Risk of death among those awaiting treatment for HIV infection in Zimbabwe: adolescents are at particular risk.

INTRODUCTION: Mortality among HIV-positive adults awaiting antiretroviral therapy (ART) has previously been found to be high. Here, we compare adolescent pre-ART mortality to that of adults in a public sector HIV care programme in Bulawayo, Zimbabwe. METHODS: In this retrospective cohort study, we compared adolescent pre-ART outcomes with those of adults enrolled for HIV care in the same clinic. Adolescents were defined as those aged 10-19 at the time of registration. Comparisons of means and proportions were carried out using two-tailed sample t-tests and chi-square tests respectively, for normally distributed data, and the Mann-Whitney U-tests for non-normally distributed data. Loss to follow-up (LTFU) was defined as missing a scheduled appointment by three or more months. RESULTS: Between 2004 and 2010, 1382 of 1628 adolescents and 7557 of 11,106 adults who registered for HIV care met the eligibility criteria for ART. Adolescents registered at a more advanced disease stage than did adults (83% vs. 73% WHO stage III/IV, respectively, p<0.001), and the median time to ART initiation was longer for adolescents than for adults [21 (10-55) days vs. 15 (7-42) days, p<0.001]. Among the 138 adolescents and 942 adults who never commenced ART, 39 (28%) of adolescents and 135 (14%) of adults died, the remainder being LTFU. Mortality among treatment-eligible adolescents awaiting ART was significantly higher than among adults (3% vs. 1.8%, respectively, p=0.004). CONCLUSIONS: Adolescents present to ART services at a later clinical stage than adults and are at an increased risk of death prior to commencing ART. Improved and innovative HIV case-finding approaches and emphasis on prompt ART initiation in adolescents are urgently needed. Following registration, defaulter tracing should be used, whether or not ART has been commenced

Risk of death among those awaiting treatment for HIV infection in Zimbabwe: adolescents are at particular risk

Abstract Introduction: Mortality among HIV-positive adults awaiting antiretroviral therapy (ART) has previously been found to be high. Here, we compare adolescent pre-ART mortality to that of adults in a public sector HIV care programme in Bulawayo, Zimbabwe. Methods: In this retrospective cohort study, we compared adolescent pre-ART outcomes with those of adults enrolled for HIV care in the same clinic. Adolescents were defined as those aged 10Á19 at the time of registration. Comparisons of means and proportions were carried out using two-tailed sample t-tests and chi-square tests respectively, for normally distributed data, and the MannÁWhitney U-tests for non-normally distributed data. Loss to follow-up (LTFU) was defined as missing a scheduled appointment by three or more months. Results: Between 2004 and 2010, 1382 of 1628 adolescents and 7557 of 11,106 adults who registered for HIV care met the eligibility criteria for ART. Adolescents registered at a more advanced disease stage than did adults (83% vs. 73% WHO stage III/ IV, respectively, pB0.001), and the median time to ART initiation was longer for adolescents than for adults [21 (10Á55) days vs. 15 (7Á42) days, p B0.001]. Among the 138 adolescents and 942 adults who never commenced ART, 39 (28%) of adolescents and 135 (14%) of adults died, the remainder being LTFU. Mortality among treatment-eligible adolescents awaiting ART was significantly higher than among adults (3% vs. 1.8%, respectively, p 00.004). Conclusions: Adolescents present to ART services at a later clinical stage than adults and are at an increased risk of death prior to commencing ART. Improved and innovative HIV case-finding approaches and emphasis on prompt ART initiation in adolescents are urgently needed. Following registration, defaulter tracing should be used, whether or not ART has been commenced

Papiers du maréchal de Bellecombe et de sa famille, 1777-1854. I Correspondance.

