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Sonali Palchaudhuri Hannock Tweya , Mina Hosseinipour University of Michigan Medical School (M4)

Sonali Palchaudhuri Hannock Tweya , Mina Hosseinipour University of Michigan Medical School (M4) Fogarty International Clinical Research Scholar 2011-2012 UNC Project – Malawi July 24, 2012.

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Sonali Palchaudhuri Hannock Tweya , Mina Hosseinipour University of Michigan Medical School (M4)

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  1. Sonali Palchaudhuri HannockTweya, Mina Hosseinipour University of Michigan Medical School (M4) Fogarty International Clinical Research Scholar 2011-2012 UNC Project – Malawi July 24, 2012 ART Monitoring Strategies: Assessment of Laboratory Test Utilization for HIV/AIDS care in ART clinics of Malawi

  2. Background Growing number on ART, changing methods of monitoring for treatment failure Limited data on efficacy of monitoring strategies Objective: Assess laboratory utilization at gold-standard ART clinics in Malawi, as a marker of success of monitoring strategies Methods: 1-year EMR retrospective review of 2 clinics that have lab access Used 6-month CD4 for monitoring Pre-ART and ART patients VL as needed Assess ordering patterns, processing reliability, time to results Project Outline

  3. Ordering •  CD4ordered much less than expected per schedule •  Very few VLs ordered, many had to be re-drawn. • Per report, tests not ordered when capacity considered low/broken

  4. CD4 analysis * Lab had 3 processing machines •  Almost 2 weeks for most samples for results to be available to physicians

  5. Viral load analysis •  Almost ½ samples do not return with results •  Results not reliably back in any time frame •  Large gaps in processing

  6. End of slide show, click to exit.

  7. QC dates for CD4 at KCH Machines 1 and 2 are CD FacsCount Machin e 3 is an Epic, run only as a back-up

  8. VL bleed to result

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