Browsing by Author "Sohn AH"

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Characteristics and outcomes of adolescents living with perinatally acquired HIV within Southern Africa.
(2020-Dec-01) Tsondai PR; Braithwaite K; Fatti G; Bolton Moore C; Chimbetete C; Rabie H; Phiri S; Sawry S; Eley B; Hobbins MA; Boulle A; Taghavi K; Sohn AH; Davies MA; Department of Pediatrics and Child Health, Tygerberg Hospital, Stellenbosch University, Parow, South Africa.; TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand.; Red Cross War Memorial Children's Hospital and Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.; Empilweni Services and Research Unit, Department of Paediatrics & Child Health, Faculty of Health Sciences, Rahima Moosa Mother and Child Hospital, University of the Witwatersrand, Johannesburg.; Kheth' Impilo, AIDS Free Living, Cape Town.; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.; Harriet Shezi Children's Clinic, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg.; Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.; Newlands Clinic, Harare, Zimbabwe.; Lighthouse Trust Clinic, Lilongwe, Malawi.; Centre for Infectious Disease Epidemiology & Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town.; Research & Quality Unit, SolidarMed, Lucerne.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Medicine, University of Alabama at Birmingham, Alabama, USA.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: Using data from 15 International epidemiology Databases to Evaluate AIDS in Southern Africa sites, we compared the characteristics and outcomes of adolescents living with perinatally acquired HIV (ALPH). METHODS: We included ALPH entering care aged less than 13 years with at least one HIV care visit during adolescence (10-19 years). We compared the characteristics and cross-sectional outcomes: transfer out, loss to follow-up (no visit in the 12 months prior to database closure), mortality, and retention between those who entered care aged less than 10 vs. aged 10-13 years; and explored predictors of mortality after age 13 years using Cox Proportional Hazards models. RESULTS: Overall, 16 229 (50% female) ALPH who entered HIV care aged less than 10 years and 8897 (54% female) aged 10-13 years were included and followed for 152 574 person-years. During follow-up, 94.1% initiated antiretroviral therapy, with those who entered care aged less than 10 more likely to have initiated antiretroviral therapy [97.9%, 95% confidence interval (CI) 97.6; 98.1%] than those who presented aged 10-13 years (87.3%, 95% CI 86.6; 88.0%). At the end of follow-up, 3% had died (entered care aged <10 vs. 10-13 years; 1.4 vs. 5.1%), 22% were loss to follow-up (16.2 vs. 33.4%), and 59% (66.4 vs. 45.4%) were retained. There was no difference in the risk of dying after the age of 13 years between adolescents entering care aged less than 10 vs. 10-13 years (adjusted hazard ratio 0.72; 95% CI 0.36; 1.42). CONCLUSION: Retention outcomes for ALPH progressively worsened with increasing age, with these outcomes substantially worse among adolescents entering HIV care aged 10-13 vs. less than 10 years.
Characterizing the double-sided cascade of care for adolescents living with HIV transitioning to adulthood across Southern Africa.
(2020-Jan) Tsondai PR; Sohn AH; Phiri S; Sikombe K; Sawry S; Chimbetete C; Fatti G; Hobbins MA; Technau KG; Rabie H; Bernheimer J; Fox MP; Judd A; Collins IJ; Davies MA; TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand.; Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.; MRC Clinical Trials Unit at UCL, University College London (UCL), London, United Kingdom.; SolidarMed, Luzern, Switzerland.; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.; Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.; Department of Paediatrics and Child Health, Tygerberg Academic Hospital, University of Stellenbosch, Stellenbosch, South Africa.; Lighthouse Trust Clinic, Lilongwe, Malawi.; Newlands Clinic, Harare, Zimbabwe.; Empilweni Services and Research Unit, Department of Paediatrics & Child Health, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Médecins Sans Frontiers, Khayelitsha, South Africa.; Kheth'Impilo, Cape Town, South Africa.; Department of Global Health and Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.; Harriet Shezi Children's Clinic, Wits Reproductive Health and HIV Research Unit, University of Witwatersrand, Johannesburg, South Africa.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
