Outcome assessment of a dedicated HIV positive health care worker clinic at a central hospital in Malawi: a retrospective observational study
Malawi has one of the world's lowest densities of Health Care Workers (HCW) per capita. This study evaluates outcomes of a dedicated HCW HIV clinic in Malawi, created at Zomba Central Hospital in January 2007. Retrospective cohort data was analyzed comparing HCW clinic patient baseline characte...
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| Veröffentlicht in: | PloS one 2011-05, Vol.6 (5), p.e19789-e19789 |
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| creator | Chan, Adrienne K van Lettow, Monique Tenthani, Lyson Kumwenda, Moses Gawa, Lucy Kadzanja, Alice Mnthambala, Austin Kambanji, Marion |
| description | Malawi has one of the world's lowest densities of Health Care Workers (HCW) per capita. This study evaluates outcomes of a dedicated HCW HIV clinic in Malawi, created at Zomba Central Hospital in January 2007.
Retrospective cohort data was analyzed comparing HCW clinic patient baseline characteristics and treatment outcomes at 18 months after inception, against those attending the general HIV clinic. In-depth interviews and focus group discussions were conducted to explore perceptions of patients and caregivers regarding program value, level of awareness and barriers for uptake amongst HCW. 306 patients were enrolled on antiretroviral therapy (ART) in the HCW HIV clinic, 6784 in the general clinic. Significantly (p |
| doi_str_mv | 10.1371/journal.pone.0019789 |
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Retrospective cohort data was analyzed comparing HCW clinic patient baseline characteristics and treatment outcomes at 18 months after inception, against those attending the general HIV clinic. In-depth interviews and focus group discussions were conducted to explore perceptions of patients and caregivers regarding program value, level of awareness and barriers for uptake amongst HCW. 306 patients were enrolled on antiretroviral therapy (ART) in the HCW HIV clinic, 6784 in the general clinic. Significantly (p<0.01) more HCW clients were initiated on ART on the basis of CD4 as opposed to WHO Stage 3/4 (36% vs.23%). Significantly fewer HCW clients defaulted (6% vs.17%), and died (4% vs.12%). The dedicated HCW HIV clinic was perceived as important and convenient in terms of reduced waiting times, and prompt and high quality care. Improved confidentiality was an appreciated quality of the HCW clinic however barriers included fear of being recognized.
Outcomes at the HCW clinic appear better compared to the general HIV clinic. The strategy of dedicated clinics to care for health providers is a means of HIV impact mitigation within human resource constrained health systems in high prevalence settings.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0019789</identifier><identifier>PMID: 21625545</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adolescent ; Adult ; AIDS ; Analysis ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Care and treatment ; Caregivers ; CD4 antigen ; Clients ; Confidentiality ; Cross-Sectional Studies ; Data processing ; Delivery of Health Care, Integrated - organization & administration ; Female ; Health care ; Health Personnel ; Highly active antiretroviral therapy ; HIV ; HIV - immunology ; HIV - pathogenicity ; HIV Infections - epidemiology ; HIV Infections - mortality ; HIV Infections - therapy ; HIV patients ; HIV Seropositivity ; Hospitals ; Human immunodeficiency virus ; Humans ; Malawi - epidemiology ; Male ; Medical diagnosis ; Medical personnel ; Medicine ; Mitigation ; Observational studies ; Outcome Assessment (Health Care) ; Patient outcomes ; Patients ; Primary care ; Program Development ; Retrospective Studies ; Security guards ; Social and Behavioral Sciences ; Survival Rate ; Syphilis ; Task forces ; Workers ; Young Adult</subject><ispartof>PloS one, 2011-05, Vol.6 (5), p.e19789-e19789</ispartof><rights>COPYRIGHT 2011 Public Library of Science</rights><rights>2011 Chan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Chan et al. 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c691t-ec7691f71f67b75fdefe3e5b18ec2363035d9b7cef5b3b86926f3fcee0b58bde3</citedby><cites>FETCH-LOGICAL-c691t-ec7691f71f67b75fdefe3e5b18ec2363035d9b7cef5b3b86926f3fcee0b58bde3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098249/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098249/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21625545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Adrienne K</creatorcontrib><creatorcontrib>van Lettow, Monique</creatorcontrib><creatorcontrib>Tenthani, Lyson</creatorcontrib><creatorcontrib>Kumwenda, Moses</creatorcontrib><creatorcontrib>Gawa, Lucy</creatorcontrib><creatorcontrib>Kadzanja, Alice</creatorcontrib><creatorcontrib>Mnthambala, Austin</creatorcontrib><creatorcontrib>Kambanji, Marion</creatorcontrib><title>Outcome assessment of a dedicated HIV positive health care worker clinic at a central hospital in Malawi: a retrospective observational study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Malawi has one of the world's lowest densities of Health Care Workers (HCW) per capita. This study evaluates outcomes of a dedicated HCW HIV clinic in Malawi, created at Zomba Central Hospital in January 2007.
Retrospective cohort data was analyzed comparing HCW clinic patient baseline characteristics and treatment outcomes at 18 months after inception, against those attending the general HIV clinic. In-depth interviews and focus group discussions were conducted to explore perceptions of patients and caregivers regarding program value, level of awareness and barriers for uptake amongst HCW. 306 patients were enrolled on antiretroviral therapy (ART) in the HCW HIV clinic, 6784 in the general clinic. Significantly (p<0.01) more HCW clients were initiated on ART on the basis of CD4 as opposed to WHO Stage 3/4 (36% vs.23%). Significantly fewer HCW clients defaulted (6% vs.17%), and died (4% vs.12%). The dedicated HCW HIV clinic was perceived as important and convenient in terms of reduced waiting times, and prompt and high quality care. Improved confidentiality was an appreciated quality of the HCW clinic however barriers included fear of being recognized.
