PMID- 25822098
OWN - NLM
STAT- MEDLINE
DCOM- 20160126
LR  - 20220402
IS  - 2047-7732 (Electronic)
IS  - 2047-7724 (Print)
IS  - 2047-7724 (Linking)
VI  - 109
IP  - 2
DP  - 2015 Mar
TI  - Enrolment trends in a comprehensive HIV programme in rural north-central Nigeria: 
      improved care indices, but declining quality of clinical data over time.
PG  - 75-83
LID - 10.1179/2047773215Y.0000000007 [doi]
AB  - BACKGROUND: Vanderbilt University affiliate Friends in Global Health was funded 
      in 2008 to support comprehensive HIV/AIDS services in north-central Nigeria. We 
      summarise programme characteristics and trends in enrolment and quality of data 
      collection in this rural, resource-limited environment. METHODS: We used 
      routinely collected programme data in supported sites from June 1 2009 to 
      September 30, 2013.Baseline characteristics were defined as those collected 
      closest to a 90-day window period before and after enrolment. Summary 
      characteristics were compared by site and enrolment year. RESULTS: We enrolled 
      3,960 HIV-infected patients into care (68% women), median age of 32 years 
      [interquartile range (IQR): 27-40]. Most clients were married (79%) and 
      unemployed (60%). At enrolment, median CD4+ cell count was 230 cells/muL (IQR: 
      114-390) and haemoglobin was 10.7 g/dL (IQR: 9.3-11.9). Advanced clinical disease 
      [World Health Organization (WHO) clinical stage III/IV] at enrolment was 
      documented in 29% of clients. Cumulative enrolment increased from 377 patients in 
      2009 to 3,960 patients by 2013.With each successive year, more clients were 
      enrolled at earlier stages of disease; in 2009, 37% of patients were identified 
      as WHO clinical stage I, while in 2013, 55% of patients were so classified. While 
      documentation of clinical staging remained stable, the completeness of CD4+ cell 
      count and haemoglobin data declined with time. CONCLUSION: Expanded testing in a 
      comprehensive HIV programme in rural Nigeria brought persons to care at earlier 
      stages of illness. Yet, as clinical services expanded, data collection quality 
      declined. The paradox of successful scaling up HIV services but deteriorating 
      quality of data underscores the importance of data management training and 
      quality improvement efforts.
FAU - Aliyu, Muktar H
AU  - Aliyu MH
FAU - Blevins, Meridith
AU  - Blevins M
FAU - Arinze, Folasade
AU  - Arinze F
FAU - Megazzini, Karen M
AU  - Megazzini KM
FAU - Bussell, Scottie
AU  - Bussell S
FAU - Dunlap, Julie
AU  - Dunlap J
FAU - Odoh, Chisom
AU  - Odoh C
FAU - Gebi, Usman I
AU  - Gebi UI
FAU - Muhammad, Mukhtar Y
AU  - Muhammad MY
FAU - Shepherd, Bryan E
AU  - Shepherd BE
FAU - Audet, Carolyn M
AU  - Audet CM
FAU - Vermund, Sten H
AU  - Vermund SH
FAU - Wester, C William
AU  - Wester CW
LA  - eng
GR  - P30 AI054999/AI/NIAID NIH HHS/United States
GR  - R01HD075075/HD/NICHD NIH HHS/United States
GR  - NIHR01HD075075/HD/NICHD NIH HHS/United States
GR  - KL2TR000445/TR/NCATS NIH HHS/United States
GR  - P30 AI110527/AI/NIAID NIH HHS/United States
GR  - R01 HD075075/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, N.I.H., Extramural
PL  - England
TA  - Pathog Glob Health
JT  - Pathogens and global health
JID - 101583421
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Adult
MH  - Anti-HIV Agents/*therapeutic use
MH  - Antiretroviral Therapy, Highly Active
MH  - CD4 Lymphocyte Count
MH  - Female
MH  - HIV Infections/*drug therapy/mortality
MH  - *Health Services Research
MH  - Humans
MH  - Male
MH  - Nigeria/epidemiology
MH  - Program Evaluation
MH  - Rural Population/statistics & numerical data
MH  - Survival Analysis
MH  - Time Factors
PMC - PMC4571821
OTO - NOTNLM
OT  - HIV/AIDS,
OT  - PEPFAR,
OT  - data quality,
OT  - enrolment,
OT  - rural Nigeria
OT  - trends,
EDAT- 2015/03/31 06:00
MHDA- 2016/01/27 06:00
PMCR- 2016/03/01
CRDT- 2015/03/31 06:00
PHST- 2015/03/31 06:00 [entrez]
PHST- 2015/03/31 06:00 [pubmed]
PHST- 2016/01/27 06:00 [medline]
PHST- 2016/03/01 00:00 [pmc-release]
AID - PGH-109-75 [pii]
AID - 10.1179/2047773215Y.0000000007 [doi]
PST - ppublish
SO  - Pathog Glob Health. 2015 Mar;109(2):75-83. doi: 10.1179/2047773215Y.0000000007.