International Epidemiologic Databases to Evaluate AIDS - Southern Africa (IeDEA-SA)

评估艾滋病的国际流行病学数据库 - 南部非洲 (IeDEA-SA)

• 批准号: 10090687
• 负责人: Mary-Ann Davies
• 金额: $ 6.79万
• 依托单位: UNIVERSITAT BERN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-03 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10090687
• 关键词: 13 year old; Acquired Immunodeficiency Syndrome; Address; Adherence; Adolescent; Adult; African; Alcohol or Other Drugs use; Alcohols; Area; Birth; Blood Vessels; CD4 Lymphocyte Count; Cardiovascular Diseases; Cardiovascular system; Caring; Cervical Cancer Screening; Cervical dysplasia; Cessation of life; Child; Clinical; Collaborations; Communicable Diseases; Continuity of Patient Care; Country; Data; Data Analyses; Data Collection; Data Linkages; Databases; Diagnosis; Disease; Drug resistance in tuberculosis; Effectiveness; Epidemic; Epidemiology; Evaluation; Event; Exposure to; Growth; Guidelines; HIV; HIV antiretroviral; HIV diagnosis; HIV therapy; HIV/TB; Health system; Healthcare; Hepatitis B; Hepatitis B Virus; Hospitalization; Human Papilloma Virus-Related Malignant Neoplasm; Illness impact; Impairment; Incidence; Individual; Infant; Infection; International; Interruption; Laboratories; Leadership; Life; Life Cycle Stages; M. tuberculosis genome; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measurement; Mental Health; Mental disorders; Metabolic; Methods; Modeling; Monitor; Morbidity - disease rate; Mother-to-child HIV transmission; Mothers; Multiregional Analyses; Outcome; Output; Patient Care; Patients; Pattern; Pharmaceutical Preparations; Population; Postpartum Depression; Pregnancy; Pregnant Women; Prevalence; Prevention; Prevention program; Private Sector; Puberty; Pulmonary Tuberculosis; Quality of life; Regimen; Research; Resources; Risk Factors; Sampling; Site; Southern Africa; Sputum; Statistical Methods; Substance abuse problem; Surveys; Tenofovir; Testing; Time; Translating; Tuberculosis; Universities; Vertical Disease Transmission; Woman; Work; antepartum depression; antiretroviral therapy; cancer care; case finding; co-infection; cohort; comorbidity; cost effective; data harmonization; follow-up; high risk; improved; improved outcome; innovation; method development; mortality; negative affect; neonatal infection; novel strategies; optimal treatments; point of care; programs; public health priorities; substance abuse treatment; therapy outcome; tool; treatment program; whole genome

The International epidemiologic Databases to Evaluate AIDS in Southern Africa (IeDEA-SA) Collaboration has two key, related overarching research purposes related to the continuum of HIV care: (i) Global surveillance and evaluation of access to, effectiveness and outcomes of HIV care, antiretroviral therapy (ART) and HIV-related comorbidity programs (ii) Informing optimal treatment and implementation guidelines for HIV and its comorbidities in resource-limited settings. These areas will be examined across the life course from pregnancy to infants (HIV-infected and exposed), children, adolescents and adults, through regional and multiregional studies, within and beyond the IeDEA-SA consortium. The HIV epidemic is being transformed by massive ART expansion with corresponding declines in AIDS- related deaths and mother-to-child transmission, as well as ART improvements through access to better drugs, laboratory tests and health system innovations. To sustain and improve on hard-won reductions in HIV-related morbidity and mortality, we need to understand and optimize long-term HIV outcomes, including retention in care across life transitions, prevention and treatment of co-morbidity with infections and non-communicable diseases (e.g. cancer, cardiovascular disease and mental health disorders) and address the impact of substance abuse. Hence, IeDEA-SA specific aims are: 1)To study the continuum of HIV and tuberculosis (TB) care from diagnosis through to long-term outcomes; 2)To study co-infections (TB; hepatitis B), cardiovascular and metabolic co-morbidities; 3)To study the burden and care of cancers in HIV+ children and adults; 4) To study the HIV/ART continuum especially long-term outcomes in HIV+ mothers and their children, from pregnancy to exposed uninfected infants through to infected infants, children and adolescents; 5) To study mental health and mental health care provision; 6) To study substance use in adolescents and adults on ART, with a cross-cutting aim (7) To develop and apply state-of-the-art statistical methods, data harmonization standards, data collection and linkage tools. Routine cohort data of nearly 900,000 HIV+ individuals (60,000 <13 years old at enrolment) will be enhanced by linkage to mortality and other disease databases (e.g. cancer and TB) together with targeted additional data collection including tracing studies to minimize mortality and co-morbidity under-ascertainment, and site surveys. Throughout, statistical methods addressing biases in routine cohort data will be developed and used. Southern Africa is the epicenter of the HIV/TB epidemic (HIV prevalence of 10-27% across the region), and IeDEA-SA includes the largest number of adults and children. IeDEA-SA is well-placed to address the specific aims through its long and successful track-record of collaboration between the epidemiologic and operational leadership at the Universities of Bern and Cape Town, clinical, scientific and programmatic experts across Southern African and other IeDEA regions, as well as with WHO, UNAIDS and other information consumers.

