☆ 4.6 Article

Impact of Drug Stock-Outs on Death and Retention to Care among HIV-Infected Patients on Combination Antiretroviral Therapy in Abidjan, Cote d'Ivoire

PLOS ONE (2010)

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PLOS ONE

卷 5, 期 10, 页码 -

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PUBLIC LIBRARY SCIENCE

DOI: 10.1371/journal.pone.0013414

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Multidisciplinary Sciences

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Agence Nationale de Recherches sur le SIDA et les patites virales
National Institute of Allergy and Infectious Diseases [K24 AI062476, R01 AI058736]
Boehringer-Ingelheim
Bristol-Myers Squibb
Gilead Sciences
Glaxo-SmithKline
Merck-Sharp and Dohme-Chibret
Pfizer
Roche
Schering Plough
Tibotec
Janssen-Cilag

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Background: To evaluate the type and frequency of antiretroviral drug stock-outs, and their impact on death and interruption in care among HIV-infected patients in Abidjan, Cote d'Ivoire. Methods and Findings: We conducted a cohort study of patients who initiated combination antiretroviral therapy (cART) in three adult HIV clinics between February 1, 2006 and June 1, 2007. Follow-up ended on February 1, 2008. The primary outcome was cART regimen modification, defined as at least one drug substitution, or discontinuation for at least one month due to drug stock-outs at the clinic pharmacy. The secondary outcome for patients who were on cART for at least six months was interruption in care, or death. A Cox regression model with time-dependent variables was used to assess the impact of antiretroviral drug stock-outs on interruption in care or death. Overall, 1,554 adults initiated cART and were followed for a mean of 13.2 months. During this time, 72 patients discontinued treatment and 98 modified their regimen because of drug stock-outs. Stock-outs involved nevirapine and fixed-dose combination zidovudine/lamivudine in 27% and 51% of cases. Of 1,554 patients, 839 (54%) initiated cART with fixed-dose stavudine/lamivudine/nevirapine and did not face stock-outs during the study period. Among the 975 patients who were on cART for at least six months, stock-out-related cART discontinuations increased the risk of interruption in care or death (adjusted hazard ratio [HR], 2.83; 95%CI, 1.25-6.44) but cART modifications did not (adjusted HR, 1.21; 95%CI, 0.46-3.16). Conclusions: cART stock-outs affected at least 11% of population on treatment. Treatment discontinuations due to stock-outs were frequent and doubled the risk of interruption in care or death. These stock-outs did not involve the most common first-line regimen. As access to cART continues to increase in sub-Saharan Africa, first-line regimens should be standardized to decrease the probability of drug stock-outs.

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Impact of rotavirus vaccine introduction in Abidjan, Cote d'Ivoire

Alice Britoh Mlan, Rachel M. Burke, Hamidou Kone, Catherine Boni-Cisse, Rebecca N'Guessan, Flore Zaba, Lepri Nicaise Aka, Kofi N'Zue, San Koffi Adom, Sie Kabran Kouadio, Armel Bherat Kouadio, Syndou Meite, Stephane Koffi, Hortense Faye-Kette, Keith Shaba, Bernard Ntsama, Joseph Biey, Negar Aliabadi, Jason M. Mwenda, Umesh D. Parashar, Jacqueline E. Tate

Summary: Cote d'Ivoire introduced rotavirus vaccine in March 2017 and conducted surveillance at a hospital in Abidjan. The study found that the introduction of the vaccine resulted in a 51% decline in rotavirus-related hospitalizations among children <5 years old, and changes in age distribution and disease severity among rotavirus-positive children.

HUMAN VACCINES & IMMUNOTHERAPEUTICS (2023)