Monitoring the treatment and health of patients accessing HIV care in low and middle-income countries
作者： SJ Hoskins
DOI:
关键词: Pediatrics 、 Developing country 、 Medicine 、 Tanzania 、 Population 、 Antiretroviral therapy 、 Environmental health 、 Low and middle income countries 、 Concordance 、 Measure outcomes 、 Human immunodeficiency virus (HIV)
摘要: Monitoring patient health in low and middle-income country HIV care programmes is challenging, as, without evidence, measurement tools derived from high-income studies have been adapted paper-based monitoring systems quickly developed. An accurate understanding of the population may be compromised. This thesis examines aspects care: access to Cotrimoxazole preventive therapy (CPT), prevalence common mental disorders (CMD), used measure outcomes on antiretroviral (ART). CPT frequently cited as being 4% with few estimating long-term access. Estimated CMD varies widely little standardisation exists. And, while international ART programme recommendations exist, no study has compared concordance, or otherwise, between information collected different countries. The first this thesis, Ugandan Tanzanian patients, estimates time diagnosis initiation, spent associated factors. These are reported data. coverage were poor. absence unique identifiers means data cannot distinguish patients who diagnosed initiate reporting periods. Furthermore, officially reported. second factors among HIV-positive Ugandans, validates for this. Prevalence was around 10% but routinely-collected identified at-risk patients. Measurement tool validity poor, their use substantially overestimates prevalence. third compares Malawi, Uganda, Ukraine Tanzania. There concordance recommendations, discordance additional data-items paediatric age-groupings. signalled a lack how best monitor treated populations. Finally, fourth proposed aim assessing predictive value existing programmatic systems.
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