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Evaluation of impact of long-lasting insecticide-treated bed nets and point-of-use water filters on HIV1 disease progression in Kenya.

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dc.contributor.author Walson JL, Sangaré LR, Singa BO, Naulikha JM, Piper BK, Yuhas K, Onchiri FM, Otieno PA, Mermin J, Zeh C, Richardson BA and John-Stewart G.
dc.date.accessioned 2019-12-07T09:19:30Z
dc.date.available 2019-12-07T09:19:30Z
dc.date.issued 2013
dc.identifier.uri http://hdl.handle.net/123456789/9969
dc.description.abstract OBJECTIVES: Among HIV-1-infected individuals in Africa, coinfection with malaria and diarrhoeal disease may be associated with more rapid HIV-1 disease progression. We sought to determine whether the use of longlasting insecticide-treated bed nets and simple point-of-use water filters can delay HIV-1 disease progression. DESIGN: A prospective cohort study. SETTING: Two HIV care sites in Kenya. PARTICIPANTS: HIV-1-infected adults not yet meeting criteria for antiretroviral therapy. INTERVENTIONS: One group received the standard of care, whereas the other received long-lasting insecticide-treated bed nets and water filters. Individuals were followed for up to 24 months. MAIN OUTCOME MEASURES: The primary outcome measures were time to CD4 cell count less than 350 cells/μl and a composite endpoint of time to CD4 cell count less than 350 cells/μl and nontraumatic death. Time to disease progression was compared using Cox proportional hazards regression. RESULTS: Of 589 individuals included, 361 received the intervention and 228 served as controls. Median baseline CD4 cell counts were similar (P=0.36). After controlling for baseline CD4 cell count, individuals receiving the intervention were 27% less likely to reach the endpoint of a CD4 cell count less than 350 cells/μl (hazard ratio 0.73; 95% confidence interval 0.57-0.95). CD4 cell count decline was also significantly less in the intervention group (-54 vs. -70 cells/μl per year, P=0.03). In addition, the incidence of malaria and diarrhoea were significantly lower in the intervention group. CONCLUSION: Provision of a long-lasting insecticide-treated bed net and water filter was associated with a delay in CD4 cell count decline and may be a simple, practical and cost-effective strategy to delay HIV-1 progression in many resource-limited settings. en_US
dc.title Evaluation of impact of long-lasting insecticide-treated bed nets and point-of-use water filters on HIV1 disease progression in Kenya. en_US


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