{"doc_desc":{"title":"ART identification","idno":"DDI-MWI-MEIRU-ARTidentification-2009-v1","producers":[{"name":"Elizabeth Munthali","abbr":"EM","affiliation":"MEIRU","role":"Metadata entry and editing"},{"name":"Chifundo Kanjala","abbr":"CK","affiliation":"MEIRU","role":"Data Documentation Project Management"},{"name":"EStelle McLean","abbr":"EM","affiliation":"MEIRU","role":"Production of the documentation used to  create this DDI document"},{"name":"Mia Crampin","abbr":"MC","affiliation":"LSHTM\/MEIRU","role":"Study Level Metadata"}],"prod_date":"2019-11-07","version_statement":{"version":"Version 1 (November 2019)"}},"study_desc":{"title_statement":{"idno":"MWI-MEIRU-ARTidentification-2009-v1","title":"ART Understanding the causes of death among HIV\/AIDS patients commencing ART in Karonga district"},"authoring_entity":[{"name":"Dr Neil French","affiliation":"London School of Hygiene and Tropical Medicine, UK"}],"oth_id":[{"name":"MEIRU Core datamanagement team","affiliation":"","email":"","role":""}],"production_statement":{"producers":[{"name":"Dr Judith Glynn","abbr":"London School of Hygiene and Tropical Medicine, UK","affiliation":"","role":"Co-applicant"},{"name":"Dr Alfred Phiri","abbr":"Karonga Prevention Study, Chilumba, Malawi","affiliation":"","role":"Co-applicant"},{"name":"Dr Bagrey Ngwira","abbr":"Karonga Prevention Study, Chilumba, Malawi","affiliation":"","role":"Co-applicant"},{"name":"Mr Phipson Munthali (DHO)","abbr":"Ministry of Health ","affiliation":"","role":"Co-applicant"},{"name":"Mr Hazzie Mvula","abbr":"Karonga Prevention Study, Chilumba, Malawi","affiliation":"","role":"Co-applicant"}],"prod_date":"2017-03-14","funding_agencies":[{"name":"Wellcome Trust","abbr":"WT","role":""}],"grant_no":"079828\/Z\/06\/Z and 096249\/Z\/11\/A"},"distribution_statement":{"depositor":[{"name":"","abbr":"","affiliation":"","uri":""}]},"series_statement":{"series_name":"Intervention Study"},"version_statement":{"version_date":"2019-11-07"},"study_info":{"topics":[{"topic":"Anti-HIV agents","vocab":"MeSH","uri":""},{"topic":"Opportunistic Infections","vocab":"MeSH","uri":""},{"topic":"Malawi","vocab":"MeSH","uri":""}],"abstract":"Despite many gains earned by the provision of ART a good proportion of HIV infected patients still die within three months of initiation of ART. The reasons for this are not clear but include: continued risk of serious co-infection prior to recovery of immunity; intensification and detrimental inflammation with immune reconstitution (IRIS: immune reconstitution inflammatory syndrome); drug reactions; and\/or ART started beyond the point of the bodies ability to recover. The clinical progression of HIV-infection is dominated by a relatively small number of frequent clinical syndromes resulting from opportunistic infections with specific aetiological agents. In Africa the commonest opportunistic infections are: Mycobacterium tuberculosis, Streptococcus pneumoniae, Cryptococcus neoformans, non-typhoidal Salmonella, human herpes virus 8, and Plasmodium falciparum. Many of these co-infections are preventable. How much each of these specific pathogens contributes to this early death and whether specific prophylaxis should be put in place is not clear. Careful clinical description backed up by quality controlled diagnostic services will help to define the role of these co-infections during the early phase of ART\nOne successfully established on ART, failure will occur when ART resistance develops. This is not inevitable but the factors that lead to resistance are incompletely understood. Long term follow-up of individuals with careful assessment of drug adherence, co-infections, viral resistance and other clinical parameters will help to define targets for interventions to prolong the effective life of first line and subsequent ART. \nThis study aimed to establish a cohort of HIV positive individuals eligible for ART and follow them with detailed clinical assessments and laboratory work in order to understand the determinants of death, co-infections (clinical failure) and virological failure while on ART in a rural Malawian population.\nPatients at ART clinics in the DSS area and Karonga district hospital (and later patients at pre-ART clinic before universal test and treat was implemented) were interviewed to gather information and link their clinic ID to their DSS ID. Clinic data were gathered from paper registers through digital photos of the register or from electronic records.\nNHSRC approval number: 448\nFunded by Wellcome Trust 079828\/Z\/06\/Z and 096249\/Z\/11\/A","coll_dates":[{"start":"2004-10-20","end":"2018-07-12","cycle":""}],"nation":[{"name":"Malawi","abbreviation":"MWI"}],"analysis_unit":"Individual","universe":"\u00b7\tAge >15 years\n\u00b7\tHIV-infected\n\u00b7\tResident within the demographic surveillance area of KPS","notes":"ART information, ART Clinic History ART treatment history\nHIV services information,"},"method":{"data_collection":{"data_collectors":[{"name":"Malawi Epidemiology and Intervention Research Unit","abbr":"MEIRU","role":"","affiliation":""}],"coll_mode":["Face-to-face [f2f]"],"research_instrument":"ARTI - ART Identification form - English\n HCCI - HCC Identification form - English","sources":[{"name":"","origin":"","characteristics":""}]}},"data_access":{"dataset_availability":{"original_archive":"Karonga District"},"dataset_use":{"contact":[{"name":"Malawi Epidemiology and Intervention Research Unit","affiliation":"","email":"","uri":""}],"conditions":"These data are made available for licensed access under the following conditions:\n\n1. Data and other material provided by MEIRU will not be redistributed or sold to other individuals, institutions or organisations without MEIRU's written agreement.\n\n2. In the case of multi-centre datasets, data originating from a single contributing member centre of the collaboration may not be analysed or reported on in isolation without the express permission of the member centre concerned.\n\n3. No attempt will be made to re-identify respondents, and there will be no use of the identity of any person or establishment discovered inadvertently. Any such discovery will be reported immediately to MEIRU.\n\n4. No attempt will be made to produce links between datasets provided by MEIRU or between MEIRU data and other datasets that could identify individuals.\n\n5. Any books, articles, conference papers, theses, dissertations, reports or other publications employing data obtained from MEIRU will cite the source, in line with the citation requirement provided with the dataset.\n\n6. An electronic copy of all publications based on the requested data will be sent to MEIRU."}}},"schematype":"survey"}