South Africa has the largest paediatric HIV treatment programme in the world, with over 160 000 HIV infected children receiving antiretroviral therapy (ART). The provision of high quality care for these children is dependent, among other factors, on an effective monitoring and evaluation system, and to this end, the South African National Department of Health adopted a software application for monitoring patients on ART known as TIER.Net. Routine data captured electronically in TIER.Net provide a rich source of information regarding the paediatric ART programme and allow for detailed analysis of programme performance over time.
In a recent publication (Lilian et al, A 10-year cohort analysis of routine paediatric ART data in a rural South African setting. Epidemiol Infect. 2016 Sep 9:1-11. [Epub ahead of print]), Rivka Lilian, Public Health Analyst at Anova, and her colleagues present an analysis of TIER.Net data for HIV infected children aged less than 15 years who initiated ART in Mopani district of Limpopo Province between 2005 and 2014.
They found substantial growth of the paediatric ART programme over time in line with national guidelines. However, challenges remain with regard to virological testing, suppression rates and retention in care, particularly in children living in poorer socio-economic areas, infants and children aged less than 3 years receiving abacavir-based regimens. These children need to be targeted for improved care, and programme planning and implementation, including supply chain management, needs to be enhanced if paediatric outcomes are to be improved.
This publication demonstrates the value of TIER.Net data in providing enhanced insights into the performance of the paediatric ART programme, highlighting interventions to improve the long-term effectiveness of the programme.
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Publication online - Cambridge University Press page