<p>The aim of the study was to measure patient waiting and service times, describe the causes of high waiting time as well as to determine staff and patient derived norms on waiting times at the Manzini Regional Hospital HIV Clinic. Literature reviewed show that complaints regarding long waiting time have been effectively dealt with through patient flow analysis studies, which measure patient waiting and service times as well as other characteristics. A descriptive cross sectional quantitative survey methodology was undertaken using a time-delimited sample of all patients attending the HIV clinic over one week and all the staff who were in contact with the patients. Waiting time tracking instruments and short questionnaires were used to collect data from both patients and staff. Data were analysed quantitatively.</p>

<p>The aim of the study was to measure patient waiting and service times, describe the causes of high waiting time as well as to determine staff and patient derived norms on waiting times at the Manzini Regional Hospital HIV Clinic. Literature reviewed show that complaints regarding long waiting time have been effectively dealt with through patient flow analysis studies, which measure patient waiting and service times as well as other characteristics. A descriptive cross sectional quantitative survey methodology was undertaken using a time-delimited sample of all patients attending the HIV clinic over one week and all the staff who were in contact with the patients. Waiting time tracking instruments and short questionnaires were used to collect data from both patients and staff. Data were analysed quantitatively.</p>

Magister Public Health - MPH / The aim of the study was to measure patient waiting and service times, describe the causes of high waiting time as well as to determine staff and patient derived norms on waiting times at the Manzini Regional Hospital HIV Clinic. Literature reviewed show that complaints regarding long waiting time have been effectively dealt with through patient flow analysis studies, which measure patient waiting and service times as well as other characteristics. A descriptive cross sectional quantitative survey methodology was undertaken using a time-delimited sample of all patients attending the HIV clinic over one week and all the staff who were in contact with the patients. Waiting time tracking instruments and short questionnaires were used to collect data from both patients and staff. Data were analysed quantitatively. / South Africa

Anal cancer, like cervical cancer, is associated with Human Papillomavirus (HPV) infection. HIV+ patients have 38-60 fold increased risk of anal cancer compared to HIV- patients prompting many to suggest routine screening given the success of cervical Pap screening. Our goal is to describe our experience with routine anal Pap screening, determine which patients are most likely to have abnormal results, if anal disease on physical exam is predictive of cytology, and correlate cytology with histology findings. Charts of all patients with an anal Pap followed at the Hospital of Saint Raphael HIV Clinic were reviewed. Demographics, immune status, sexually transmitted disease history, cytology and histology data was extracted from medical charts. Patients with an anal Pap between November 1, 2002-November 30, 2004 were included. Those with an insufficient sample were excluded. Analysis was done using ÷2 for comparison of proportions and student t-test for continuous variables. Overall, 265/560 HIV+ patients had at least one anal Pap. Seventy-four of these 265 patients had an abnormal anal Pap. Mean age was 44 yrs, and 68% were men. Fifty-nine percent were African American, 34% White, and 17% Hispanic. Those with an abnormal Pap were more likely to be White (p=.03), and be gay or bisexual men (p=.02). They were also more likely to have lower CD4+ nadir (142 vs 223, p=.005) and CD4+ at time of anal Pap (353 vs 497, p<.001). Those with an abnormal anal Pap also had more anal disease (30% vs 9%, p<.001), history of warts (23% vs 12%, p=.02) and herpes (35% vs 22%, p=.02). Anal disease on physical exam had a sensitivity of 56% and specificity of 77% for abnormal cytology findings. On histology two patients had Anal Intraepithelial Neoplasia (AIN ) I, 2 AIN II, 3 AIN III, and 2 Squamous Cell Carcinoma In Situ. There was no correlation between cytology and histology. Routine anal cytology screening is a feasible tool to incorporate into an ethnically diverse HIV clinic for identifying precancerous anal lesions, a group which has been largely overlooked. Anal disease on physical exam is a poor predictor of abnormal cytology and there was no correlation between severity of disease on cytology and histology. However, further follow-up study is required to determine the impact on morbidity and mortality.