INTRODUCTION: As adolescents and young people living with HIV (AYLH) age, they face a "transition cascade," a series of steps associated with transitions in their care as they become responsible for their own healthcare. In high-income countries, this usually includes transfer from predominantly paediatric/adolescent to adult clinics. In sub-Saharan Africa, paediatric HIV care is mostly provided in decentralized, non-specialist primary care clinics, where "transition" may not necessarily include transfer of care but entails becoming more autonomous for one's HIV care. Using different age thresholds as proxies for when "transition" to autonomy might occur, we evaluated pre- and post-transition outcomes among AYLH. METHODS: We included AYLH aged <16 years at enrolment, receiving antiretroviral therapy (ART) within International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) sites (2004 to 2017) with no history of transferring care. Using the ages of 16, 18, 20 and 22 years as proxies for "transition to autonomy," we compared the outcomes: no gap in care (≥2 clinic visits) and viral suppression (HIV-RNA <400 copies/mL) in the 12 months before and after each age threshold. Using log-binomial regression, we examined factors associated with no gap in care (retention) in the 12 months post-transition. RESULTS: A total of 5516 AYLH from 16 sites were included at "transition" age 16 (transition-16y), 3864 at 18 (transition-18y), 1463 at 20 (transition-20y) and 440 at 22 years (transition-22y). At transition-18y, in the 12 months pre- and post-transition, 83% versus 74% of AYLH had no gap in care (difference 9.3 (95% confidence interval (CI) 7.8 to 10.9)); while 65% versus 62% were virally suppressed (difference 2.7 (-1.0 to 6.5%)). The strongest predictor of being retained post-transition was having no gap in the preceding year, across all transition age thresholds (transition-16y: adjusted risk ratio (aRR) 1.72; 95% CI (1.60 to 1.86); transition-18y: aRR 1.76 (1.61 to 1.92); transition-20y: aRR 1.75 (1.53 to 2.01); transition-22y: aRR 1.47; (1.21 to 1.78)). CONCLUSIONS: AYLH with gaps in care need targeted support to prevent non-retention as they take on greater responsibility for their healthcare. Interventions to increase virologic suppression rates are necessary for all AYLH ageing to adulthood.
Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis.
(2022-Mar) Jesson J; Crichton S; Quartagno M; Yotebieng M; Abrams EJ; Chokephaibulkit K; Le Coeur S; Aké-Assi MH; Patel K; Pinto J; Paul M; Vreeman R; Davies MA; Ben-Farhat J; Van Dyke R; Judd A; Mofenson L; Vicari M; Seage G; Bekker LG; Essajee S; Gibb D; Penazzato M; Collins IJ; Wools-Kaloustian K; Slogrove A; Powis K; Williams P; Matshaba M; Thahane L; Nyasulu P; Lukhele B; Mwita L; Kekitiinwa-Rukyalekere A; Wanless S; Goetghebuer T; Thorne C; Warszawski J; Galli L; van Rossum AMC; Giaquinto C; Marczynska M; Marques L; Prata F; Ene L; Okhonskaya L; Navarro M; Frick A; Naver L; Kahlert C; Volokha A; Chappell E; Pape JW; Rouzier V; Marcelin A; Succi R; Sohn AH; Kariminia A; Edmonds A; Lelo P; Lyamuya R; Ogalo EA; Odhiambo FA; Haas AD; Bolton C; Muhairwe J; Tweya H; Sylla M; D'Almeida M; Renner L; Abzug MJ; Oleske J; Purswani M; Teasdale C; Nuwagaba-Biribonwoha H; Goodall R; Leroy V; Medical University of Warsaw, Hospital of Infectious Diseases in Warsaw, Warsaw, Poland.; TREAT Asia/amfAR, Bangkok, Thailand.; Baylor College of Medicine Children's Foundation, Mwanza, Tanzania.; Hospital St Pierre, Brussels, Belgium.; Inserm U1018, Centre de recherche en Epidémiologie et Santé des Populations, Paris, France.; Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.; Moi Teaching and Referral Hospital, Eldoret, Kenya.; Hospital General Universitario "Gregorio Marañón", Madrid, Spain.; HIV Department, World Health Organization, Geneva, Switzerland.; Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA.; Padova University/PENTA Foundation, Padua, Italy.; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.; Baylor College of Medicine Children's Foundation, Maseru, Lesotho.; Baylor College of Medicine Children's Foundation, Lilongwe, Botswana.; Baylor College of Medicine Children's Foundation, Kampala, Uganda.; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Department of Global Health, Icahn School of Medicine at Mount Sinai, New York, USA.; International AIDS Society, Geneva, Switzerland.; Epicentre, Médecins Sans Frontières, Paris, France.; Baylor College of Medicine Children's Foundation, Lilongwe, Malawi.; Hospital de Santa