TitleLost Opportunities to Complete CD4+ Lymphocyte Testing Among Patients Who Tested Positive for HIV in South Africa
AuthorsLarson B.A., Brennan A., McNamara L., Long L., Rosen S., Sanne I., Fox M.P.
PublicationBull World Health Organ. 2010 Sep; 88(9):675-80.
AbstractOBJECTIVE: To estimate rates of completion of CD4+ lymphocyte testing (CD4 testing) within 12 weeks of testing positive for human immunodeficiency virus (HIV) at a large HIV/AIDS clinic in South Africa, and to identify clinical and demographic predictors for completion. METHODS: In our study, CD4 testing was considered complete once a patient had retrieved the test results. To determine the rate of CD4 testing completion, we reviewed the records of all clinic patients who tested positive for HIV between January 2008 and February 2009. We identified predictors for completion through multivariate logistic regression. FINDINGS: Of the 416 patients who tested positive for HIV, 84.6% initiated CD4 testing within the study timeframe. Of these patients, 54.3% were immediately eligible for antiretroviral therapy (ART) because of a CD4 cell count 200/microl), only 14.9% completed CD4 testing within 12 weeks. Overall, of HIV+ patients who initiated CD4 testing, 65% did not complete it within 12 weeks of diagnosis. The higher the baseline CD4 cell count, the lower the odds of completing CD4 testing within 12 weeks. CONCLUSION: Patient losses between HIV testing, baseline CD4 cell count and the start of care and ART are high. As a result, many patients receive ART too late. Health information systems that link testing programmes with care and treatment programmes are needed.
Related ProjectsEconomics and Epidemiology of HIV/AIDS, Tuberculosis, and Non-Communicable Diseases in Africa
Child and Family Applied Research Project (CFAR)