Journey towards universal viral load monitoring in Maputo, Mozambique: many gaps, but encouraging signs.
Int Health
; 9(4): 206-214, 2017 07 01.
Article
em En
| MEDLINE
| ID: mdl-28810670
ABSTRACT
Introduction:
Viral load (VL) monitoring for people on antiretroviral therapy (ART) is extremely challenging in resource-limited settings. We assessed the VL testing scale-up in six Médecins Sans Frontières supported health centres in Maputo, Mozambique, during 2014-15.Methods:
In a retrospective cohort study, routine programme data were used to describe VL testing uptake and results, and multi-variate logistical regression to estimate predictors of VL testing uptake and suppression.Results:
Uptake of a first VL test was 40% (17 236/43 579). Uptake of a follow-up VL test for patients with a high first VL result was 35% (1095/3100). Factors associated with a higher uptake included age below 15 years, longer time on ART and attending tailored service delivery platforms. Virological suppression was higher in pregnant/breastfeeding women and in community ART Group members. Patients with a high first VL result (18%; 3100/17 236) were mostly younger, had been on ART longer or had tuberculosis. Out of 1095 attending for a follow-up VL test, 678 (62%) had virological failure. Of those, less than one-third had started second line ART.Conclusion:
This was the first study describing the uptake and results of VL testing scale-up in Mozambique. Identified gaps show patient and programmatic challenges. Where service delivery was customized to patient needs, VL monitoring was more successful.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
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Monitoramento de Medicamentos
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Fármacos Anti-HIV
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Carga Viral
Tipo de estudo:
Diagnostic_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Male
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Pregnancy
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article