Scale-up of Kenya's national HIV viral load program: Findings and lessons learned
Scale-up of Kenya's national HIV viral load program: Findings and lessons learned
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DOI：
10.1371/journal.pone.0190659
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发表时间：
2018-01-11
期刊：
影响因子：
3.7
通讯作者：
Boeke, Caroline E.
中科院分区：
文献类型：
--
作者：
Mwau, Matilu;Syeunda, Catherine Akinyi;Boeke, Caroline E.
肯尼亚是第一个扩大国家艾滋病毒载量监测计划的非洲国家之一。我们试图利用国家数据库评估项目规模，并确定需要加强系统的领域。方法从肯尼亚国家病毒载量数据库中提取2012年1月至2016年3月的数据。随着时间的推移，对1,108,356项检测的特征进行了评估，包括检测原因、周转时间、检测结果、治疗方案和社会人口信息。结果到2016年，提供病毒载量检测的设施增加到2000个，每月进行40万次检测。截至2016年3月，大多数（84.2%）检测是出于常规监测目的进行的，从设施级样本采集到从实验室发送结果的周转时间为21(24)[中位数（IQR）]天。虽然重复病毒载量测试的比例随着时间的推移而增加，但数量低于预期。病毒载量升高在儿童和青少年患者中更为常见
ObjectivesKenya is one of the first African countries to scale up a national HIV viral load monitoring program. We sought to assess program scale up using the national database and identify areas for systems strengthening.MethodsData from January 2012 to March 2016 were extracted from Kenya's national viral load database. Characteristics of 1,108,356 tests were assessed over time, including reason for testing, turnaround times, test results, treatment regimens, and socio-demographic information.ResultsThe number of facilities offering viral load testing increased to similar to 2,000 with >40,000 tests being conducted per month by 2016. By March 2016, most (84.2%) tests were conducted for routine monitoring purposes and the turnaround time from facility-level sample collection to result dispatch from the lab was 21(24) [median (IQR)] days. Although the proportions of repeat viral load tests increased over time, the volumes were lower than expected. Elevated viral load was much more common in pediatric and adolescent patients (0-