Immunological and clinical measurements are the primary means of monitoring patients receiving antiretroviral therapy (ART) for treatment failure. It is unknown to what extent long-standing WHO and national CD4 and weight monitoring guidelines have been adopted in practice. Using data extracted from the charts of 32, 540 ART patients at 146 facilities in Kenya, Ugandan and Zambia we descriptively analyzed the availability of immunological and clinical information at baseline, and the percent of established patients meeting weight and CD4 guidelines from 2009-2011. We used mixed effects logistic regressions to assess facility and patient factors associated with meeting monitoring guidelines. Counterfactual scenarios were examined to evaluate the relative importance of inadequate care seeking and inadequate facility provision of testing. Baseline WHO stage and weight measurements were available for over 90% of the most recently initiating cohorts, while 80% had a CD4 measurement andImmunological and clinical measurements are the primary means of monitoring patients receiving antiretroviral therapy (ART) for treatment failure.
|Title||:||Trends and Determinants of ART Patient Monitoring Practices in Kenya, Uganda and Zambia|