Maria, Lisboa, Portugal.; Institut National d'Etude Demographique (INED), Mortality, Health and Epidemiology Unit, Paris, France.; Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.; Centro Hospitalar do Porto, Porto, Portugal.; Indiana University School of Medicine, Indianapolis, Indiana, USA.; Korle Bu Teaching Hospital, Accra, Ghana.; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.; Morogoro Regional Hospital, Morogoro, Tanzania.; Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; Department of Health Sciences, University of Florence, Florence, Italy.; Baylor International Pediatric AIDS Initiative, Texas Children's Hospital-USA, Houston, Texas, USA.; Victor Babes Hospital, Bucharest, Romania.; MRC Clinical Trials Unit, University College London, London, UK.; Children's Hospital of Eastern Switzerland, Saint Gallen, Switzerland.; University Hospital Yopougon, Abidjan, Côte d'Ivoire.; Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Rotterdam, The Netherlands.; Department of Paediatrics & Child Health, Faculty of Medicine & Health Sciences, Stellenbosch University, Worcester, South Africa.; Lighthouse Trust Clinic, Lilongwe, Malawi.; Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.; Rutgers - New Jersey Medical School, Newark, New Jersey, USA.; Institut de Recherche pour le Developpement (IRD), UMI-174/PHPT, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.; Siriraj Institute of Clinical Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Salaya, Thailand.; Baylor College of Medicine Children's Foundation, Mbabane, eSwatini.; SolidarMed, Lesotho, Zimbabwe.; CHU Gabriel Toure, Bamako, Mali.; Centre National Hospitalier Universitaire Hubert K. Maga, Cotonou, Benin.; Bronx-Lebanon Hospital Center, Bronx, New York, USA.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.; Tulane University Health Sciences Center, New Orleans, Louisiana, USA.; University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.; GHESKIO Center, Port-au-Prince, Haiti.; Republican Hospital of Infectious Diseases, St Petersburg, Russian Federation.; Department of Pediatrics, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.; UNICEF, New York, USA.; CERPOP, Inserm, Université Paul Sabatier Toulouse 3, Toulouse, France.; Universidade Federal de Sao Paulo, Sao Paulo, Brazil.; Infection Disease Unit, Meyer Children's University Hospital, Florence, Italy.; Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.; Pediatric Hospital Kalembe Lembe, Lingwala, Demogratic Republic of Congo.; Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine.; ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, USA.; Hospital Universitari Vall d' Hebron, Vall d' Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
INTRODUCTION: Adolescents living with HIV are subject to multiple co-morbidities, including growth retardation and immunodeficiency. We describe growth and CD4 evolution during adolescence using data from the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) global project. METHODS: Data were collected between 1994 and 2015 from 11 CIPHER networks worldwide. Adolescents with perinatally acquired HIV infection (APH) who initiated antiretroviral therapy (ART) before age 10 years, with at least one height or CD4 count measurement while aged 10-17 years, were included. Growth was measured using height-for-age Z-scores (HAZ, stunting if <-2 SD, WHO growth charts). Linear mixed-effects models were used to study the evolution of each outcome between ages 10 and 17. For growth, sex-specific models with fractional polynomials were used to model non-linear relationships for age at ART initiation, HAZ at age 10 and time, defined as current age from 10 to 17 years of age. RESULTS: A total of 20,939 and 19,557 APH were included for the growth and CD4 analyses, respectively. Half were females, two-thirds lived in East and Southern Africa, and median age at ART initiation ranged from <3 years in North America and Europe to >7 years in sub-Saharan African regions. At age 10, stunting ranged from 6% in North America and Europe to 39% in the Asia-Pacific; 19% overall had CD4 counts <500 cells/mm CONCLUSIONS: Growth patterns during adolescence differed substantially by sex and region, while CD4 patterns were similar, with an observed CD4 decline that needs further investigation. Early diagnosis and timely initiation of treatment in early childhood to prevent growth retardation and immunodeficiency are critical to improving APH growth and CD4 outcomes by the time they reach adulthood.
