Imperial College London
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ProfessorKathMaitland

Faculty of Medicine, Department of Surgery & Cancer

Professor of Tropical Paediatric Infectious Disease
 
 
 
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k.maitland CV

 
 
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Based full-time at KEMRI/Wellcome Programme, KenyaQueen Elizabeth and Queen Mary HospitalSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Walker:2020:10.1002/jia2.25469,
author = {Walker, SM and Cox, E and Revill, P and Musiime, V and BwakuraDangarembizi, M and Mallewa, J and Cheruiyot, P and Maitland, K and Ford, N and Gibb, DM and Walker, AS and Soares, M and Mugyenyi, P and Kityo, C and Musiime, V and Wavamunno, P and Nambi, E and Ocitti, P and Ndigendawani, M and Kabahenda, S and Kemigisa, M and Acen, J and Olebo, D and Mpamize, G and Amone, A and Okweny, D and Mbonye, A and Nambaziira, F and Rweyora, A and Kangah, M and Kabaswahili, V and Abach, J and Abongomera, G and Omongin, J and Aciro, I and Philliam, A and Arach, B and Ocung, E and Amone, G and Miles, P and Adong, C and Tumsuiime, C and Kidega, P and Otto, B and Apio, F and Baleeta, K and Mukuye, A and Abwola, M and Ssennono, F and Baliruno, D and Tuhirwe, S and Namisi, R and Kigongo, F and Kikyonkyo, D and Mushahara, F and Okweny, D and Tusiime, J and Musiime, A and Nankya, A and Atwongyeire, D and Sirikye, S and Mula, S and Noowe, N and Lugemwa, A and Kasozi, M and Mwebe, S and Atwine, L and Senkind},
doi = {10.1002/jia2.25469},
journal = {Journal of the International AIDS Society},
pages = {1--11},
title = {The costeffectiveness of prophylaxis strategies for individuals with advanced HIV starting treatment in Africa},
url = {http://dx.doi.org/10.1002/jia2.25469},
volume = {23},
year = {2020}
}
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TY  - JOUR
AB  - IntroductionMany HIVpositive individuals in Africa have advanced disease when initiating antiretroviral therapy (ART) so have high risks of opportunistic infections and death. The REALITY trial found that an enhancedprophylaxis package including fluconazole reduced mortality by 27% in individuals starting ART with CD4 <100 cells/mm3. We investigated the costeffectiveness of this enhancedprophylaxis package versus other strategies, including using cryptococcal antigen (CrAg) testing, in individuals with CD4 <200 cells/mm3 or <100 cells/mm3 at ART initiation and all individuals regardless of CD4 count.MethodsThe REALITY trial enrolled from June 2013 to April 2015. A decisionanalytic model was developed to estimate the costeffectiveness of six management strategies in individuals initiating ART in the REALITY trial countries. Strategies included standardprophylaxis, enhancedprophylaxis, standardprophylaxis with fluconazole; and three CrAg testing strategies, the first stratifying individuals to enhancedprophylaxis (CrAgpositive) or standardprophylaxis (CrAgnegative), the second to enhancedprophylaxis (CrAgpositive) or enhancedprophylaxis without fluconazole (CrAgnegative) and the third to standardprophylaxis with fluconazole (CrAgpositive) or without fluconazole (CrAgnegative). The model estimated costs, lifeyears and qualityadjusted lifeyears (QALY) over 48 weeks using three competing mortality risks: cryptococcal meningitis; tuberculosis, serious bacterial infection or other known cause; and unknown cause.ResultsEnhancedprophylaxis was costeffective at costeffectiveness thresholds of US$300 and US$500 per QALY with an incremental costeffectiveness ratio (ICER) of US$157 per QALY in the CD4 <200 cells/mm3 population providing enhancedprophylaxis components are sourced at lowest available prices. The ICER reduced in more severely immunosuppressed individuals (US$113 per QALY in the CD4 <100 cells/mm3 population) and increased
