The international epidemiological databases to evaluate AIDS (IeDEA) in sub-Saharan Africa-2025
South Africa, 2004 - 2025
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IeDEA.2004-2025
The international epidemiological databases to evaluate AIDS (IeDEA) in sub-Saharan Africa-2025
| Name | Country code |
|---|---|
| South Africa | ZA |
TIER.net http://tier.net/ is an electronic patient management system that is used for monitoring and evaluation of HIV care and treatment programmes in government health facilities throughout South Africa. The system was designed as part of a 3-tier approach to implementing a full electronic medical records (EMR) system. This approach provides a flexible solution that allows facilities to transition towards EMR in stages, as their infrastructure improves, and resources become available. TIER.net http://tier.net/ forms the second tier, whereby patient's paper clinical records are entered into a non-networked computer at the health facility and transferred periodically to a central database.
The TIER.net http://tier.net/ database contains information on clinic visit attendance, laboratory results and ART dispensing records for all patients on ART. The system was implemented in uMkhanyakude district in 2013; patient records from all visits before 2013 were back captured into the system. AHRI has a memorandum of agreement with the Department of Health to receive the TIER.net http://tier.net/ data for the 17 clinics in the Hlabisa health sub-district and Hlabisa hospital. A dedicated data entry clerk based in each clinic enters information from patients' paper clinical records into the TIER.net http://tier.net/ system after each patient visit. Laboratory results are manually entered into TIER.net http://tier.net/ after they have been received by the clinic (i.e. are not imported electronically from the National Health Laboratory Service (NHLS) system).
Currently, pre-ART visits are not recorded in TIER.net http://tier.net/, although modules to capture HIV testing and pre-ART care may be implemented in the future.
Clinical Data
Individuals on ART at one of the 17 clinics from Hlabisa sub-district, uMkhanyakude district
Version
v4.0.0
Scope
| Topic | Vocabulary | URI |
|---|---|---|
| HIV, Epidemiology, KwaZulu-Natal, Antiretroviral therapy, Hlabisa, Population Cohort | Africa Health Research Institute | www.ahri.org |
Coverage
Hlabisa sub-district, KwaZulu-Natal, South Africa
Individuals from Hlabisa sub-district, KwaZulu-Natal, South Africa
Producers and sponsors
| Name | Affiliation |
|---|---|
| Dr Abraham Jacobus Herbst | Africa Health Research Institute |
| Prof. Willem Hanekom | Africa Health Research Institute |
| Prof. Janet Seeley | Africa Health Research Institute |
| Prof. Maryam Shahmanesh | Africa Health Research Institute |
| Dr. Guy Harling | Africa Health Research Institute |
| Dr. Mark Siedner | Africa Health Research Institute |
| Name |
|---|
| Africa Health Research Institute |
| Name | Abbreviation | Role |
|---|---|---|
| Welcome Trust | WT | Funder |
| DSI-MRC South African Population Research Infrastructure Network | SAPRIN | Funder |
| South Africa Department of Health | DoH | Data Custodian |
| Name | Affiliation | Role |
|---|---|---|
| Dickman Gareta | AHRI | Research Data Management |
| Kathy Baisley | AHRI | Statistics |
| Eugene Prenzler | AHRI | IT infrastructure |
| Brendan Gilbert | AHRI | IT infrastructure |
Sampling
All individuals accessing ART treatment and care in the 17 clinics in Hlabisa sub-district, KwaZulu-Natal, South Africa
Data collection
| Start | End |
|---|---|
| 2004-01-01 | 2025-09-20 |
Data processing
Tier.Net data is processed and stored on servers under the physical control of AHRI until datasets are made available on the data repository. The data is de-identified and can then be downloaded for processing on the data user's computer.
Data is stored on industry-standard relational databases with data integrity and user authentication for access control. Data is replicated on at least a daily basis to the Durban site of the Institution to provide secure offsite storage of data. Transactional logs are backed up every 30 minutes to enable recovery of data in the event of equipment failure.
All users of the system are authenticated through individual passwords with minimum complexity and regular change rules (passwords must be at least eight digits, with a mix of small and capital letters, at least one numeric or non-alphabetic digit and changed at least every 45 days). AHRI uses industry standard malware and intrusion detection with at least annual penetration tests by a reputable outside security audit company.
Data Access
Access to the data requires accurate completion of the online data access application form accessible on the AHRI Data repository(https://data.ahri.org/). Data users are required to abide by the data use conditions stipulated on the application for access to the data. Failure to do so may result in their data access privileges being revoked by the Data Custodian. In order to recognise the effort and intellectual contributions of AHRI investigators in producing and curating the data, users of AHRI data must acknowledge the source of the data and abide by the terms and conditions under which the data is accessed and must cite the dataset in publication using the citation provided as part of this documentation. All analytical datasets published on the AHRI Data Repository are assigned digital object identifier (DOIs) and the DOIs can be found on the Data Repository under Study Description tab - Access policy. AHRI data users are required to always cite the dataset using the relevant DOI.
Herbst, A. J., Hanekom, W., Seeley, J., Shahmanesh, M., Harling, G., & Siedner, M. (2025). The international epidemiological databases to evaluate AIDS (IeDEA) in sub-Saharan Africa-2025 [Data set]. Africa Health Research Institute.
DOI: https://doi.org/10.23664/IEDEA.2004-2025
Metadata production
DDI.IeDEA.2004-2025
| Name | Abbreviation |
|---|---|
| Africa Health Research Institute | AHRI |