Monitoring of early warning indicators for HIV drug resistance in antiretroviral therapy clinics in Zimbabwe.

Monitoring human immunodeficiency virus drug resistance (HIVDR) early warning indicators (EWIs) can help national antiretroviral treatment (ART) programs to identify clinic factors associated with HIVDR emergence and provide evidence to support national program and clinic-level adjustments, if necessary. World Health Organization-recommended HIVDR EWIs were monitored in Zimbabwe using routinely available data at selected ART clinics between 2007 and 2009. As Zimbabwe's national ART coverage increases, improved ART information systems are required to strengthen routine national ART monitoring and evaluation and facilitate scale-up of HIVDR EWI monitoring. Attention should be paid to minimizing loss to follow-up, supporting adherence, and ensuring clinic-level drug supply continuity.

A report on the Zimbabwe Antiretroviral Therapy (ART) programme progress towards achieving MGD6 target 6B: achievement and challenges.

Zimbabwe's target to achieve Universal Access to treatment for HIV and AIDS, was severely affected by a decade long economic recession that threatened to reverse all the country's social and economic indicators. Despite these challenges, by September 2010, 282,916 adults and children (47.7% of those in need of treatment) were on treatment at 509 sites countrywide since national scale up started. ART services are predominantly offered through the public sector, with the private sector being an untapped potential resource for ART services for the future. Challenges of skilled and adequately trained human resources have hindered progress towards service availability. Providing access to children in particular has been constrained by lack of clinical mentorship for health workers, weak systems for support supervision, and inadequate HIV diagnostic services especially for children under 18 months and challenges with follow up of the HIV-exposed infants. Though the country has not met its target of Universal Access by 2010, significant progress has been made with over a 30-fold increase in service availability.

A review of burns treated over a one-year period at Mpilo Central Hospital, Zimbabwe.

A retrospective study is presented of 297 patients (57% male and 43% female) treated for burns at Mpilo Central Hospital, Bulawayo, Zimbabwe in 1991. Of the patients, 73% were in the paediatric age group, 60% of whom were under 5 years of age. Most burns occurred at home (90%), with the majority occurring in the kitchen (61%). The commonest burning agent was hot water (55%). Open-fire burns accounted for 18% of cases. The surface area of burns ranged from 1% to 80% with a mean of 7%. The majority of patients (84%) had superficial thickness burns. Only 6% of the patients required active resuscitation with intravenous fluids. A total of 159 organisms were isolated on 111 pus swabs. The most commonly isolated organism was Staphylococcus aureus (66%). Seven patients (five children and two adults) died, giving a mortality rate of 2%. Although it is desirable to have a purpose-built burns unit this study shows that satisfactory results can be achieved with limited facilities. In our practice, where 90% of burns occur in the home situation, an active public-education campaign would help to reduce the incidence of burns.