CHAMPS Receives Grant to Investigate HIV-Related Deaths in Africa

The Child Health and Mortality Prevention Surveillance (CHAMPS) network, supported by a new grant from the Bill & Melinda Gates Foundation, aims to delve into the causes of death among adults living with HIV in Africa. CHAMPS, primarily focused on reducing child mortality, extends its reach to address the persistently high rates of HIV-related deaths in low-resource areas.

Despite expanded access to antiretroviral therapy, HIV-related mortality remains a challenge in communities served by CHAMPS. Around 40% of projected AIDS-related deaths in the next decade could be averted by tackling advanced HIV disease (AHD). While tuberculosis is a well-known contributor, other underlying causes among adults with HIV remain unclear in the African context.

Victor Akelo, CHAMPS senior director, highlights the importance of utilizing CHAMPS data to fill these knowledge gaps and enhance HIV programs. In Kenya alone, an estimated 21,000 deaths occurred due to AIDS-related illnesses in 2022, underlining the urgency of understanding definitive causes to optimize interventions.

Building on its expertise in investigating child mortality, CHAMPS will extend its methodology to study deaths among adults with HIV in Kenya, Sierra Leone, Mozambique, and South Africa. The study, funded by the recent grant, will employ CHAMPS procedures along with additional tests to probe markers of AHD.

CHAMPS employs various techniques including minimally invasive tissue sampling, histopathology, and molecular diagnostics to pinpoint causes of death. Data and analysis from the three-year study will be readily accessible to local and global health programs, aiding in the evaluation and improvement of HIV services in underserved communities.

Results in Other African Nations

Mozambique

“Mozambique has made remarkable progress in the battle against HIV, as the prevalence rate has decreased from 16.2% in 2009 to 11.5% in 2019. Nonetheless, the limited availability of health care and the stigma associated with HIV still pose significant challenges for the country. Our study’s launch in Mozambique demonstrates our unwavering commitment to evidence-based health care strategies. By utilizing state-of-the-art laboratory facilities and fostering collaborative partnerships, we are well positioned to generate essential insights into the factors contributing to mortality among adults living with HIV. This will help drive progress toward more effective interventions and improved health outcomes.” – Inacio Mandomando, CHAMPS Mozambique co-director

Sierra Leone

“Recently, we have seen a disproportionately high prevalence of HIV (24%) among adult deaths in Sierra Leone, despite the current prevalence among living adults being estimated at 1.7%. The study to be conducted in Sierra Leone is a significant step in our collective efforts to better address a possible ‘hidden HIV epidemic’ in the country, as well as tackle the complex challenges faced by individuals living with HIV. With the help of rigorous data collection and analysis and existing strong partnerships established across the CHAMPS Sierra Leone platform, we aim to identify factors associated with advanced HIV disease, further explore the root causes of HIV mortality and co-create targeted interventions for saving lives and promoting health equity.” – Ikechukwu (Ike) Ogbuanu, CHAMPS Sierra Leone site director

South Africa

With a national HIV prevalence rate of 19.6% among adults aged 15-49, South Africa has the highest absolute number of people living with HIV in the world, totaling 8.45 million in 2022.

“This study in South Africa represents a significant opportunity for advancement in comprehending and tackling the challenges encountered by adults living with HIV. Through granular investigation of the causes of death in persons who were living with HIV in the era of antiretroviral therapy, the insights from the study can be instrumental for informing what additional interventions are required to address the ongoing disproportionately higher incidence and mortality rate in this population.” – Ziyaad Dangor, CHAMPS South Africa co-director