{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:09:04Z","timestamp":1761512944806},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2011,3,9]],"date-time":"2011-03-09T00:00:00Z","timestamp":1299628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2011,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Objective\u2002<\/jats:bold> To investigate the effect of antiretroviral therapy on trends of incidence, aetiology and clinical outcomes of bacteraemia among HIV\u2010infected Ugandans in a semi\u2010urban setting.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> A cohort of HIV\u20101\u2010infected Ugandans aged 15 or older was followed from 2000 to 2008. Clinical, haematological and immunological measurements were taken at 6\u2010monthly visits. Additionally, patients reported to outpatient clinics whenever they were ill. Patients with elevated axillary temperature above 37.4\u2003\u00b0C consistently triggered clinical assessment (with mandatory blood cultures) and empirical management protocol. Daily cotrimoxazole prophylaxis and highly active antiretroviral therapy (HAART) were introduced stepwise to eligible patients in August 2000 and February 2003, respectively. We compared the rates of bacteraemia across five calendar periods using random\u2010effects Poisson regression for the effect of HAART at the population level.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> A total of 246 bacteraemia episodes (including multiple episodes) were documented among 188 individuals (crude incidence: 42.4 events per 1000 person\u2010years; 95% CI: 35.0, 51.4). The most common species isolated was <jats:italic>Streptococcus pneumoniae<\/jats:italic>. After adjustment for current age, clinical characteristics at enrolment (CD4+ T\u2010cell counts and WHO stage) and time since enrolment, the incidence of bacteraemia dropped significantly when HAART was widely available compared with the period when treatment was not available (adjusted hazard ratio: 0.17; 95% CI: 0.09, 0.35). No poor health outcomes (death or lack of clinical response to antibiotics) after bacteraemia occurred after complete access to HAART.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> HAART availability in a resource\u2010poor setting substantially reduced the trends of bacteraemia among HIV\u2010infected adults. This may further impact on future morbidity and healthcare costs of HIV\u2010infected people.<\/jats:p>","DOI":"10.1111\/j.1365-3156.2011.02754.x","type":"journal-article","created":{"date-parts":[[2011,3,10]],"date-time":"2011-03-10T02:52:18Z","timestamp":1299725538000},"page":"756-765","source":"Crossref","is-referenced-by-count":9,"title":["Decreasing trends of bacteraemia among HIV\u2010infected Ugandan adults: incidence, aetiology, clinical outcomes and effect of antiretroviral therapy in a semi\u2010urban setting (2000\u20132008)"],"prefix":"10.1111","volume":"16","author":[{"given":"Stella Zawedde","family":"Muyanja","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Larke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Rutebarika","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismael","family":"Kaddu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Nakubulwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Levin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heiner","family":"Grosskurth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Miiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,3,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/321820"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1258\/0956462971918698"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1179\/joc.2003.15.1.60"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02377-1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0903029"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(90)92096-Z"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/jinf.2000.0779"},{"key":"e_1_2_7_9_1","first-page":"S43","article-title":"Natural history and spectrum of disease in adults with HIV\/AIDS in Africa","volume":"11","author":"Grant A","year":"1997","journal-title":"AIDS"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.13.1533"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1086\/430356"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1086\/520681"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0007782"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-0871"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2003.09.004"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199907090-00019"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2010.02528.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365549409008630"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-1293.2003.00146.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1086\/497144"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2009.02259.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)62067-5"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1201-9712(02)90130-X"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70072-4"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042560-199812150-00007"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1086\/517165"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042560-200002010-00006"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/168.3.564"},{"key":"e_1_2_7_29_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1097\/01.qai.0000221679.14445.1b","article-title":"Feasibility and effectiveness of cotrimoxazole prophylaxis for HIV\u20101\u2010infected adults attending an HIV\/AIDS clinic in Uganda","volume":"42","author":"Watera C","year":"2006","journal-title":"Journal of Acquired Immune Deficiency Syndromes"},{"key":"e_1_2_7_30_1","first-page":"711","article-title":"Proposed \u2018World Health Organization staging system for HIV infection and disease\u2019: preliminary testing by an international collaborative cross\u2010sectional study. The WHO International Collaborating Group for the Study of the WHO Staging System","volume":"7","author":"WHO","year":"1993","journal-title":"AIDS"},{"key":"e_1_2_7_31_1","unstructured":"WHO(2005)Interim WHO clinical staging of HIV\/AIDS and HIV\/AIDS case definitions for surveillance: African Region. In: WHO G. (Ed.) who.int\/hq\/2005\/who_HIV_2005.02.pdf."},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.2.594-597.2002"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-3156.2011.02754.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-3156.2011.02754.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T02:17:47Z","timestamp":1698718667000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-3156.2011.02754.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,3,9]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2011,6]]}},"alternative-id":["10.1111\/j.1365-3156.2011.02754.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-3156.2011.02754.x","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,3,9]]}}}