Assessing viral load testing adherence and coverage and the related client outcomes in the 90:90:90 era: A case study of Ntchisi District Hospital

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Date
2020-06-05
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Kamuzu University of Health Sciences
Abstract
This will be a retrospective quantitative cohort study. The problem to be studied: Viral load (VL) testing is one of the essential measure of HIV client progress in regards to ART where suppression shows treatment success. So this study intends to find out the level of VL coverage and adherence to protocol and describe the relationship between those clinical factors and the development of Tuberculosis (TB), infantile deaths and miscarriages. Main objectives: To assess the viral load testing adherence and coverage and the related client outcomes Specific objectives 1. To assess the level of clinical adherence and coverage in regards to viral load time frames 2. To measure the prevalence of Tuberculosis in HIV care enrolled clients and the related VL adherence and coverage before diagnosis 3. To estimate the rate of miscarriages in HIV clients and the related VL adherence and coverage prior to incident 4. To determine the prevalence of infantile deaths and the related VL adherence and coverage prior to the incident Methodology Study design: The study will employ a retrospective quantitative cohort design. Study place: This will be conducted in Ntchisi district. Respondents will be recruited from Ntchisi district hospital ART clinic. Study population: HIV reactive clients attending Ntchisi district hospital ART clinic will be eligible for this study. Study Period: The study will run from April 2019 to July 2020. This is a 16-month period which conceptualization of the proposal to thesis submission will be done. Data collection procedures: This study will utilize a checklist to extract data following the subjects consent. The checklist will look at such variables as age, sex, marital status of HIV positive patients, TB status, infantile deaths status, miscarriages, the number of VL tests and the times when their viral load testing was done. Mainly the clients master cards, and the prevention of mother to child transmission (PMTCT) registers utilized will be used to extract such data. Data management and analysis: All data will be kept in Microsoft excel with a passcode for safety. So, these data will be exported to Stata wherein cleaning and analysis will occur. Moreover, respondents’ identities will not be identifiable since they will be represented by codes. Data analysis will involve both descriptive and inferential statistics. Constraints: The researcher supposes there might be missing VL results in other study participants. In regards to this, the researcher plans to rectify this by following up with the central laboratory. Implications of the study: Results from this study are expected to contribute knowledge to the body of research in HIV medicine. For that cause, this information will be important when developing interventions for HIV clients’ care, providers protocol, including mentorship and supervision schedules. Expected findings and their dissemination: This study will find the period prevalence of Tuberculosis, miscarriages, and infantile deaths in people living with HIV (PLHIV). Moreover, this will show coverage and adherence frequencies in regards to VL testing in PLHIV and the relationship and association between the dependent and independent variables. Moreover, the results be contained in the author’s Master of Global Health thesis that will be submitted to COMREC and college library.
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