Impact of Universal Antiretroviral Treatment Eligibility on Rapid Treatment Initiation Among Young Adolescents with Human Immunodeficiency Virus in Sub-Saharan Africa.
(2020-Aug-04) Tymejczyk O; Brazier E; Wools-Kaloustian K; Davies MA; Dilorenzo M; Edmonds A; Vreeman R; Bolton C; Twizere C; Okoko N; Phiri S; Nakigozi G; Lelo P; von Groote P; Sohn AH; Nash D; Lighthouse Trust, Lilongwe, Malawi.; TREAT Asia, amfAR-The Foundation for AIDS Research, Bangkok, Thailand.; Rakai Health Sciences Program, Kalisizo, Uganda.; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.; Department of Epidemiology and Biostatistics, School of Public Health, City University of New York, New York, NY, USA.; Indiana University School of Medicine, Indianapolis, Indiana, USA.; Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.; Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Centre Hospitalo-Universitaire de Kamenge, Bujumbura, Burundi.; Kalembelembe Pediatric Hospital, Kinshasa, Democratic Republic of the Congo.; Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA.; Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.; Boston Medical Center, Boston, Massachusetts, USA.; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: Young adolescents with perinatally acquired human immunodeficiency virus (HIV) are at risk for poor care outcomes. We examined whether universal antiretroviral treatment (ART) eligibility policies (Treat All) improved rapid ART initiation after care enrollment among 10-14-year-olds in 7 sub-Saharan African countries. METHODS: Regression discontinuity analysis and data for 6912 patients aged 10-14-years were used to estimate changes in rapid ART initiation (within 30 days of care enrollment) after adoption of Treat All policies in 2 groups of countries: Uganda and Zambia (policy adopted in 2013) and Burundi, Democratic Republic of the Congo, Kenya, Malawi, and Rwanda (policy adopted in 2016). RESULTS: There were immediate increases in rapid ART initiation among young adolescents after national adoption of Treat All. Increases were greater in countries adopting the policy in 2016 than in those adopting it in 2013: 23.4 percentage points (pp) (95% confidence interval, 13.9-32.8) versus 11.2pp (2.5-19.9). However, the rate of increase in rapid ART initiation among 10-14-year-olds rose appreciably in countries with earlier treatment expansions, from 1.5pp per year before Treat All to 7.7pp per year afterward. CONCLUSIONS: Universal ART eligibility has increased rapid treatment initiation among young adolescents enrolling in HIV care. Further research should assess their retention in care and viral suppression under Treat All.
Temporal Trends in Co-trimoxazole Use Among Children on Antiretroviral Therapy and the Impact of Co-trimoxazole on Mortality Rates in Children Without Severe Immunodeficiency.
(2019-Nov-06) Boettiger DC; Law MG; Sohn AH; Davies MA; Wools-Kaloustian K; Leroy V; Yotebieng M; Vinikoor M; Vreeman R; Amorissani-Folquet M; Edmonds A; Fatti G; Batte J; Renner L; Adedimeji A; Kariminia A; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.; Department of Paediatrics, Korlebu Hospital, Accra, Ghana.; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.; TREAT Asia/amfAR-Foundation for AIDS Research, Bangkok, Thailand.; Centre for Infectious Disease Research in Zambia, Lusaka.; Department of Medicine, University of North Carolina at Chapel Hill.; INSERM, Laboratoire d'Epidémiologie et Analyses en Santé Publique (LEASP)-UMR 1027, Toulouse, France.; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.; Indiana University School of Medicine, Indianapolis.; The Kirby Institute, University of New South Wales, Sydney, Australia.; Department of Paediatrics, University Hospital of Cocody, Abidjan, Côte d'Ivoire.; Kheth'Impilo AIDS Free Living, Cape Town, South Africa.; Rakai Health Science Program, Uganda.; Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa.; College of Public Health, The Ohio State University, Columbus.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: Co-trimoxazole is recommended for all children with human immunodeficiency virus. In this analysis, we evaluate trends in pediatric co-trimoxazole use and survival on co-trimoxazole in children using antiretroviral therapy (ART). METHODS: We used data collected between January 1, 2006, and March 31, 2016, from the International Epidemiology Databases to Evaluate AIDS. Logistic regression was used to evaluate factors associated with using co-trimoxazole at ART initiation. Competing risk regression was used to assess factors associated with death. RESULTS: A total of 54113 children were included in this study. The prevalence of co-trimoxazole use at ART initiation increased from 66.5% in 2006 to a peak of 85.6% in 2010 and then declined to 48.5% in 2015-2016. A similar trend was observed among children who started ART with severe immunodeficiency. After adjusting for year of ART initiation, younger age (odds ratio [OR], 1.18 for <1 vs 1 to <5 years of age [95% confidence interval (CI), 1.09-1.28]), lower height-for-age z score (OR, 1.15 for less than -3 vs greater than -2 [95% CI, 1.08-1.22]), anemia (OR, 1.08 [95% CI, 1.02-1.15]), severe immunodeficiency (OR, 1.25 [95% CI, 1.18-1.32]), and receiving care in East Africa (OR, 8.97 vs Southern Africa [95% CI, 8.17-9.85]) were associated with a high prevalence of co-trimoxazole use. Survival did not differ according to co-trimoxazole use in children without severe immunodeficiency (hazard ratio, 1.01 for nonusers versus users [95% CI, 0.77-1.34]). CONCLUSIONS: Recent declines in co-trimoxazole use may not be linked to the current shift toward early ART initiation. Randomized trial data might be needed to establish the survival benefit of co-trimoxazole in children without severe immunodeficiency.
