Introduction: In response to suboptimal adherence and retention, South Africa’s National Department of Health developed and implemented National Adherence Guidelines for Chronic Diseases. We evaluated the effect of a package of adherence interventions beginning in January 2016 and report on the impact of Fast-Track Treatment Initiation Counselling (FTIC) on ART initiation, adherence and retention. Methods: We conducted a cluster-randomized mixed-methods evaluation in 4 provinces at 12
The World Health Organization recommends "sameday" initiation of antiretroviral therapy (ART) for HIV patients eligible and ready1. This recommendation has been adopted by both South Africa2 and Kenya3. Identifying efficient, safe, and feasible procedures for determining same-day eligibility and readiness is now a priority. The WHO guidelines cited evidence from clinical trials suggesting that offering treatment to patients at their first clinical encounter has the potential to increase
The Financial Capacity Building for Provinces (FINCAP) project, run in partnership by the Centre for Economic Governance and Accountability in Africa (CEGAA) and the Health Economics and Epidemiology Research Office (HE2RO), focuses on providing capacity building and technical support to HIV, STI and TB (HAST) programme and finance managers in provincial departments of health in South Africa. The intervention was designed to improve budget planning, costing, expenditure tracking and reporting
The paper uses an interrupted time series analysis to outline the impact on ART and other services at three primary health care (PHC) clinics in one region of Johannesburg after removal of PEPFAR funding for a co-located ART clinic and integration of HIV treatment into PHC. The three clinics fared differently after PEPFAR funding was removed, but overall, in this study, integration of ART with PHC services did not result in large-scale reductions in overall service delivery. One facility did
The World Health Organisation (WHO) estimates that approximately 54 million people survived TB between 2000 and 2017 alone. There is increasing evidence of long term respiratory complications following TB in a proportion of these patients, preventing them from returning to their normal lives. Patients can suffer from airflow obstruction, restrictive and fibrotic defects, bronchiectasis and aspergillomas amongst other conditions. With chronic obstructive pulmonary disease (COPD) being the
The number of South African adolescents receiving HIV care and treatment in South Africa is growing. By use of routinely collected laboratory data from South Africa’s National HIV Programme, we aimed to quantify the numbers of adolescents accessing HIV care and treatment over time, characterise the role of perinatal infection in these trends, and estimate proportions of adolescents seeking HIV care and antiretroviral therapy (ART) in South Africa’s public sector. Methods: We did a
Limited research investigating treatment outcomes for HIV-positive orphans compared with non-orphans has shown mixed results, with several studies indicating that HIV-positive orphans are at greater risk of delayed access to HIV care and poor antiretroviral therapy (ART) adherence, while other data suggest that ART outcomes of orphans can be similar to those of non-orphans. Understanding the impact of orphan status on short-term ART outcomes could improve targeted intervention strategies, and
Many African countries have had at least two years’ experience with universal treatment eligibility for HIV. The literature contains few descriptions, though, of populations starting treatment since adoption of universal eligibility. Using baseline data from a clinical trial of same-day ART initiation, we describe the populations presenting for HIV testing or care at study clinics in Kenya and South Africa in 2017-18, during the era of same-day initiation. Methods: The Simplified Algorithm
In South Africa, prevention of mother to child transmission (PMTCT)has reduced MTCT from 3.6% in 2011 to 1.3% in 2017. However,there are challenges in reaching vulnerable HIV-positive children;those at increased risk of malnutrition or present late with advanced disease. Macro – and micro nutrient deficiencies, common in HIV,may accelerate disease progression. This was a prospective cohort study of paediatric patients (aged 1–10 years) initiating ART between 08/2014 and 09/2016 at a public
The World Health Organization recommends "same-day" initiation of antiretroviral therapy (ART) for HIV patients who are eligible and ready. Identifying efficient, safe, and feasible procedures for determining same-day eligibility and readiness is now a priority. The Simplified Algorithm for Treatment Eligibility (SLATE) study evaluated a clinical algorithm that allows healthcare workers to determine eligibility for same-day treatment and to initiate ART at the patient’s first clinic
According to the most recent estimates, 16.4 million people are receiving antiretroviral therapy (ART) for HIV in sub-Saharan Africa.1 Global “90-90-90” targets for HIV diagnosis, treatment, and viral suppression call for universal access and rapid-scale-up of treatment coverage, which would require another 3 million patients to be added to the national HIV treatment programs in eastern and southern Africa.1 Meanwhile, donor spending in low and middle-income countries has declined over the
Routine viral load testing is the WHO-recommended method for monitoring HIV-infected patients on ART, and many countries are rapidly scaling up testing capacity at centralized laboratories. Providing testing access to the most remote populations and facilities (the “last mile”) is especially challenging. Using a geospatial optimization model, we estimated the incremental costs of accessing the most remote 20% of patients in Zambia by expanding the transportation network required to bring
