private sector ART clinics had registered a total of 72,328 patients for treatment. Of these, 2,643 (3.7%) were teachers. Adjusting for double-registration caused by clinic transfers, it is estimated that 2,380 individual teachers had ever accessed ART. There were 15% of teachers starting ART in WHO clinical stage 1 or 2 with a CD4-lymphocyte count of <or=250/mm(3) and 85% starting in stage 3 or 4. By 30(th) September 2006, 1,850 teachers were alive on ART (3.5% of all teachers in Malawi). The probability of being alive on ART at 6-months, 12-months, 18-months and 24-months after treatment initiation was 84%, 79%, 75% and 73% respectively. Retention in treatment was better for women (adjusted HR = 1.8) and in those starting ART in WHO Clinical Stage 1 and 2 (adjusted HR = 1.8). CONCLUSION/SIGNIFICANCE: Rapid scale up of ART has allowed 2,380 HIV-positive teachers to access life-prolonging treatment. There is evidence that this intervention can help to mitigate some of the shortages of teaching personnel in resource-poor countries affected by a generalised HIV epidemic.
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spelling doaj.art-821552be07d04b4b8a8b35fe39b034922022-12-22T02:05:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032007-01-0127e62010.1371/journal.pone.0000620A national survey of teachers on antiretroviral therapy in Malawi: access, retention in therapy and survival.Simon D MakombeAndreas JahnHannock TweyaStuart ChukaJoseph Kwong-Leung YuMindy HochgesangJohn Aberle-GrasseLameck ThamboErik J SchoutenKelita KamotoAnthony D HarriesBACKGROUND: HIV/AIDS is having a devastating effect on the education sector in sub-Saharan Africa. A national survey was conducted in all public sector and private sector facilities in Malawi providing antiretroviral therapy (ART) to determine the uptake of ART by teachers and their outcomes while on treatment. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective cohort study was carried out based on patient follow-up records from ART Registers and treatment master cards in all 138 ART clinics in Malawi; observations were censored on September 30(th) 2006. By this date, Malawi's 102 public sector and 36 private sector ART clinics had registered a total of 72,328 patients for treatment. Of these, 2,643 (3.7%) were teachers. Adjusting for double-registration caused by clinic transfers, it is estimated that 2,380 individual teachers had ever accessed ART. There were 15% of teachers starting ART in WHO clinical stage 1 or 2 with a CD4-lymphocyte count of <or=250/mm(3) and 85% starting in stage 3 or 4. By 30(th) September 2006, 1,850 teachers were alive on ART (3.5% of all teachers in Malawi). The probability of being alive on ART at 6-months, 12-months, 18-months and 24-months after treatment initiation was 84%, 79%, 75% and 73% respectively. Retention in treatment was better for women (adjusted HR = 1.8) and in those starting ART in WHO Clinical Stage 1 and 2 (adjusted HR = 1.8). CONCLUSION/SIGNIFICANCE: Rapid scale up of ART has allowed 2,380 HIV-positive teachers to access life-prolonging treatment. There is evidence that this intervention can help to mitigate some of the shortages of teaching personnel in resource-poor countries affected by a generalised HIV epidemic.http://europepmc.org/articles/PMC1905945?pdf=render
spellingShingle Simon D Makombe
Andreas Jahn
Hannock Tweya
Stuart Chuka
Joseph Kwong-Leung Yu
Mindy Hochgesang
John Aberle-Grasse
Lameck Thambo
Erik J Schouten
Kelita Kamoto
Anthony D Harries
A national survey of teachers on antiretroviral therapy in Malawi: access, retention in therapy and survival.
PLoS ONE
title A national survey of teachers on antiretroviral therapy in Malawi: access, retention in therapy and survival.
title_full A national survey of teachers on antiretroviral therapy in Malawi: access, retention in therapy and survival.
title_fullStr A national survey of teachers on antiretroviral therapy in Malawi: access, retention in therapy and survival.
title_full_unstemmed A national survey of teachers on antiretroviral therapy in Malawi: access, retention in therapy and survival.
title_short A national survey of teachers on antiretroviral therapy in Malawi: access, retention in therapy and survival.
title_sort national survey of teachers on antiretroviral therapy in malawi access retention in therapy and survival
url http://europepmc.org/articles/PMC1905945?pdf=render
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