* * *
IeDEA West Africa
International epidemiologic Databases to Evaluate AIDS
* * *
The WADA (West Africa Data Base on Antiretroviral Therapy) collaboration was launched in July 2006 and renews in 2011 his
commitment to continue and expand the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Program in West Africa,
the region 8 of this program for five additional years. The WADA collaboration is a consortium of leading clinicians and
clinical epidemiologists. WADA is coordinated by the WADA Coordinating Center (CC) at the Bordeaux School of Public Health
(ISPED) within the Bordeaux University, France with a WADA Regional Office (RO) hosted by PAC-CI, a research-oriented non-governmental
organization based in Abidjan, Côte d’Ivoire.
WADA is a unique collaboration among clinical centres in West Africa with almost five years of experience. Its mission is
to conduct hypothesis-driven epidemiological research on the prognosis and outcomes of HIV-1 and HIV-2-infected people,
including adults, pregnant mothers, and children in care and generally on treatment, as well as HIV-exposed children.
The overall aims of WADA are :
- To measure the effectiveness of combination antiretroviral treatment (ART) in HIV-infected individuals in West Africa
in the long term, and to assess factors that influence outcomes
- To increase the capacity for delivering ART durably in West Africa by increasing the capacity for monitoring clinical
outcomes at the individual and population levels in adults and children
- To document the morbidity burden in HIV-infected individuals in care in HIV programs throughout West Africa.
The priority research agenda will address the following topics: retention in care, natural history of HIV-2 and HIV-1/HIV-2
infections, cancer, malaria, hepatitis B, pregnancy outcomes, pharmacovigilance, adolescent and pediatric access and efficiency
All activities will be carried out in the West Africa region but this database will also contribute to the multi-regional
research agenda of the IeDEA initiative.
- Pediatric (Dr Valériane
Leroy, Pediatric Study Coordinator)
The overall purpose of the Pediatric West African Database on AIDS (pWADA) research program is to better document the operational
access to HIV care and its long-term outcomes among HIV-exposed and HIV-infected children.
We have chosen the following specific aims :
- Early infant diagnosis (EID) and early access to ART in HIV-infected children :
- To ascertain reasons for missed opportunity of EID and of early ART;
- To assess interventions to promote earlier EID and earlier ART delivery;
- Retention (to be conducted in consistency with the adult research agenda):
- To ascertain reasons and outcomes in children lost to care;
- To assess interventions to improve retention in care of children;
- Documentation of long-term outcomes:
- To study disease progression (clinical, immunological, virological) and utilization of health care resources in HIV-infected
children without and with ART and cotrimoxazole prophylaxis;
- To measure the cost-effectiveness of HIV pediatric care;
- Improving the care of HIV-infected adolescents on ART (Dr Elise Arrivé):
- To document prospectively the growth and immunological response to ART;
- To assess the impact of disclosure to the adolescents of their HIV status;
- To facilitate the transfer of adolescents from pediatric to adult wards.
- Cancer (Dr Antoine
Jaquet, Cancer Study Coordinator)
- To initiate a cancer case registration in WADA;
- To explore the infectious etiology of cancer in West Africa;
- To study the association between ART and immunological status with occurrence of cervical malignancies and to expand systematic
cervical screening procedures.
- HIV-2 (Dr Didier
Ekouévi, HIV-2 Study Coordinator)
- In HIV-2 or HIV-1/HIV-2 infected patients not eligible for ART:
- - To describe the time to reach ART eligibility criteria;
- - To study mortality, loss-to-follow-up and new AIDS-classifying clinical events.
- In HIV-2 or HIV-1/HIV-2 infected patients on ART:
- - To describe clinical, immunological and virological characteristics at initiation of ART;
- - To study immunological and virological responses to ART, according to the ART regimen;
- - To estimate the 12-month and 24-month mortality risk after ART initiation;
- - To study frequency of severe adverse events and the reasons of switching ART regimen.
- To characterize the mutations in HIV-2 reverse transcriptase (RT) and Protease those confer ARV resistance and to establish
an HIV-2 resistance database.
- To develop a validated algorithm to distinguish HIV-1/HIV-2 dual infection from dual reaction using rapid HIV tests utilized
in clinical settings;
- To create the epidemiological, clinical and biological capacity for clinical trials research for the treatment of HIV-2
infection in West Africa.
- Morbidity (Dr Nathalie De Rekeneire)
- Reasons of hospitalization
To investigate the morbidity and mortality in HIV-infected adults and children hospitalized in tertiary hospital wards in
- Severe morbidity surveillance
in HIV care programs
To implement a surveillance system of overall severe morbidity occurring in HIV infected individuals after initiation of
ART, in order to of assess its frequency, to describe the type of pathologies diagnosed and the frequency of imprecise diagnosis
(symptoms), and to follow time trends. This system will be characterized by both a minimum standardization between sites
and an adaptation to the local organization in order to last long enough.
- Hepatitis (Dr Patrick Coffie)