HIV Adult Mortality in African Populations in the ART Era    

The project goal is to estimate the relative contribution of undiagnosed HIV, untreated HIV, treatment failure or side-effect, and treatment drop-out to overall and HIV-associated mortality in HIV positive adults in the ALPHA Network (x-ref Collaborating Partners) surveillance communities (including Manicaland, Zimbabwe). This will be achieved through the following objectives:

1. Estimating trends in coverage of HIV diagnostic, care and treatment services. 
   
2. Monitoring mortality in the surveillance populations classified by extent of contact with treatment programs. 
   
3. Comparing results from different sites in the context of the national programs that serve the communities.
   
4. Describing the causes of deaths and assessing HIV-attributable mortality by treatment program contact.
   
5. Exploring real time record linkage between surveillance sites and their local clinics to improve the reliability of measures of program contact.  
   

During the last year, the project will focus on publishing updated analyses, developing estimation tools that can be used outside of specialist research settings, and examining data quality issues in more depth.  Results from this work will be presented to policy makers in national health ministries, WHO, UNAIDS and GFATM at the end of the project to look at the policy implications of our findings.

The table below gives basic details about the ten independent HDSS surveillance sites participating in this study led by the ALPHA Network:

Coming soon... 

Contact person: Basia Zaba (LSHTM) and Simon Gregson (Imperial College London

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  Publications

Reniers G, Slaymaker E, Nakiyingi-Miiro J, Nyamukapa C, Crampin AC, Herbst K, Urassa M, Otieno F, Gregson S, Sewe M, Michael D, Lutalo T, Hosegood V, Kasamba I, Price A, Nabukalu D, Mclean E, Zaba B. Mortality trends in the era of antiretroviral therapy: evidence from the Network for Analysing Longitudinal Population based HIV/AIDS data on Africa. AIDS 2014; 28(4): s533-s542.

Slaymaker E, Todd J, Marston M, Calvert C, Michael D, Nakiyingi JS, Crampin AC, Lutalo T, Herbst K, Zaba B. How have ART treatment programmes changed the patterns of excess mortality in people living with HIV? Estimates from four countries in east and southern Africa. Global Health Action 2014; 7: 22789