Table 2.
Uptake of regular monitoring for patients on ART at different time points of treatment follow-up
| First author, year | Follow-ups | Number of patient retained in care | Proportion of patient monitored for treatment response n (%) by # monitoring approaches | Laboratory testing services | Testing site | Notes | ||
|---|---|---|---|---|---|---|---|---|
| Virological | Immunological | Clinicala | ||||||
| Assefa, 2011 [30] | 6 months | Health center: 5072/6197 Hospital: 24,821/31,269 |
Not report (NR) | 54% | NR | Not stated | Not stated | Number of patients received immunological monitoring with CD4 count documented was not reported. Data (proportion of patient monitored) was not reported separately for each level of care |
| 12 months | Health center: 3042/4022 Hospital: 17,037/23,039 |
NR | 51% | |||||
| 24 months | Health center 650/856 Hospital : 4419/6595 |
NR | 51% | |||||
| Bedelu, 2007 [17] | 12 months | Health clinic: 482/595 Hospital: 289/430 |
Health clinic: 296/482 (61.4%) Hospital: 41/289 (14.2%) |
Health clinic: 348/482 (72.2%) Hospital: 81/289 (28%) |
NR | Not stated | Not stated | |
| Boulle, 2010 [19] | 1 year | 4512 | 3932/4512 (87%) | 3823/4512 (85%) | NR | CD4 and VL provided 6-monthly after staring ART | Not stated | VL: NucliScens EasyQHIV-1 assay CD4: single-platform panleucogating method Type of blood used not reported |
| 2 years | 2561 | 2198/2561 (86%) | 2108/2561 (82%) | |||||
| 3 years | 1235 | 983/1235 (79.6%) | 931/1235 (75.4%) | |||||
| 4 years | 458 | 351/458 (76.6%) | 341/458 (74.5%) | |||||
| 5 years | 191 | 148/191 (77.5%) | 127/191 (66.5%) | |||||
| Brennan, 2011 [16] | 12 months | Hospital : 1958/2079 Primary health care: 681/693 |
Hospital: 1774/1958 (90.6%) PHC 676/681 (99.2%) |
PHC: 95% Hospital: 81% |
Clinical monitor performed every 2 months by nurse at PHC; 6 monthly by doctor at hospital | CD4 and VL test measured every 6 month | Not stated | Inconsistency in data on % patients with CD4 and VL data available between text and table. Number of patients with 12 months CD4 count available not reported |
| Fatti, 2010 [41] | 12 months | 11,960 | 6725 (56.2%) | NR | Patients attend monthly clinical checks | CD4 count and VL monitored 6 monthly for patient on treatment by SA NHL services | Off-site except for large hospital | Data (n/N) on proportion of patient received and had VL available was reported for all level of care |
| 24 months | 4029 | 2525 (62.6%) | ||||||
| 36 months | 545 | 342 (62.8%) | ||||||
| Fairall, 2012 [13] | 12 months | Primary care: 2823/3029 Hospital: 2981/3202 |
Primary care: 2582/2823 (91.5%) Hospital: 2656/2981 (89.1%) |
NR | NR | Not stated | Not stated | |
| Hansudewe-chakul, 2012 [15] | 12, 24, 36, 48 months (VL data available at baseline and at least 1 follow-up) | Community hospital: 154 Tertiary hospital : 133 |
CH: 22/154 (14.3%) TH: 38/133 (28.6%) |
NR | Clinical monitoring using CDC classification; | CD4% assessed 6 monthly, routine VL testing not available. VL measured at 12 month intervals for 48 months | Not stated | No time point specific provided for % patient with VL data available. Scheduled clinic visit 6 monthly at tertiary hospital |
| Janssen, 2010 [21] | 6–12 months | 447 | 193/447 (43.2%) | CD4%: 310/447 (69.3%); CD4: 315/447 (70.5%) | NR | Laboratory tests (CD4, VL, Hemoglobin/albumin) repeated 6 monthly | VL testing at referral hospital (75 km away); other tests at local hospital | |
| Jobanputra, 2014 [26] | 12 months | 5563 | 4767/5563 (86%) | NR | NR | VL measured annually using a Generic HIV VL platform (Biocentric) | VL testing at regional virology laboratory | |
| Mutevedzi, 2010 [20] | 12 months | 2527/3010 | 758/2527 (30%) | NR | NR | CD4 count and VL measured every 6 months | VL testing at provincial lab | VL measured by Nucli-Sens Easy HIV-1 assay). Type of blood used not report |
| Rich, 2012 [22] | 24 months | 926 | 275/926 (29.7%) | 710/926 (76.7%) | NR | CD4 count measured 6 monthly using BD fluorescence-activated cell sorting count system | Not stated | |
| Selke, 2010 [14] | 12 months | Intervention: 87 Control: 102 |
Intervention: 86/87 (99%) Control: 96/102 (94.1%) |
Intervention: 87/87 (100%) Control: 96/102 (94.1%) |
Intervention: 74/87 (85%) Control: 87/102 (85.3%) |
VL and CD4 count obtained at initial and close out research visit. Additional CD4 count at 6 months | Not stated | |
| Shumbusho, 2009 [24] | 6 months | 217 | NR | 193/217 (88.9%) | 83.4%: side effect screening at all visits (frequency not reported) | CD4 count measured every 6 month using BD FACS Count | District hospital laboratory | |
| 12 months | 123 | NR | 104/123 (84.5%) | |||||
| 18 months | 43 | NR | 31/43 (72.1%) | |||||
| 24 months | 10 | 10/10 (100%) | ||||||
| Uzodike, 2015 [18] | Jun 2011 | 488 | 407/488 (83.4%) | 461/488 (94.5%) | 412/488 (84.4%) | CD4 and VL monitored 6 monthly | Not stated | Clinical monitoring carried out monthly by nurses |
| Dec 2011 | 466/488 (95.5%) | 464/488 (95.1%) | NR | |||||
| Jun 2012 | 444/488 (91.0%) | 430/488 (88.1%) | 381/488 (78%) | |||||
| Vogt, 2015 [23] | 6 months | 1250 | NR | 194/1250 (15.5%) | 1250/2145 (58%) | Whole blood collected in EDTA tube for testing by BD Fascount and Partect Cyflow | District hospital laboratory | Data is presented for both hospital and RHCs |
| 12 months | 1199 | NR | 74/1199 (6.2%) | 1199/2145 (56%) | ||||
| Walter, 2014 [12] | 6 months | 11,243 | NR | 5859 (52%) | NR | Not stated | Not stated | |
| 12 months | 8644 | 5160 (60%) | ||||||
| 18 months | 6467 | 4110 (64%) | ||||||
| 24 months | 4485 | 3201 (71%) | ||||||
aClinical monitoring using WHO clinical staging except mentioned otherwise