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Clinical outcomes of antiretroviral therapy patients following the implementation of new eligibility criteria in Sekhukhune District

Thesis (MPH.) --University of Limpopo, 2018 / Background: The prevalence of HIV in South Africa has increased largely due to
the combined effect of new infections, and a successfully expanded antiretroviral
treatment programme, which has increased survival among people living with HIV.
As the up-scaling of patients on ART has been increased, the aim of the current
study was to investigate the variations of the clinical outcomes between patients
initiated with CD4 < 350 and of those above 350 after the implementation of the new
eligibility criteria for ARV therapy. Methods The current study used quantitative approach to retrospectively review a total of 488 records of adult patient who were registered in health facilities which were purposefully sampled from Sekhukhune District of Limpopo Province. SPSS version 23.0 was used to analyse data. Results Approximately 60% of the patients initiated on ART were having CD4 count <350
and male patients were more at 74% as compared to females at 54.7%. Patients
who started ART with a baseline CD4 >350 had a high rate of lost to follow up within
3 months after start of ART at 15% than those with a baseline CD4 <350 at 10.2.
More patients were lost to follow-up shortly after starting treatment at 3 months at an
average of 13.8% in both CD4 counts. Majority of patients retained in care were
those who started ART treatment with a baseline CD4<350 at 87.4%. Viral load
completion rate at 12 months was higher than that of 6 months, at 86.8 and 80.5
respectively. Patients with a baseline CD4 >350 suppressed more than those who
started ART with a baseline CD4 <350 at both 6 and 12 months at >90%
suppression rate. Lastly, most of the patients died within 3 months of ART treatment
and had a baseline CD4 < 350 than at 2.4% those with a baseline CD4 >350 at
0.6%. Conclusions The implementation of the new eligibility criteria of ART initiation improves the clinical outcome of patients on ART. There are still patients that are missed to be monitored viral load bloods which play a key role in determining the clinical
outcomes of patients. Clinicians and nurses should adhere to the recommended time
frames for monitoring of ART patients to improve clinical outcomes. Keywords: HIV/AIDS, antiretroviral therapy, clinical outcome, ART initiation;
Eligibility Criteria;

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ul/oai:ulspace.ul.ac.za:10386/2367
Date January 2018
CreatorsMakgato, Valerie Kedibone
ContributorsSkaal, L., Maimela, E.
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Formatx, 74 leaves
RelationPDF

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