ArticleBMC infectious diseases2021
Optimised electronic patient records to improve clinical monitoring of HIV-positive patients in rural South Africa (MONART trial): study protocol for a cluster-randomised trial.
Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05071573 (Optimised Electronic Patient Records to Improve Clinical Monitoring of HIV-positive Patients in Rural South Africa), which is not on this map. Cited by 6 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Optimised Electronic Patient Records to Improve Clinical Monitoring of HIV-positive Patients in Rural South Africa (MONART Trial)
Who cites it
6 citing papers in PubMed.
- Optimised electronic patient records to improve clinical monitoring of people living with HIV (MONART trial) intervention: a qualitative process evaluation.BMC health services research · 2026Article
- Linkage of HIV treatment and population-based surveillance records in rural South Africa: the AHRI Unified Data Platform (AUDP).Archives of public health = Archives belges de sante publique · 2026Article
- Record linkage without patient identifiers: Proof of concept using data from South Africa's national HIV program.PLOS global public health · 2025Article
- Viral load suppression among HIV-positive adult patients on the first-line antiretroviral treatment regimen in health facilities in the City of Ekurhuleni, Gauteng province, South Africa.The Pan African medical journal · 2024Article
- Assessing the cost and utilization of SMS printers by primary health care facilities: lessons learned from South Africa.Journal of public health in Africa · 2023Article
- Design and management considerations for control groups in hybrid effectiveness-implementation trials: Narrative review & case studies.Frontiers in health services · 2023Review
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Authors and funding
11 authors.
Funding
Abstract
backgroundThere is poor viral load monitoring (VLM) and inadequate management of virological failure in HIV-positive individuals on antiretroviral therapy in rural KwaZulu-Natal, South Africa. This could be contributing to increasing HIV drug resistance in the setting. This study aims to investigate the clinical and process impediments in VLM within the health system and to evaluate a quality improvement package (QIP) to address the identified gaps. The QIP comprises (i) a designated viral load champion responsible for administrative management and triaging of viral load results (ii) technological enhancement of the routine clinic-based Three Interlinked Electronic Register (TIER.Net) to facilitate daily automatic import of viral load results from the National Health Service Laboratory to TIER.Net (iii) development of a dashboard system to support VLM. METHODS/
designThe study will evaluate the effectiveness of the QIP compared to current care for improving VLM and virological suppression using an effectiveness implementation hybrid type 3 design. This will use a cluster-randomised design with the primary healthcare clinics as the unit of randomisation with ten clinics randomised in a 1:1 ratio to either the intervention or control arm. We will enrol 150 HIV-positive individuals who had been on ART for ≥ 12 months from each of the ten clinics (750 in 5 intervention clinics vs. 750 in 5 control clinics) and follow them up for a period of 12 months. The primary outcome is the proportion of all patients who have a viral load (VL) measurement and are virally suppressed (composite outcome) after 12 months of follow up. Secondary outcomes during follow up include proportion of all patients with at least one documented VL in TIER.Net, proportion with VL ≥ 50 copies/mL, proportion with VL ≥ 1000 copies/mL (virological failure) and subsequent switch to second-line ART. DISCUSSION: We aim to provide evidence that a staff-centred quality improvement package, designated viral load monitoring champion, and augmentation of TIER.Net with a dashboard system will improve viral load monitoring and lead to improved virological suppression.
trial registrationThis trial is registered on ClinicalTrials.gov on 8 Oct 2021. Identifier: NCT05071573; https://clinicaltrials.gov/ct2/show/NCT05071573?term=NCT05071573&draw=2&rank=1.
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