Impact of the implementation of new guidelines on the management of patients with HIV infection at an advanced HIV clinic in Kinshasa, Democratic Republic of Congo (DRC)
| Autor: | N. Ntabugi, Petros Isaakidis, Rosie Burton, F. Mangana, G van Cutsem, R. Moudachirou, Gisele Mucinya, Rebecca Harrison, T. Kaluangila, L. D. Massaquoi |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Adolescent Point-of-care testing 030106 microbiology Human immunodeficiency virus (HIV) Guidelines as Topic HIV Infections medicine.disease_cause Ambulatory Care Facilities lcsh:Infectious and parasitic diseases Young Adult 03 medical and health sciences 0302 clinical medicine Medical microbiology HIV clinical management Statistical significance Diagnostic equipment Humans Tuberculosis Medicine lcsh:RC109-216 Hospital Mortality 030212 general & internal medicine Retrospective Studies Advanced HIV Sub-Saharan Africa business.industry Guideline Middle Aged HIV infection CD4 Lymphocyte Count Infectious Diseases Anti-Retroviral Agents Clinical diagnosis Emergency medicine Democratic Republic of the Congo Hiv patients Female HIV clinical guideline business Toxoplasmosis Research Article |
| Zdroj: | Europe PubMed Central BMC Infectious Diseases BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-9 (2020) |
| Popis: | Background HIV continues to be the main determinant morbidity with high mortality rates in Sub-Saharan Africa, with a high number of patients being late presenters with advanced HIV. Clinical management of advanced HIV patients is thus complex and requires strict adherence to updated, empirical and simplified guidelines. The current study investigated the impact of the implementation of a new clinical guideline on the management of advanced HIV in Kinshasa, Democratic Republic of Congo (DRC). Methods A retrospective analysis of routine clinical data of advanced HIV patients was conducted for the periods; February 2016 to March 2017, before implementation of new guidelines, and November 2017 to July 2018, after the implementation of new guidelines. Eligible patients were patients with CD4 Results Two hundred four and Two hundred thirty-one patients were eligible for inclusion before and after the implementation of new guidelines respectively. Sex and age distributions were similar for both periods, and median CD4 were 36 & 52 cell/μl, before and after the new guidelines implementation, respectively. 40.7% of patients had at least 1 missed/incorrect diagnosis before the new guidelines compared to 30% after new guidelines, p p Conclusions Simplification and implementation of a new and improved HIV clinical guideline coupled with the installation of laboratory equipment and point of care tests potentially helped reduce incorrect diagnosis and improve clinical outcomes of patients with advanced HIV. Regulating authorities should consider developing simplified versions of guidelines followed by the provision of basic diagnostic equipment to health centers. |
| Databáze: | OpenAIRE |
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