ArticleBMC infectious diseases2020
A packaged intervention to improve viral load monitoring within a deeply rural health district of South Africa.
Article in BMC infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 13 citations in OpenAlex.
- Viral suppression in adults on efavirenz- or dolutegravir-based antiretroviral therapy in Mopani District, South Africa.Southern African journal of HIV medicine · 2025Article
- Healthcare practitioners' experiences in managing HIV among young people in Namibia.Curationis · 2024Article
- Depression: an individual-level early warning indicator of virologic failure in HIV patients in South Africa.Public health action · 2024Article
- Associations of inflammation-related proteome with demographic and clinical characteristics of people with HIV in South Africa.Proteomics. Clinical applications · 2024Article
- Food Insecurity Is Associated With Low Tenofovir Diphosphate in Dried Blood Spots in South African Persons With HIV.Open forum infectious diseases · 2023Article
- Comparing effectiveness of first-line antiretroviral therapy between peri-urban and rural clinics in KwaZulu-Natal, South Africa.HIV medicine · 2022Article
- Crosstalk between Host Genome and Metabolome among People with HIV in South Africa.Metabolites · 2022Article
- Higher Risk of Mortality and Virologic Failure in HIV-Infected Patients With High Viral Load at Antiretroviral Therapy Initiation: An Observational Cohort Study in Chongqing, China.Frontiers in public health · 2022Observational
- Tenofovir diphosphate levels in dried blood spots are associated with virologic failure and resistance to first-line therapy in South Africa: a case-control cohort study.Journal of the International AIDS Society · 2021Article
- Impact of pre-existing drug resistance on risk of virological failure in South Africa.The Journal of antimicrobial chemotherapy · 2021Article
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Authors and funding
12 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundThe KwaZulu-Natal (KZN) province of South Africa has the highest prevalence of HIV infection in the world. Viral load (VL) testing is a crucial tool for clinical and programmatic monitoring. Within uMkhanyakude district, VL suppression rates were 91% among patients with VL data; however, VL performance rates averaged only 38·7%. The objective of this study was to determine if enhanced clinic processes and community outreach could improve VL monitoring within this district.
methodsA packaged intervention was implemented at three rural clinics in the setting of the KZN HIV AIDS Drug Resistance Surveillance Study. This included file hygiene, outreach, a VL register and documentation revisions. Chart audits were used to assess fidelity. Outcome measures included percentage VL performed and suppressed. Each rural clinic was matched with a peri-urban clinic for comparison before and after the start of each phase of the intervention. Monthly sample proportions were modelled using quasi-likelihood regression methods for over-dispersed binomial data.
resultsMkuze and Jozini clinics increased VL performance overall from 33·9% and 35·3% to 75·8% and 72·4%, respectively which was significantly greater than the increases in the comparison clinics (RR 1·86 and 1·68, p < 0·01). VL suppression rates similarly increased overall by 39·3% and 36·2% (RR 1·84 and 1·70, p < 0·01). The Chart Intervention phase showed significant increases in fidelity 16 months after implementation.
conclusionsThe packaged intervention improved VL performance and suppression rates overall but was significant in Mkuze and Jozini. Larger sustained efforts will be needed to have a similar impact throughout the province.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.