The Tuberculosis Sentinel Research Network (TB-SRN) of the International epidemiology Databases to Evaluate AIDS (IeDEA): protocol for a prospective cohort study in Africa, Southeast Asia and Latin America.
(2024-Jan-09) Enane LA; Duda SN; Chanyachukul T; Bolton-Moore C; Navuluri N; Messou E; Mbonze N; McDade LR; Figueiredo MC; Ross J; Evans D; Diero L; Akpata R; Zotova N; Freeman A; Pierre MF; Rupasinghe D; Ballif M; Byakwaga H; de Castro N; Tabala M; Sterling TR; Sohn AH; Fenner L; Wools-Kaloustian K; Poda A; Yotebieng M; Huebner R; Marcy O; Duke Global Health Institute, Duke University, Durham, North Carolina, USA.; Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.; Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; The Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA lenane@iu.edu.; Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.; Vanderbilt Institute of Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Mbarara University of Science and Technology Faculty of Medicine, Mbarara, Uganda.; Center for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.; Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland.; Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand.; Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Université de Bordeaux, Bordeaux, France.; The Kirby Institute, UNSW, Sydney, New South Wales, Australia.; Centre de Prise en Charge de Recherche et de Formation (Aconda-CePReF), Abidjan, Côte d'Ivoire.; Vanderbilt Tuberculosis Center, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Indiana University Center for Global Health Equity, Indianapolis, Indiana, USA.; The Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti.; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.; Department of Medicine, Moi University College of Health Sciences, Eldoret, Kenya.; Centre Hospitalier Universitaire Sourô Sanou, Bobo Dioulasso, Burkina Faso.
INTRODUCTION: Tuberculosis (TB) is a leading infectious cause of death globally. It is the most common opportunistic infection in people living with HIV, and the most common cause of their morbidity and mortality. Following TB treatment, surviving individuals may be at risk for post-TB lung disease. The TB Sentinel Research Network (TB-SRN) provides a platform for coordinated observational TB research within the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. METHODS AND ANALYSIS: This prospective, observational cohort study will assess treatment and post-treatment outcomes of pulmonary TB (microbiologically confirmed or clinically diagnosed) among 2600 people aged ≥15 years, with and without HIV coinfection, consecutively enrolled at 16 sites in 11 countries, across 6 of IeDEA's global regions. Data regarding clinical and sociodemographic factors, mental health, health-related quality of life, pulmonary function, and laboratory and radiographic findings will be collected using standardised questionnaires and data collection tools, beginning from the initiation of TB treatment and through 12 months after the end of treatment. Data will be aggregated for proposed analyses. ETHICS AND DISSEMINATION: Ethics approval was obtained at all implementing study sites, including the Vanderbilt University Medical Center Human Research Protections Programme. Participants will provide informed consent; for minors, this includes both adolescent assent and the consent of their parent or primary caregiver. Protections for vulnerable groups are included, in alignment with local standards and considerations at sites. Procedures for requesting use and analysis of TB-SRN data are publicly available. Findings from TB-SRN analyses will be shared with national TB programmes to inform TB programming and policy, and disseminated at regional and global conferences and other venues.