Publications by authors named "Charles Azih"
Article Synopsis
- The Swaziland Ministry of Health introduced new procedures to boost early enrollment in HIV care during the Soka Uncobe male circumcision campaign and the SHIMS survey, evaluating these measures in 2013-2014.
- Among 1,105 clients diagnosed with HIV, only 14.0%, 24.3%, and 37.0% enrolled in HIV care within 3, 12, and 24 months, respectively, with younger age groups showing significantly lower enrollment rates.
- Compliance with the new linkage procedures was poor, with referral forms found for less than half of clients and very few following through with appointments, indicating a need for improved services to enhance enrollment in HIV care.
Background: In 2007, Swaziland initiated a hub-and-spoke model for decentralizing antiretroviral therapy (ART) access for HIV-infected children (<15 years old). Decentralization was facilitated through (1) down referral of stable children on ART from overburdened central facilities (hubs) to primary healthcare clinics (spokes) and (2) pediatric ART initiation at spokes (spoke initiation).
Methods: We conducted a nationally representative retrospective cohort study among children starting ART during 2004-2010 to assess effect of down referral and spoke initiation on rates of loss to follow-up (LTFU), death and attrition (death or LTFU).
Article Synopsis
- In 2007, Swaziland adopted a hub-and-spoke model to improve access to antiretroviral therapy (ART) by down-referring stable patients from overloaded central facilities to local clinics (spokes) and allowing ART initiation at these spoke clinics.
- A study conducted from 2004 to 2010 analyzed the impact of these strategies on patient outcomes, specifically focusing on loss to follow-up (LTFU), death, and overall attrition.
- The results indicated that down-referral significantly reduced the risk of LTFU and attrition without affecting mortality rates, suggesting that this model could enhance the effectiveness of ART programs in the future.
Introduction: This study explores factors associated with virological detectability, and viral re-suppression after enhanced adherence counselling, in adults and children on antiretroviral therapy (ART) in Swaziland.
Methods: This descriptive study used laboratory data from 7/5/2012 to 30/9/2013, which were linked with the national ART database to provide information on time on ART and CD4 count; information on enhanced adherence counselling was obtained from file review in health facilities. Multivariable logistic regression was used to explore the relationship between viral load, gender, age, time on ART, CD4 count and receiving (or not receiving) enhanced adherence counselling.
Although scale-up of antiretroviral therapy (ART) since 2005 has contributed to declines of about 30% in the global annual number of human immunodeficiency (HIV)-related deaths and declines in global HIV incidence, estimated annual HIV-related deaths among adolescents have increased by about 50% and estimated adolescent HIV incidence has been relatively stable. In 2012, an estimated 2,500 (40%) of all 6,300 daily new HIV infections occurred among persons aged 15-24 years. Difficulty enrolling adolescents and young adults in ART and high rates of loss to follow-up (LTFU) after ART initiation might be contributing to mortality and HIV incidence in this age group, but data are limited.
View Article and Find Full Text PDFImpact and programmatic implications of routine viral load monitoring in Swaziland.
J Acquir Immune Defic Syndr
September 2014
Objective: To assess the programmatic quality (coverage of testing, counseling, and retesting), cost, and outcomes (viral suppression, treatment decisions) of routine viral load (VL) monitoring in Swaziland.
Design: Retrospective cohort study of patients undergoing routine VL monitoring in Swaziland (October 1, 2012 to March 31, 2013).
Results: Of 5563 patients eligible for routine VL testing monitoring in the period of study, an estimated 4767 patients (86%) underwent testing that year.