AU  - Walker,SM
AU  - Cox,E
AU  - Revill,P
AU  - Musiime,V
AU  - BwakuraDangarembizi,M
AU  - Mallewa,J
AU  - Cheruiyot,P
AU  - Maitland,K
AU  - Ford,N
AU  - Gibb,DM
AU  - Walker,AS
AU  - Soares,M
AU  - Mugyenyi,P
AU  - Kityo,C
AU  - Musiime,V
AU  - Wavamunno,P
AU  - Nambi,E
AU  - Ocitti,P
AU  - Ndigendawani,M
AU  - Kabahenda,S
AU  - Kemigisa,M
AU  - Acen,J
AU  - Olebo,D
AU  - Mpamize,G
AU  - Amone,A
AU  - Okweny,D
AU  - Mbonye,A
AU  - Nambaziira,F
AU  - Rweyora,A
AU  - Kangah,M
AU  - Kabaswahili,V
AU  - Abach,J
AU  - Abongomera,G
AU  - Omongin,J
AU  - Aciro,I
AU  - Philliam,A
AU  - Arach,B
AU  - Ocung,E
AU  - Amone,G
AU  - Miles,P
AU  - Adong,C
AU  - Tumsuiime,C
AU  - Kidega,P
AU  - Otto,B
AU  - Apio,F
AU  - Baleeta,K
AU  - Mukuye,A
AU  - Abwola,M
AU  - Ssennono,F
AU  - Baliruno,D
AU  - Tuhirwe,S
AU  - Namisi,R
AU  - Kigongo,F
AU  - Kikyonkyo,D
AU  - Mushahara,F
AU  - Okweny,D
AU  - Tusiime,J
AU  - Musiime,A
AU  - Nankya,A
AU  - Atwongyeire,D
AU  - Sirikye,S
AU  - Mula,S
AU  - Noowe,N
AU  - Lugemwa,A
AU  - Kasozi,M
AU  - Mwebe,S
AU  - Atwine,L
AU  - Senkindu,T
AU  - Natuhurira,T
AU  - Katemba,C
AU  - Ninsiima,E
AU  - Acaku,M
AU  - Kyomuhangi,J
AU  - Ankunda,R
AU  - Tukwasibwe,D
AU  - Ayesiga,L
AU  - Hakim,J
AU  - Nathoo,K
AU  - BwakuraDangarembizi,M
AU  - Reid,A
AU  - Chidziva,E
AU  - Mhute,T
AU  - Tinago,GC
AU  - Bhiri,J
AU  - Mudzingwa,S
AU  - Phiri,M
AU  - Steamer,J
AU  - Nhema,R
AU  - Warambwa,C
AU  - Musoro,G
AU  - Mutsai,S
AU  - Nemasango,B
AU  - Moyo,C
AU  - Chitongo,S
AU  - Rashirai,K
AU  - Vhembo,S
AU  - Mlambo,B
AU  - Nkomani,S
AU  - Ndemera,B
AU  - Willard,M
AU  - Berejena,C
AU  - Musodza,Y
AU  - Matiza,P
AU  - Mudenge,B
AU  - Guti,V
AU  - Etyang,A
AU  - Agutu,C
AU  - Berkley,J
AU  - Maitland,K
AU  - Njuguna,P
AU  - Mwaringa,S
AU  - Etyang,T
AU  - Awuondo,K
AU  - Wale,S
AU  - Shangala,J
AU  - Kithunga,J
AU  - Mwarumba,S
AU  - Said,Maitha S
AU  - Mutai,R
AU  - Lozi,Lewa M
AU  - Mwambingu,G
AU  - Mwanzu,A
AU  - Kalama,C
AU  - Latham,H
AU  - Shikuku,J
AU  - Fondo,A
AU  - Njogu,A
AU  - Khadenge,C
AU  - Mwakisha,B
AU  - Siika,A
AU  - WoolsKaloustian,K
AU  - Nyandiko,W
AU  - Cheruiyot,P
AU  - Sudoi,A
AU  - Wachira,S
AU  - Meli,B
AU  - Karoney,M
AU  - Nzioka,A
AU  - Tanui,M
AU  - Mokaya,M
AU  - Ekiru,W
AU  - Mboya,C
AU  - Mwimali,D
AU  - Mengich,C
AU  - Choge,J
AU  - Injera,W
AU  - Njenga,K
AU  - Cherutich,S
AU  - Anyango,Orido M
AU  - Omondi,Lwande G
AU  - Rutto,P
AU  - Mudogo,A
AU  - Kutto,I
AU  - Shali,A
AU  - Jaika,L
AU  - Jerotich,H
AU  - Pierre,M
AU  - Mallewa,J
AU  - Kaunda,S
AU  - Van,Oosterhout J
AU  - O'Hare,B
AU  - Heydermann,R
AU  - Gonzalez,C
AU  - Dzabala,N
AU  - Kelly,C
AU  - Denis,B
AU  - Selemani,G
AU  - Nyondo,Mipando L
AU  - Chirwa,E
AU  - Banda,P
AU  - Mvula,L
AU  - Msuku,H
AU  - Ziwoya,M
AU  - Manda,Y
AU  - Nicholas,S
AU  - Masesa,C
AU  - Mwalukomo,T
AU  - Makhaza,L
AU  - Sheha,I
AU  - Bwanali,J
AU  - Limbuni,M
AU  - Gibb,D
AU  - Thomas
DO  - 10.1002/jia2.25469
EP  - 11
PY  - 2020///
SN  - 1758-2652
SP  - 1
TI  - The costeffectiveness of prophylaxis strategies for individuals with advanced HIV starting treatment in Africa
T2  - Journal of the International AIDS Society
UR  - http://dx.doi.org/10.1002/jia2.25469
UR  - https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25469
UR  - http://hdl.handle.net/10044/1/77814
VL  - 23
ER  -
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