International epidemiology databases to evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012-2019.

Journal: BMJ open

Volume: 10

Issue: 5

Year of Publication: 2021

Affiliated Institutions:  Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA. French National Research Institute for Sustainable Development (IRD), Inserm, UMR , University of Bordeaux, Bordeaux, France. Institute for Implementation Science in Population Health, City University of New York, New York, New York, USA. Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA. Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa. Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland matthias.egger@ispm.unibe.ch.

Abstract summary 

The objectives of the International epidemiology databases to evaluate AIDS (IeDEA) are to (i) evaluate the delivery of combination antiretroviral therapy (ART) in children, adolescents and adults in sub-Saharan Africa, (ii) to describe ART regimen effectiveness, durability and tolerability, (iii) to examine HIV-related comorbidities and coinfections and (iv) to examine the pregnancy-related and HIV-related outcomes of women on ART and their infants exposed to HIV or ART in utero or via breast milk.IeDEA is organised in four regions (Central, East, Southern and West Africa), with 240 treatment and care sites, six data centres at African, European and US universities, and almost 1.4 million children, adolescents and adult people living with HIV (PLWHIV) enrolled.The data include socio-demographic characteristics, clinical outcomes, opportunistic events, treatment regimens, clinic visits and laboratory measurements. They have been used to analyse outcomes in PLWHIV-1 or PLWHIV-2 who initiate ART, including determinants of mortality, of switching to second-line and third-line ART, drug resistance, loss to follow-up and the immunological and virological response to different ART regimens. Programme-level estimates of mortality have been corrected for loss to follow-up. We examined the impact of coinfection with hepatitis B and C, and the epidemiology of different cancers and of (multidrug resistant) tuberculosis, renal disease and of mental illness. The adoption of 'Treat All', making ART available to all PLWHIV regardless of CD4+ cell count or clinical stage was another important research topic.IeDEA has formulated several research priorities for the 'Treat All' era in sub-Saharan Africa. It recently obtained funding to set up sentinel sites where additional data are prospectively collected on cardiometabolic risks factors as well as mental health and liver diseases, and is planning to create a drug resistance database.

Authors & Co-authors:  Chammartin Frédérique F Dao Ostinelli Cam Ha CH Anastos Kathryn K Jaquet Antoine A Brazier Ellen E Brown Steven S Dabis Francois F Davies Mary-Ann MA Duda Stephany N SN Malateste Karen K Nash Denis D Wools-Kaloustian Kara K von Groote Per M PM Egger Matthias M

Study Outcome 

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Statistics
Citations :  UNAIDS Global AIDS update 2016. Geneva, Switzerland, 2016.
Authors :  14
Identifiers
Doi : e035246
SSN : 2044-6055
Study Population
Women
Mesh Terms
Acquired Immunodeficiency Syndrome
Other Terms
HIV & AIDS;epidemiology;infectious diseases;tuberculosis
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England