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Browsing Protocols by Author "Chibwana, Chikaiko"

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    Assessing Viral Load suppression in clients receiving 6 Multi Month Refill at Dedza District Hospital
    (Kamuzu University of Health Sciences, 2022-01-19) Chibwana, Chikaiko
    Type of Study This will be retrospective cohort study design. Problem Human Immunodeficiency Virus (HIV) positive clients taking Anti-Retroviral Therapy (ART) put on newly introduced Service Delivery Model (DSD) of 6 Multi Months Refill (6MMR) take about 6 months before they are seen at a clinic for clinical assessment including adherence counselling by a professional health worker. Studies done in some countries have associated this long period to have negative effect on Viral Load (VL) suppression. High viral load is associated with increased risk of opportunistic infections, treatment failure and death. Broad Objective To assess viral load suppression among clients on 6 MMR enrolled at ART clinic at Dedza District Hospital. Specific Objectives 1. To establish viral load suppression rate in clients on 6 MMR enrolled at Dedza District Hospital ART clinic. 2. To compare viral load suppression rates among clients on 3 Multi Months Refill (3 MMR) to those on 6 MMR enrolled at Dedza District Hospital ART clinic 3. To identify factors associated with viral load suppression in clients receiving 6 MMR enrolled at Dedza District ART clinic Methodology Study Place The study will take place in Dedza district at Dedza District Hospital. Data will be collected at Dedza District Hospital ART clinic. Study Population Participants to the study will be HIV positive clients enrolled at Dedza ART clinic, 18 years old and who were given 3 or 6 MMR from September 2019 to July 2021. Study Period The study period will be 12 months (from April 2021 to May 2022) including time for developing protocol, data extraction tools, obtaining all appropriate approvals, training of study assistants, data collection, data analysis, writing dissertation and dissemination. Data collection Procedures The study will utilize secondary data that will be extracted from ART, HIV Testing Services (HTS), appointment registers, client master cards and Electronic Master Record (EMR) using a designed data collection tools. The following variables will be collected: Demographic data, type of employment, distance from the hospital, place of residence (rural, urban or semi urban), type of relation with guardian, months on ART regimen, pill count, comorbidity with Tuberculosis (TB), viral load result after receiving either 3 MMR or 6 MMR. Data analysis Multivariate binary logistic regression will be used to test if each of explanatory variables is associated with Viral Load Suppression among clients on 6 MMR. Constraints Being a retrospective study that will use secondary data, some data valuables like employment status, pill count and viral load results might be missing. However, the researcher plans to be looking for the missing data in Electronic Master Record (EMR), in paper based master cards and Laboratory registers for viral load loads results. Expected Findings The study will establish rates of viral suppression and identify factors associated with viral load suppression in clients receiving 6 MMR. The findings will inform policy makers in deciding the right clients to be put on 6 MMR basing on the factors that will be associated with viral load suppression. Dissemination Research finding will submitted to College of Medicine Research and Ethics Committee (COMREC), College of Medicine Library and Dedza District Hospital. Manuscript will be prepared for peer Journal publication.