Evaluation of a health system intervention to improve virological management in an antiretroviral programme at a municipal clinic in central Durban
Southern African Journal of HIV Medicine
Field | Value | |
Title | Evaluation of a health system intervention to improve virological management in an antiretroviral programme at a municipal clinic in central Durban | |
Creator | Cloete, Christie M. Hampton, Jane Chetty, Terusha Ngomane, Thando Spooner, Elizabeth Zako, Linda M.G. Reddy, Shabashini Reddy, Tarylee Luthuli, Nozipho Ngobese, Hope Ramjee, Gita Coutsoudis, Anna Kiepiela, Photini | |
Description | Background: With the largest antiretroviral therapy (ART) programme globally, demand for effective HIV management is increasing in South Africa. While viral load (VL) testing is conducted, VL follow-up and management are sub-optimal.Objectives: The objective of this study was to address gaps in the VL cascade to improve VL testing and management.Methods: Antiretroviral therapy records were sampled for an in-depth review. The study team then reviewed individual records, focusing on ART management, virological suppression and retention. Multifaceted interventions focused on virological control, including a clinical summary chart for ART care; streamlining laboratory results receipt and management; monitoring VL suppression, flagging virological failure and missed visits for follow-up; down-referral of stable patients eligible for the chronic club system; and training of personnel and patients.Results: Pre-intervention, 78% (94/120) of eligible patients had VL tests, versus 92% (145/158) post-intervention (p = 0.0009). Pre-intervention, 59% (71/120) of patients accessed their VL results, versus 86% (136/158) post-intervention (p 0.0001). Post-intervention, 73% (19/26) of patients eligible for ART change were appropriately managed, versus 11% (4/36) pre-intervention (p 0.0001). Only 27% had no regimen changes (7/26) post-intervention, versus 81% (29/36) pre-intervention (p 0.0001).Conclusion: Service delivery was streamlined to facilitate HIV services by focusing on VL test monitoring, protocol training and accessibility of results, thereby improving clinical management. | |
Publisher | AOSIS | |
Date | 2019-09-26 | |
Identifier | 10.4102/sajhivmed.v20i1.985 | |
Source | Southern African Journal of HIV Medicine; Vol 20, No 1 (2019); 8 pages 2078-6751 1608-9693 | |
Language | eng | |
Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajhivmed.org.za/index.php/hivmed/article/view/985/1629
https://sajhivmed.org.za/index.php/hivmed/article/view/985/1628
https://sajhivmed.org.za/index.php/hivmed/article/view/985/1630
https://sajhivmed.org.za/index.php/hivmed/article/view/985/1627
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