Late stage presentation of HIV-positive patients to antiretroviral outpatient clinic in Zambia
Background: The World Health Organization (WHO) and the Zambian Ministry of Health set out new guidelines on combination antiretroviral therapy (cART) in 2013 expanding the eligibility criteria for patients with HIV. Objectives: The primary objective were to determine when cART was initiated in HIV...
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| Format: | Article |
| Language: | English |
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AOSIS
2017-11-01
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| Series: | Southern African Journal of HIV Medicine |
| Subjects: | |
| Online Access: | https://sajhivmed.org.za/index.php/hivmed/article/view/717 |
| _version_ | 1818055974058983424 |
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| author | Timothy Martin Morgan Mweene |
| author_facet | Timothy Martin Morgan Mweene |
| author_sort | Timothy Martin |
| collection | DOAJ |
| description | Background: The World Health Organization (WHO) and the Zambian Ministry of Health set out new guidelines on combination antiretroviral therapy (cART) in 2013 expanding the eligibility criteria for patients with HIV.
Objectives: The primary objective were to determine when cART was initiated in HIV-positive outpatients according to clinical and immunological criteria, and to identify what proportion of patients who were eligible for cART according to 2013 WHO and 2013 Zambian cART guidelines were currently on cART.
Methodology: This was a clinical audit of HIV-positive outpatients attending the cART clinic at Ndola Central Hospital in Ndola, Zambia, with retrospective cross-sectional chart review and survey design. Data were collected from clinical records and interviews with patients.
Results: A total of 99% of patients eligible for cART according to 2013 guidelines were on treatment. Clinical staging of patients at initiated on cART (n = 206) was as follows: 28% clinical stage I, 21% clinical stage II, 36% clinical stage III and 15% clinical stage IV. The median CD4 count when patients were started on cART was 147 cells/mm3 .
Conclusion: The results show that a majority of patients were initiated on cART late in their disease course according to immunological (CD4 < 200 cell/mm3 ) and clinical criteria (stage III or IV). However, the vast majority of patients eligible for cART were currently on treatment. The late initiation of cART appears to be a result of late diagnosis of HIV. |
| first_indexed | 2024-12-10T12:21:28Z |
| format | Article |
| id | doaj.art-5dec592e9bd1409c87e4c1a29e166063 |
| institution | Directory Open Access Journal |
| issn | 1608-9693 2078-6751 |
| language | English |
| last_indexed | 2024-12-10T12:21:28Z |
| publishDate | 2017-11-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Southern African Journal of HIV Medicine |
| spelling | doaj.art-5dec592e9bd1409c87e4c1a29e1660632022-12-22T01:49:03ZengAOSISSouthern African Journal of HIV Medicine1608-96932078-67512017-11-01181e1e810.4102/sajhivmed.v18i1.717568Late stage presentation of HIV-positive patients to antiretroviral outpatient clinic in ZambiaTimothy Martin0Morgan Mweene1The School of Medicine, Medical Sciences and Nutrition, University of AberdeenZambia Medical Association, Lusaka, Zambia; Zambia College of Physicians, Zambia; East Central and Southern Africa College of Physicians, Zambia; International Society of Nephrology, Brussels, BelgiumBackground: The World Health Organization (WHO) and the Zambian Ministry of Health set out new guidelines on combination antiretroviral therapy (cART) in 2013 expanding the eligibility criteria for patients with HIV. Objectives: The primary objective were to determine when cART was initiated in HIV-positive outpatients according to clinical and immunological criteria, and to identify what proportion of patients who were eligible for cART according to 2013 WHO and 2013 Zambian cART guidelines were currently on cART. Methodology: This was a clinical audit of HIV-positive outpatients attending the cART clinic at Ndola Central Hospital in Ndola, Zambia, with retrospective cross-sectional chart review and survey design. Data were collected from clinical records and interviews with patients. Results: A total of 99% of patients eligible for cART according to 2013 guidelines were on treatment. Clinical staging of patients at initiated on cART (n = 206) was as follows: 28% clinical stage I, 21% clinical stage II, 36% clinical stage III and 15% clinical stage IV. The median CD4 count when patients were started on cART was 147 cells/mm3 . Conclusion: The results show that a majority of patients were initiated on cART late in their disease course according to immunological (CD4 < 200 cell/mm3 ) and clinical criteria (stage III or IV). However, the vast majority of patients eligible for cART were currently on treatment. The late initiation of cART appears to be a result of late diagnosis of HIV.https://sajhivmed.org.za/index.php/hivmed/article/view/717HIVAIDScARTcombination antiretroviral therapyclinical auditWHO cART guidelinesZambian ministry of health cART guidelines |
| spellingShingle | Timothy Martin Morgan Mweene Late stage presentation of HIV-positive patients to antiretroviral outpatient clinic in Zambia Southern African Journal of HIV Medicine HIV AIDS cART combination antiretroviral therapy clinical audit WHO cART guidelines Zambian ministry of health cART guidelines |
| title | Late stage presentation of HIV-positive patients to antiretroviral outpatient clinic in Zambia |
| title_full | Late stage presentation of HIV-positive patients to antiretroviral outpatient clinic in Zambia |
| title_fullStr | Late stage presentation of HIV-positive patients to antiretroviral outpatient clinic in Zambia |
| title_full_unstemmed | Late stage presentation of HIV-positive patients to antiretroviral outpatient clinic in Zambia |
| title_short | Late stage presentation of HIV-positive patients to antiretroviral outpatient clinic in Zambia |
| title_sort | late stage presentation of hiv positive patients to antiretroviral outpatient clinic in zambia |
| topic | HIV AIDS cART combination antiretroviral therapy clinical audit WHO cART guidelines Zambian ministry of health cART guidelines |
| url | https://sajhivmed.org.za/index.php/hivmed/article/view/717 |
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