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Antiretroviral therapy outcomes among HIV infected clients in Gweru City, Zimbabwe 2006-2011: a cohort analysis

Antiretroviral therapy outcomes among HIV infected clients in Gweru City, Zimbabwe 2006-2011: a cohort analysis

Gerald Shambira1,&, Notion Tafara Gombe1, Casey Daniel Hall2, Meeyoung Mattie Park2, Joseph Asamoah Frimpong3

 

1Zimbabwe Field Epidemiology Training Program, Zimbabwe, 2Emory University, Atlanta, USA, 3Liberia Field Epidemiology Training Program, Liberia

 

 

&Corresponding author
Gerald Shambira, Zimbabwe Field Epidemiology Training Program, Zimbabwe

 

 

Abstract

The government of Zimbabwe began providing antiretroviral therapy (ART) to People Living with HIV/AIDS (PLHIV) in public institutions in 2004. In Midlands province two clinics constituted the most active HIV care service points, with patients being followed up through a comprehensive patient monitoring and tracking system which captured specific patient variables and outcomes over time. The data from 2006 to 2011 were subjected to analysis to answer specific research questions and this case study is based on that analysis. The goal of this case study is to build participants' capacity to undertake secondary data analysis and interpretation using a dataset for HIV antiretroviral therapy in Zimbabwe and to draw conclusions which inform recommendations. Case studies in applied epidemiology allow students to practice applying epidemiologic skills in the classroom to address real-world public health problems. Case studies as a vital component of an applied epidemiology curriculum are instrumental in reinforcing principles and skills covered in lectures or in background reading. The target audience includes Field Epidemiology and Laboratory Training Programs (FELTPs), university students, district health executives, and health information officers.

 

 

How to use this case study    Down

General instructions: case studies in applied epidemiology allow students to practice applying epidemiologic skills in the classroom to address real-world public health problems. Case studies are used as a vital component of an applied epidemiology curriculum, rather than as stand-alone tools. They are well suited to reinforcing principles and skills already covered in a lecture or in background reading. Ideally, 1-2 instructors facilitate the case study for 8 to 20 students in a classroom or conference room. Traditionally, the instructor directs a participant to read aloud a paragraph or two, going around the room and giving each participant a chance to read. When the participant reads a question, the instructor directs all participants to perform calculations, construct graphs, or engage in a discussion of the answer. Sometimes, the instructor can split the class to play different roles or take different sides in answering the question. As a result, participants learn from each other, not just from the instructors.

 

Audience: residents in Field Epidemiology Training Programs (FETPs), Field Epidemiology and Laboratory Training Programs (FELTPs), university students, district health executives, health information officers from the public health sector, and other partner organizations at national and regional level. Participants will have basic graduate qualification in health-related field, e.g. medical degree, nursing, environmental health, social science.

 

Prerequisites: before using this case study, case study participants should have received lectures or other instruction in basic epidemiology, statistics, and secondary data analysis.

 

Materials needed: white board or flip chart and markers, graph paper, computers with MS Excel (optional)

 

Level of training and associated public health activity: advanced – epidemiology and public health research

 

Time required: approximately 3 hours

 

Language: English

 

 

Case study material Up    Down

 

 

Competing interests Up    Down

The authors declare no competing intyerest.

 

 

Acknowledgments Up    Down

This case study is based on an unpublished investigation conducted in 2011-12 by Blessing Mutede, a Graduate of the Zimbabwe Field Epidemiology Training Program (ZFETP). We wish to thank the African Field Epidemiology Network (AFENET) for sponsoring the training and the Zimbabwe Program Director, Professor Mufuta Tshimanga for nominating and supporting the training of the two Zimbabwean participants. We also wish to acknowledge the following for their peer review during the case study workshop: Mahmood Dalhat, Olufunmilayo Ibitola Fawole, Jane Githuku and Doreen Tuhebwe.

 

 

References Up    Down

  1. Rosen S, Fox MP, Gill CJ. Patient retention in antiretroviral therapy programs in sub-Saharan Africa: a systematic review. PLoS Med. 2007; 4(10): e298. PubMed | Google Scholar

  2. Zimbabwe Ministry of Health and Child Care. Antiretroviral Programme Annual Review. 2013. Google Scholar

  3. Zimbabwe Ministry of Health and Child Care. Guidelines for Antiretroviral Therapy for the Prevention and Treatment of HIV in Zimbabwe. Harere, Zimbabwe. 2013.
  4. WHO. WHO Case Definitions of HIV for Surveillance and Revised Clinical Staging and Immunological Classification of HIV-Related Disease in Adults and Children. Geneva, Switzerland. 2006.