SciELO - Scientific Electronic Library Online

 
vol.99 issue9Monitoring the South African national antiretroviral treatment programme, 2003 - 2007: the IeDEA Southern Africa collaborationPotential for medical error: incorrectly completed request forms for thyroid function tests limit pathologists' advice to clinicians author indexsubject indexarticles search
Home Pagealphabetic serial listing  

SAMJ: South African Medical Journal

Print version ISSN 0256-9574

Abstract

ADAM, Muhammad Aarif  and  JOHNSON, Leigh F. Estimation of adult antiretroviral treatment coverage in South Africa. SAMJ, S. Afr. med. j. [online]. 2009, vol.99, n.9, pp. 661-667. ISSN 0256-9574.

OBJETIVES: To estimate the annual numbers of individuals receiving antiretroviral treatment in South Africa up to mid-2008, and the coverage of antiretroviral treatment in adults according to various definitions of need. METHODS: Antiretroviral coverage is defined as the number of patients receiving antiretroviral treatment at a point in time, divided by the number needing treatment. Numbers of patients receiving antiretroviral treatment are estimated from public sector data, and data provided by disease management programmes and NGO programmes. The unmet need for treatment in adults is estimated using a Markov model of HIV progression in adults, combined with estimates of annual new HIV infections from a national AIDS and demographic model. RESULTS: By the middle of 2008, 568 000 adults and children were receiving antiretroviral treatment in South Africa, with the public health sector accounting for 79% of this total. Using the current Department of Health criteria for defining antiretroviral eligibility (CD4+ count <200/µl or World Health Organization (WHO) stage 4), antiretroviral coverage in adults was 40.2% in 2008 - up from 4.9% in 2004. Coverage increases to 54.2% if eligibility is based on WHO stage 4 only, but falls to 22.2% if the Southern African HIV Clinicians Society guidelines are used to define eligibility. Coverage in 2008 varied between provinces, from 25.8% in the Free State to 71.7% CONCLUSIONS: Significant progress has been made in expanding access to antiretroviral treatment in South Africa since 2004, but a substantial unmet need for treatment in adults remains.

        · text in English     · pdf in English