Scale-up of HIV Viral Load Monitoring--Seven Sub-Saharan African Countries
| Autor: | Abdoulaye Dieng Sarr, Andrea A. Kim, Sundeep Gupta, Yogan Pillay, Wendy Stevens, Kevin M. De Cock, Sergio Carmona, Christina Mwangi, Michael Mwasekaga, Dennis Ellenberger, Simon Agolory, Nancy W. Knight, Christiane Adje Toure, Geoffrey Chipungu, Souleymane Sawadogo, Marie Downer, Varough M. Deyde, William B. MacLeod, Charles Kiyaga, J. Mwangi, Laura N. Broyles, Hellen Muttai, Daniel E. Singer, Boniface Makumbi, John N. Nkengasong, Marie Yolande Borget, Lucy Ng’ang’a, Shirley Lee Lecher, Peter N. Fonjungo, Jonathan E. Kaplan |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Government
Health (social science) Epidemiology business.industry Anti-HIV Agents Health Toxicology and Mutagenesis Developing country Distribution (economics) HIV Infections General Medicine Viral Load medicine.disease Antiretroviral therapy Procurement Health Information Management Acquired immunodeficiency syndrome (AIDS) Environmental health Population Surveillance Immunology medicine Humans business Viral load Developed country Africa South of the Sahara |
| Zdroj: | MMWR. Morbidity and mortality weekly report. 64(46) |
| ISSN: | 1545-861X |
| Popis: | To achieve global targets for universal treatment set forth by the Joint United Nations Programme on human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (UNAIDS), viral load monitoring for HIV-infected persons receiving antiretroviral therapy (ART) must become the standard of care in low- and middle-income countries (LMIC) (1). CDC and other U.S. government agencies, as part of the President's Emergency Plan for AIDS Relief, are supporting multiple countries in sub-Saharan Africa to change from the use of CD4 cell counts for monitoring of clinical response to ART to the use of viral load monitoring, which is the standard of care in developed countries. Viral load monitoring is the preferred method for immunologic monitoring because it enables earlier and more accurate detection of treatment failure before immunologic decline. This report highlights the initial successes and challenges of viral load monitoring in seven countries that have chosen to scale up viral load testing as a national monitoring strategy for patients on ART in response to World Health Organization (WHO) recommendations. Countries initiating viral load scale-up in 2014 observed increases in coverage after scale-up, and countries initiating in 2015 are anticipating similar trends. However, in six of the seven countries, viral load testing coverage in 2015 remained below target levels. Inefficient specimen transport, need for training, delays in procurement and distribution, and limited financial resources to support scale-up hindered progress. Country commitment and effective partnerships are essential to address the financial, operational, technical, and policy challenges of the rising demand for viral load monitoring. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|