Outcomes at the HCW clinic appear better compared to the general HIV clinic. The strategy of dedicated clinics to care for health providers is a means of HIV impact mitigation within human resource constrained health systems in high prevalence settings.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adolescent</subject><subject>Adult</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Care and treatment</subject><subject>Caregivers</subject><subject>CD4 antigen</subject><subject>Clients</subject><subject>Confidentiality</subject><subject>Cross-Sectional Studies</subject><subject>Data processing</subject><subject>Delivery of Health Care, Integrated - organization & administration</subject><subject>Female</subject><subject>Health care</subject><subject>Health Personnel</subject><subject>Highly active antiretroviral therapy</subject><subject>HIV</subject><subject>HIV - immunology</subject><subject>HIV - pathogenicity</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - mortality</subject><subject>HIV Infections - therapy</subject><subject>HIV patients</subject><subject>HIV Seropositivity</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Malawi - epidemiology</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>Mitigation</subject><subject>Observational studies</subject><subject>Outcome Assessment (Health Care)</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Primary care</subject><subject>Program Development</subject><subject>Retrospective Studies</subject><subject>Security guards</subject><subject>Social and Behavioral Sciences</subject><subject>Survival Rate</subject><subject>Syphilis</subject><subject>Task forces</subject><subject>Workers</subject><subject>Young 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assessment of a dedicated HIV positive health care worker clinic at a central hospital in Malawi: a retrospective observational study</title><author>Chan, Adrienne K ; van Lettow, Monique ; Tenthani, Lyson ; Kumwenda, Moses ; Gawa, Lucy ; Kadzanja, Alice ; Mnthambala, Austin ; Kambanji, Marion</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c691t-ec7691f71f67b75fdefe3e5b18ec2363035d9b7cef5b3b86926f3fcee0b58bde3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adolescent</topic><topic>Adult</topic><topic>AIDS</topic><topic>Analysis</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Care and treatment</topic><topic>Caregivers</topic><topic>CD4 antigen</topic><topic>Clients</topic><topic>Confidentiality</topic><topic>Cross-Sectional Studies</topic><topic>Data processing</topic><topic>Delivery of Health Care, Integrated - organization & administration</topic><topic>Female</topic><topic>Health care</topic><topic>Health Personnel</topic><topic>Highly active antiretroviral therapy</topic><topic>HIV</topic><topic>HIV - immunology</topic><topic>HIV - pathogenicity</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - mortality</topic><topic>HIV Infections - therapy</topic><topic>HIV patients</topic><topic>HIV Seropositivity</topic><topic>Hospitals</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Malawi - epidemiology</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical personnel</topic><topic>Medicine</topic><topic>Mitigation</topic><topic>Observational studies</topic><topic>Outcome Assessment (Health Care)</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Primary care</topic><topic>Program Development</topic><topic>Retrospective 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One</addtitle><date>2011-05-19</date><risdate>2011</risdate><volume>6</volume><issue>5</issue><spage>e19789</spage><epage>e19789</epage><pages>e19789-e19789</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Malawi has one of the world's lowest densities of Health Care Workers (HCW) per capita. This study evaluates outcomes of a dedicated HCW HIV clinic in Malawi, created at Zomba Central Hospital in January 2007.
Retrospective cohort data was analyzed comparing HCW clinic patient baseline characteristics and treatment outcomes at 18 months after inception, against those attending the general HIV clinic. In-depth interviews and focus group discussions were conducted to explore perceptions of patients and caregivers regarding program value, level of awareness and barriers for uptake amongst HCW. 306 patients were enrolled on antiretroviral therapy (ART) in the HCW HIV clinic, 6784 in the general clinic. Significantly (p<0.01) more HCW clients were initiated on ART on the basis of CD4 as opposed to WHO Stage 3/4 (36% vs.23%). Significantly fewer HCW clients defaulted (6% vs.17%), and died (4% vs.12%). The dedicated HCW HIV clinic was perceived as important and convenient in terms of reduced waiting times, and prompt and high quality care. Improved confidentiality was an appreciated quality of the HCW clinic however barriers included fear of being recognized.
Outcomes at the HCW clinic appear better compared to the general HIV clinic. The strategy of dedicated clinics to care for health providers is a means of HIV impact mitigation within human resource constrained health systems in high prevalence settings.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>21625545</pmid><doi>10.1371/journal.pone.0019789</doi><tpages>e19789</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Acquired immune deficiency syndrome Adolescent Adult AIDS Analysis Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Care and treatment Caregivers CD4 antigen Clients Confidentiality Cross-Sectional Studies Data processing Delivery of Health Care, Integrated - organization & administration Female Health care Health Personnel Highly active antiretroviral therapy HIV HIV - immunology HIV - pathogenicity HIV Infections - epidemiology HIV Infections - mortality HIV Infections - therapy HIV patients HIV Seropositivity Hospitals Human immunodeficiency virus Humans Malawi - epidemiology Male Medical diagnosis Medical personnel Medicine Mitigation Observational studies Outcome Assessment (Health Care) Patient outcomes Patients Primary care Program Development Retrospective Studies Security guards Social and Behavioral Sciences Survival Rate Syphilis Task forces Workers Young Adult |
| title | Outcome assessment of a dedicated HIV positive health care worker clinic at a central hospital in Malawi: a retrospective observational study |
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