H Muttai1, K F Laserson2, I Akello3, L Nyabiage4, J Gondi4, J Mutegi3, J Williamson2, A K Nakashima5, M-L Ackers5. 1. US Centers for Disease Control and Prevention, Kisumu, Kenya. 2. US Centers for Disease Control and Prevention, Kisumu, Kenya ; Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya. 3. Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya. 4. Ministry of Health, Nairobi, Kenya. 5. US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Abstract
SETTING: In 2008, the Kenya tuberculosis (TB) program reported low (31%) antiretroviral therapy (ART) uptake among human immunodeficiency virus (HIV) infected TB patients. OBJECTIVE: To confirm ART coverage and identify factors associated with HIV clinic enrollment and ART initiation among TB patients. DESIGN: Retrospective chart abstraction of adult TB patients newly diagnosed with HIV and eligible for ART at 58 Nyanza Province TB clinics between October 2006 and April 2008. TB data were linked to HIV clinic data at 50 facilities that provided ART. Associations with HIV clinic enrollment and ART were evaluated. RESULTS: Among 1137 ART-eligible TB patient records sampled, 32% documented HIV clinic enrollment and 29% ART. Date fields were largely incomplete; 11% of the patient records included HIV testing dates and ≤1% had dates for cotrimoxazole prophylaxis, HIV clinic enrollment and ART initiation. Adding HIV clinic data increased HIV clinic enrollment and ART documentation to respectively 62% and 44%. Among TB patients in HIV care, female sex, older age group and baseline CD4 documentation were associated with ART initiation. CONCLUSION: Linking data increased documentation of HIV clinic enrollment and ART uptake. Continued efforts are required to improve the documentation of HIV service delivery, especially in TB clinics. Interventions to increase ART uptake are needed for younger patients and men.
SETTING: In 2008, the Kenya tuberculosis (TB) program reported low (31%) antiretroviral therapy (ART) uptake among human immunodeficiency virus (HIV) infected TBpatients. OBJECTIVE: To confirm ART coverage and identify factors associated with HIV clinic enrollment and ART initiation among TB patients. DESIGN: Retrospective chart abstraction of adult TB patients newly diagnosed with HIV and eligible for ART at 58 Nyanza Province TB clinics between October 2006 and April 2008. TB data were linked to HIV clinic data at 50 facilities that provided ART. Associations with HIV clinic enrollment and ART were evaluated. RESULTS: Among 1137 ART-eligible TB patient records sampled, 32% documented HIV clinic enrollment and 29% ART. Date fields were largely incomplete; 11% of the patient records included HIV testing dates and ≤1% had dates for cotrimoxazole prophylaxis, HIV clinic enrollment and ART initiation. Adding HIV clinic data increased HIV clinic enrollment and ART documentation to respectively 62% and 44%. Among TB patients in HIV care, female sex, older age group and baseline CD4 documentation were associated with ART initiation. CONCLUSION: Linking data increased documentation of HIV clinic enrollment and ART uptake. Continued efforts are required to improve the documentation of HIV service delivery, especially in TB clinics. Interventions to increase ART uptake are needed for younger patients and men.
Authors: Helena Legido-Quigley; Catherine M Montgomery; Palwasha Khan; Rifat Atun; Ade Fakoya; Haileyesus Getahun; Alison D Grant Journal: Trop Med Int Health Date: 2012-12-10 Impact factor: 2.622
Authors: Elena Losina; Ingrid V Bassett; Janet Giddy; Senica Chetty; Susan Regan; Rochelle P Walensky; Douglas Ross; Callie A Scott; Lauren M Uhler; Jeffrey N Katz; Helga Holst; Kenneth A Freedberg Journal: PLoS One Date: 2010-03-04 Impact factor: 3.240
Authors: Eric S Pevzner; Greet Vandebriel; David W Lowrance; Michel Gasana; Alyssa Finlay Journal: BMC Public Health Date: 2011-07-11 Impact factor: 3.295
Authors: Douglas N Shaffer; Eunice T Obiero; Josphat B Bett; Ignatius N Kiptoo; Jonah K Maswai; Fredrick K Sawe; E Jane Carter Journal: AIDS Res Treat Date: 2012-02-16
Authors: Bernhard Kerschberger; Katherine Hilderbrand; Andrew M Boulle; David Coetzee; Eric Goemaere; Virginia De Azevedo; Gilles Van Cutsem Journal: PLoS One Date: 2012-10-05 Impact factor: 3.240