南部非洲艾滋病评估国际流行病学数据库 (IeDEA-SA) 合作 与艾滋病毒护理的连续性相关的两个关键的、相关的总体研究目的： (i) 全球监测 以及艾滋病毒护理、抗逆转录病毒治疗 (ART) 和治疗的可及性、有效性和结果的评估 与艾滋病毒相关的合并症计划 (ii) 提供最佳治疗和实施指南 资源有限环境中的艾滋病毒及其合并症。这些领域将在整个生命过程中受到检查 从怀孕到婴儿（艾滋病毒感染者和暴露者）、儿童、青少年和成人，通过区域和 IeDEA-SA 联盟内部和外部的多区域研究。 艾滋病毒的流行正在通过大规模抗逆转录病毒疗法的推广而发生改变，艾滋病的发病率也相应下降。 相关的死亡和母婴传播，以及通过获得更好的抗逆转录病毒疗法来改善 药物、实验室测试和卫生系统创新。维持和改善来之不易的减排 与艾滋病毒相关的发病率和死亡率，我们需要了解和优化艾滋病毒的长期结果， 包括在人生转变过程中保留护理、预防和治疗合并症 感染和非传染性疾病（例如癌症、心血管疾病和心理健康 疾病）并解决药物滥用的影响。因此，IeDEA-SA 的具体目标是： 1) 研究 从诊断到长期结果的艾滋病毒和结核病 (TB) 护理的连续性； 2）学习 合并感染（结核病、乙型肝炎）、心血管和代谢合并症； 3）研究负担和照顾 HIV+儿童和成人的癌症； 4) 研究 HIV/ART 连续体，特别是长期结果 HIV+母亲及其子女，从怀孕到接触未感染的婴儿，再到感染的婴儿， 儿童和青少年； 5）研究心理健康和心理保健的提供； 6）学习内容 在青少年和成人中使用 ART，具有跨领域目标 (7) 开发和应用最先进的技术 统计方法、数据统一标准、数据收集和链接工具。常规队列数据 近 900,000 名 HIV+ 个体（60,000 名登记时年龄<13 岁）将因与死亡率的联系而得到加强 和其他疾病数据库（例如癌症和结核病）以及有针对性的额外数据收集，包括 追踪研究以尽量减少死亡率和合并症的确定以及现场调查。自始至终， 将开发和使用解决常规队列数据偏差的统计方法。 南部非洲是艾滋病毒/结核病流行的中心（该地区艾滋病毒感染率为 10-27%），并且 IeDEA-SA 包括数量最多的成人和儿童。 IeDEA-SA 能够很好地解决具体问题 其目标是通过流行病学和业务部门之间长期而成功的合作记录 伯尔尼大学和开普敦大学的领导层，以及各地的临床、科学和规划专家 南部非洲和其他 IeDEA 地区，以及世界卫生组织、联合国艾滋病规划署和其他信息消费者。