Bellecombe, Maréchal de, gouverneur général de Saint-Domingue. Papiers, correspondanceContient : Agoult, Comte Jean-Antoine d', aide-major général. Lettre(s) ; Angosse, Jean-Paul d'Angosse dit le Marquis d'. Lettre(s) ; Artau. Lettre(s) ; Assaut, Chevalier d'. Lettre(s) ; Baradat, médecin à Haïti. Certificat ; Beccard. Lettre(s) ; Bedene, inspecteur des chasses du comte d'Artois. Lettre(s) ; Bertron, F.. Lettre(s) ; Beuret. Lettre(s) ; Bion. Lettre(s) ; Brion. Lettre(s) ; Blanchardon et Bellet, négociants. Note(s) ; Blondeau. Lettre(s) ; Bongars, Marquis de, intendant de Saint-Domingue. Lettre(s) ; Bonhomme. Lettre(s) ; Bonnaffés. Lettre(s) ; Borie. Lettre(s) ; Bouguereau, capitaine de port à Port-au-Prince. Lettre(s) ; Bourdon. Lettre(s) ; Broudeau, de. Lettre(s) ; Cairon. Lettre(s) ; Casamajor, de, commandant à Port de Paix, Saint-Domingue. Lettre(s) ; Castries, Charles-Eugène-Gabriel de La Croix, Marquis de, maréchal de France. Billet ; Caussade. Lettre(s) ; Chanson. Lettre(s) ; Charet de Fromentaux. Lettre(s) ; Hochet de La Terrie. Lettre(s) ; Chauvet. Lettre(s) ; Cheureau. Lettre(s) ; Clermont, Mme de, née Montalembert. Lettre(s) ; Cloupit, Louis. Lettre(s) ; Collas, major de bataillon. Lettre(s) ; Comptone, J.. Lettre(s) ; Cournoyer. Lettre(s) ; Couronat. Lettre(s) ; Coustard. Lettre(s) ; Crémont. Lettre(s) ; Croix. Lettre(s) ; Dailleboust. Lettre(s) ; Dalleman, Comte, colonel du Régiment de Saintonge. Lettre(s) ; Dangeard de Virazel. Lettre(s) ; Degrèse, F.. Lettre(s) ; Delafitte, Chevalier. Lettre(s) ; Delamardelle, Guillaume-Pierre-Antoine, procureur général au Conseil Supérieur de Port-au-Prince. Lettre(s) ; Panon des Bassayns, Henry-Paulin Panon dit . Lettre(s) ; Desjardins, G.. Lettre(s) ; Des Touches, Chevalier. Lettre(s) ; Devaudore, Chevalier. Lettre(s) ; Dierx, J.. Lettre(s) ; Dioré, Chevalier Étienne-Jean. Lettre(s) ; Dubourg de Moulveau. Lettre(s) ; Dudillot, négociant. Lettre(s) ; Dufaur. Lettre(s) ; Du Gravier, Comte. Lettre(s) ; Du Grès, Chevalier. Lettre(s) ; Duhard. Lettre(s) ; Duhart-Tremaïs. Lettre(s) ; Du Périer. Lettre(s) ; Du Platon, Bertrand. Lettre(s) ; Du Plessis. Lettre(s) ; Duran. Lettre(s) ; Durège de Beaulieu. Lettre(s) ; Durieux, procureur du Roi. Lettre(s) ; Feger Gramont. Lettre(s) ; Foache, Stanislas. Lettre(s) ; Fontanille de Bragerac. Lettre(s) ; Frignet, arpenteur du Roi à Saint-Domingue. Lettre(s) ; Frontin. Lettre(s) ; Fumel, Comte de. Lettre(s) ; Gafrignac. Lettre(s) ; Galaup, Chevalier de. Lettre(s) ; Gaube. Lettre(s) ; Graube. Lettre(s) ; Gérard, négociant à Lorient. Lettre(s) ; Gérard, négociant à Lorient. Relevé de comptes ; Gérard, négociant à Lorient. Lettre(s) de ses successeurs ; Gorman, Comte de. Lettre(s) ; Gounou des Changes, J.. Lettre(s) ; Gradir, David. Lettre(s) ; Greslau. Lettre(s) ; Grimouville, Vicomte de. Lettre(s) ; Gripière de Laval, Marquis de. Lettre(s) ; Hardy. Lettre(s) ; Hiriard, Cécile. Lettre(s) ; Julien, Louis. Lettre(s) ; Kerenscoff. Lettre(s) ; Le Deist de Kerivalant. Lettre(s) ; Labasset. Lettre(s) ; Lafforre ainé. Lettre(s) ; Dioré, Chevalier Étienne-Jean. Pièce le concernant ; La Gracinière, capitaine au Régiment de l'Isle de France. Lettre(s) ; Lamothe Duthiers. Lettre(s) ; La Rivière, de. Lettre(s) ; Laroujayrie. Reçu signé ; Lattes ainé, J.. Lettre(s) ; Laumur, M. de. Lettre(s) ; Launay, Denis. Lettre(s) ; Launay, de, bijoutier. Lettre(s) ; Laval, Vicomte de. Lettre(s) ; Le Brasseur. Lettre(s) ; Le Forestier. Lettre(s) ; Léger. Lettre(s) ; Le Guen, L.. Lettre(s) ; Leroux. Lettre(s) ; Le Royer. Lettre(s) ; Lesaniquer. Lettre(s) ; Le Vacher. Reconnaissance de rente ; Loppinos. Lettre(s) ; Loustau. Lettre(s) ; Marin cadet. Lettre(s) ; Martrou. Lettre(s) ; Mélin, secrétaire du Roi. Lettre(s) ; Michel. Lettre(s) ; Mistral. Lettre(s) ; Montalembert. Lettre(s) ; Montbrun, P.. Lettre(s) ; Panon-Montbrun, Henri-Charles. Lettre(s) ; Morel. Lettre(s) ; Nolivos. Lettre(s) ; Pécalbert. Lettre(s) ; Peyrelongue de Bony. Lettre(s) ; Peyrelongue de Bony (Mme). Lettre(s) ; Piller, Comte de. Lettre(s) ; Pitot. Lettre(s) ; Planthion, B.. Lettre(s) ; Poissonnier. Lettre(s) ; Poly d'Aurbigny. Lettre(s) ; Raffin de Lamartielle. Lettre(s) ; Rivière, F.. Lettre(s) ; Roberjot. Lettre(s) ; Romainville, de. Lettre(s) ; Ronseray, de. Lettre(s) ; Rostaing, Marquis de. Lettre(s) ; Roudil. Lettre(s) ; Saint-Martin, Chevalier de. Lettre(s) ; Saint-Paul, de. Lettre(s) ; Saint-Paul de Doumic. Lettre(s) ; Saint-Sauveur, Raymond de. Lettre(s) ; Saint-Victor, Chevalier de. Lettre(s) ; Seilhac, Comte de. Lettre(s) ; Sentout. Lettre(s) ; Shindane. Lettre(s) ; Souillac, Vicomte de. Lettre(s) ; Testas, Pierre. Lettre(s) ; Trémaire. Lettre(s) ; Soutine. Lettre(s) ; Tonnay, Chevalier de. Lettre(s) ; Villas, M. de. Lettre(s) ; Villiers, M. de. Lettre(s) ; Virieux. Lettre(s) ; Vogüe, Monseigneur Jacques-Joseph-François de. Lettre(s)Numérisation effectuée à partir d'un document original