ArticleSouth African family practice : official journal of the South African Academy of Family Practice/Primary Care2020
Not yet 90-90-90: A quality improvement approach to human immunodeficiency virus viral suppression in paediatric patients in the rural Eastern Cape, South Africa.
Article in South African family practice : official journal of the South African Academy of Family Practice/Primary Care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Characterizing the HIV care continuum among children and adolescents with HIV in eastern and southern Africa in the era of "Universal Test and Treat": A systematic review and meta-analysis.Journal of the International AIDS Society · 2025Pooled it
- Achieving the fast track 90-90-90 and 95-95-95 targets in sub-Saharan Africa: A rapid review.Journal of public health in Africa · 2025Review
- Risk factors for sustained virological non-suppression among children and adolescents living with HIV in Zimbabwe and Malawi: a secondary data analysis.BMC pediatrics · 2022Article
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Authors and funding
3 authors.
Funding
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Abstract
backgroundA strategy implemented by the South African Department of Health to manage the high burden of human immunodeficiency virus (HIV) has been to task-shift services to primary health care clinics. Outcomes of paediatric patients with HIV are poorer than those of adults, particularly in rural areas. Viral suppression in paediatric patients at the feeder clinics of a rural South African hospital was anecdotally far below the aim of the Joint United Nations Programme on HIV/AIDS (UNAIDS) of 90%.
methodsA quality improvement approach was used to conduct a baseline assessment of HIV viral suppression in paediatric patients and other process measures, implement a clinical mentorship intervention and evaluate its effectiveness.
resultsAn initial audit of 235 clinical folders of paediatric patients with HIV revealed a viral suppression of 55.3%. Other poor measures included prescription accuracy, viral loads performed within schedule and response to successive high viral loads. A clinical mentorship intervention using dedicated doctor outreach was implemented and the audit repeated after 12 months (263 folders). Viral suppression improved to 67.4%, as did most other process measures.
conclusionThe quality improvement approach regarding the aim to significantly improve viral suppression in paediatric patients through the implementation of clinical mentorship was successful.
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