Characterizing HIV status documentation among cancer patients at regional cancer centers in Malawi, Zimbabwe, and South Africa

Infectious Agents and Cancer

Research

Michalina A. Montaño¹  Rachel Bender Ignacio²  Margaret Borok³  Takudzwa Mtisi³  Ntokozo Ndlovu³  Maureen Joffe⁴  Agatha Bula⁵  Maganizo B. Chagomerana⁶ 

[1] Department of Global Health, University of Washington, Seattle, USA;Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, USA;Fred Hutchinson Cancer Center, Vaccine and Infectious Diseases Division, Seattle, USA;Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, USA;Fred Hutchinson Cancer Center, Vaccine and Infectious Diseases Division, Seattle, USA;Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe;Strengthening Oncology Services Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa;UNC Project Malawi, Lilongwe, Malawi;UNC Project Malawi, Lilongwe, Malawi;Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA;

关键词: HIV;    Oncology;    Epidemiology;    Malawi;    South Africa;    Zimbabwe;   

DOI  :  10.1186/s13027-023-00548-1

 received in 2023-08-03, accepted in 2023-10-18,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionIn East and Southern Africa, people with HIV (PWH) experience worse cancer-related outcomes and are at higher risk of developing certain cancers. Siloed care delivery pathways pose a substantial barrier to co-management of HIV and cancer care delivery.MethodsWe conducted cross-sectional studies of adult cancer patients at public radiotherapy and oncology units in Malawi (Kamuzu Central Hospital), Zimbabwe (Parirenyatwa Group of Hospitals), and South Africa (Charlotte Maxeke Hospital) between 2018 and 2019. We abstracted cancer- and HIV-related data from new cancer patient records and used Poisson regression with robust variance to identify patient characteristics associated with HIV documentation.ResultsWe included 1,648 records from Malawi (median age 46 years), 1,044 records from South Africa (median age 55 years), and 1,135 records from Zimbabwe (median age 52 years). Records from all three sites were predominately from female patients; the most common cancers were cervical (Malawi [29%] and Zimbabwe [43%]) and breast (South Africa [87%]). HIV status was documented in 22% of cancer records from Malawi, 92% from South Africa, and 86% from Zimbabwe. Patients with infection-related cancers were more likely to have HIV status documented in Malawi (adjusted prevalence ratio [aPR]: 1.92, 95% confidence interval [CI]: 1.56–2.38) and Zimbabwe (aPR: 1.16, 95%CI: 1.10–1.22). Patients aged ≥ 60 years were less likely to have HIV status documented (Malawi: aPR: 0.66, 95% CI: 0.50–0.87; Zimbabwe: aPR: 0.76, 95%CI: 0.72–0.81) than patients under age 40 years. Patient age and cancer type were not associated with HIV status documentation in South Africa.ConclusionDifferent cancer centers have different gaps in HIV status documentation and will require tailored strategies to improve processes for ascertaining and recording HIV-related information in cancer records. Further research by our consortium to identify opportunities for integrating HIV and cancer care delivery is underway.

【 授权许可】

CC BY   
© The Author(s) 2023

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