Viral load detection and management on first line ART in rural Rwanda

Autor: Jean de Dieu Ndagijimana Ntwali, Tom Decroo, Muhayimpundu Ribakare, Athanase Kiromera, Placidie Mugwaneza, Sabin Nsanzimana, Lutgarde Lynen
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-9 (2019)
Druh dokumentu: article
ISSN: 1471-2334
DOI: 10.1186/s12879-018-3639-y
Popis: Abstract Background To achieve the ambitious 90–90-90 UNAIDS targets, access to routine viral load (VL) is critical. To measure VL, Rwanda has relied on a national reference laboratory for years. In 2014, a VL testing platform was implemented in a rural District in the Northern Province. Here we analyze the uptake of VL testing, identification of risks for detectable VL (≥1000 copies/ml), and the management of patients with a detectable VL. Methods A retrospective cohort study of patients who started ART between July 2012 and June 2015 and followed until end December 2016. Using descriptive statistics, we describe the VL cascade, from VL uptake to the start of second-line ART in patients diagnosed with virological failure. We estimate predictors of having a detectable VL using logistic regression. Results The uptake of VL testing increased progressively between 2013 and 2016, raising from 25.6% (39/152) in 2013 up to 93.2% (510/547) in 2016.In 2016, 88.5% (n = 451) of patients tested, had a suppressed VL. Predictors of having a detectable VL included being male (aOR 2.1; 95%CI 1.12–4.02; p = 0.02), being a sex worker (aOR 6.4; 95%CI 1.1–36.0; p = 0.04), having a WHO clinical stage IV when starting ART (aOR 8.8; 95%CI 1.8–43.0; p
Databáze: Directory of Open Access Journals
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje