AEGiS-Glasgow [PL3.2] How effective is the WHO monitoring system for patients on antiretroviral treatment? Lessons learnt during the roll-out of antiretrovirals in the Western Cape Province, South Africa

Eighth International Congress on Drug Therapy in HIV Infection

Glasgow, UK - 12-16 November 2006

[PL3.2] HOW EFFECTIVE IS THE WHO MONITORING SYSTEM FOR PATIENTS ON ANTIRETROVIRAL TREATMENT? LESSONS LEARNT DURING THE ROLL-OUT OF ANTIRETROVIRALS IN THE WESTERN CAPE PROVINCE, SOUTH AFRICA

Int Cong Drug Therapy HIV 2006 Nov 12-16;8:Abstract No. PL3.2

Peter Bock, Andrew Boulle, Meg Osler
Fareed Abdullah Public Health, University of Cape Town, Cape Town, South Africa; Department of Health, Provincial Government of the Western Cape, Cape Town, South Africa; International AIDS Alliance, Bristol, UK

PURPOSE OF THE STUDY: Patients in the Western Cape Province, South Africa (WC) have been on antiretrovirals in the public health service since January 2001. The WC has adopted the WHO monitoring system for patients on antiretrovirals. This paper investigates the data produced by this system and outlines aspects of the monitoring system that need improvement.

METHODS: The monitoring system uses principles of cohort study design, with data aggregated at facility level. Data is drawn from a facility based register and assimilated with data from sites using electronic systems. Analytic techniques include Poisson regression and Kaplan Meier survival analysis.

SUMMARY OF RESULTS: The system has captured follow up data on 8698 adults and 1271 of children starting antiretroviral treatment from January 2001 to July 2005. 93.6%, 90.1%, 84. 5%, 81.7% and 82.9% of patients are still in care at 3, 6, 12, 24, and 36 months respectively. Viral load suppression rates are consistently between 87 and 91% at increasing durations of treatment. Regression analysis in adults showed an increased incidence rate ratio for death at six months in patients who had a baseline CD4 <50 cells/mm³. (IRR= 8.2, 95% CIs 2.9 to 22.8) Results for children are similar.

CONCLUSIONS: Patient retention and viral load suppression rates are highly comparable with data from other studies; indicating the feasibility of an antiretroviral program in the public health sector in South Africa. The monitoring system had proved effective; however experience in the field has shown that improvements to its design and implementation need to be made.

Plenary Session: New Challenges in Providing ART [IAS Session]

2006-11-12
PL3.2

Copyright © 2006 - Thomson ACUMED® All rights reserved. Thomson ACUMED® is an intelligent and innovative medical marketing and communications agency – a new division of The Gardiner-Caldwell Group Ltd, part of The Thomson Corporation, located in Tytherington, UK.

Reproduction of this abstract (other than one copy for personal reference) must be cleared through the authors.