HIV drug resistance early warning indicators in Namibia for public health action
| Autor: | Michael DeKlerk, Milner Siboleka, Justice Gweshe, Alfons Badi, Michael Gawanab, Victor Sumbi, Anna Jonas, Kiger Lau, Samson Mwinga, Steven Y. Hong, Dawn Pereko, Michael R. Jordan, Logan Jerger, Abraham Blom |
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| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Non-Clinical Medicine Anti-HIV Agents lcsh:Medicine HIV Infections Viral diseases Pharmacology World Health Organization Global Health Patient care Antibiotic resistance Pharmacotherapy Environmental health Antiretroviral Therapy Highly Active Drug Resistance Viral medicine Health Status Indicators Humans Lost to follow-up Practice Patterns Physicians' lcsh:Science Treatment Guidelines Multidisciplinary Health Care Policy Warning system Geography business.industry Public health lcsh:R HIV HIV diagnosis and management Antiretroviral therapy Namibia HIV epidemiology Medicine Infectious diseases lcsh:Q Lost to Follow-Up Public Health business HIV drug resistance Research Article |
| Zdroj: | PLoS ONE PLoS ONE, Vol 8, Iss 6, p e65653 (2013) |
| ISSN: | 1932-6203 |
| Popis: | Background HIV drug resistance (HIVDR) testing is not routinely available in many resource-limited settings, therefore antiretroviral therapy (ART) program and site factors known to be associated with emergence of HIVDR should be monitored to optimize the quality of patient care and minimize the emergence of preventable HIVDR. Methods In 2010, Namibia selected five World Health Organization Early Warning Indicators (EWIs) and scaled-up monitoring from 9 to 33 ART sites: ART prescribing practices, Patients lost to follow-up (LTFU) at 12 months, Patients switched to a second-line regimen at 12 months, On-time antiretroviral (ARV) drug pick-up, and ARV drug-supply continuity. Results Records allowed reporting on three of the five selected EWIs. 22 of 33 (67%) sites met the target of 100% initiated on appropriate first-line regimens. 17 of 33 (52%) sites met the target of ≤20% LTFU. 15 of 33 (45%) sites met the target of 0% switched to a second-line regimen. Conclusions EWI monitoring directly resulted in public health action which will optimize the quality of care, specifically the strengthening of ART record systems, engagement of ART sites, and operational research for improved adherence assessment and ART patient defaulter tracing. |
| Databáze: | OpenAIRE |
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