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Early warning indicators of HIV drug resistance in the southern highlands region of Tanzania: Lessons from a cross-sectional surveillance study

The World Health Organization early warning indicators (EWIs) permit surveillance of factors associated with the emergence of HIV drug resistance (HIVDR). We examined cross- and within-region performance on HIVDR EWIs for selected HIV care and treatment clinics (CTCs) in five regions of southern Tan...

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Autores principales: Khamadi, Samoel A., Mavere, Caroline, Bahemana, Emmanuel, Lwilla, Anange, Mizinduko, Mucho, Bwigane, Seth, Peter, Adela, Makando, Joy, Peter, Benjamin, Agaba, Patricia, Shah, Neha, Julu, Boniphase, Ganesan, Kavitha, Coakley, Peter, Lee, Elizabeth H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062592/
https://www.ncbi.nlm.nih.gov/pubmed/36996096
http://dx.doi.org/10.1371/journal.pgph.0000929
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author Khamadi, Samoel A.
Mavere, Caroline
Bahemana, Emmanuel
Lwilla, Anange
Mizinduko, Mucho
Bwigane, Seth
Peter, Adela
Makando, Joy
Peter, Benjamin
Agaba, Patricia
Shah, Neha
Julu, Boniphase
Ganesan, Kavitha
Coakley, Peter
Lee, Elizabeth H.
author_facet Khamadi, Samoel A.
Mavere, Caroline
Bahemana, Emmanuel
Lwilla, Anange
Mizinduko, Mucho
Bwigane, Seth
Peter, Adela
Makando, Joy
Peter, Benjamin
Agaba, Patricia
Shah, Neha
Julu, Boniphase
Ganesan, Kavitha
Coakley, Peter
Lee, Elizabeth H.
author_sort Khamadi, Samoel A.
collection PubMed
description The World Health Organization early warning indicators (EWIs) permit surveillance of factors associated with the emergence of HIV drug resistance (HIVDR). We examined cross- and within-region performance on HIVDR EWIs for selected HIV care and treatment clinics (CTCs) in five regions of southern Tanzania. We retrospectively abstracted EWI data from 50 CTCs for the January to December 2013 period. EWIs included the following: on time ART pick-up, retention on ART, ARV stockouts, and pharmacy prescribing and dispensing practices. Data for pediatric and adult people living with HIV were abstracted from source files, and frequencies and proportions were calculated for each EWI overall, as well as stratified by region, facility, and age group. Across and within all regions, on average, on-time pick-up of pills (63.0%), retention on ART (76.0%), and pharmacy stockouts (69.0%) were consistently poor for the pediatric population. Similarly, on-time pill pick up (66.0%), retention on ART (72.0%) and pharmacy stockouts (53.0%) for adults were also poor. By contrast, performance on pharmacy prescribing and dispensing practices were as desired for both pediatric and adult populations with few facility-level exceptions. In this study, regions and facilities in the southern highlands of Tanzania reported widespread presence of HIVDR risk factors, including sub-optimal timeliness of pill pickup, retention on ART, and drug stockouts. There is an urgent need to implement the WHO EWIs monitoring to minimize the emergence of preventable HIV drug resistance and to maintain the effectiveness of first and second-line ART regimens. This is particularly critical in the context of new ART drug roll-out such as dolutegravir during the COVID-19 pandemic when resultant HIV service disruptions require careful monitoring, and for virologic suppression as countries move closer to epidemic control.
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spelling pubmed-100625922023-03-31 Early warning indicators of HIV drug resistance in the southern highlands region of Tanzania: Lessons from a cross-sectional surveillance study Khamadi, Samoel A. Mavere, Caroline Bahemana, Emmanuel Lwilla, Anange Mizinduko, Mucho Bwigane, Seth Peter, Adela Makando, Joy Peter, Benjamin Agaba, Patricia Shah, Neha Julu, Boniphase Ganesan, Kavitha Coakley, Peter Lee, Elizabeth H. PLOS Glob Public Health Research Article The World Health Organization early warning indicators (EWIs) permit surveillance of factors associated with the emergence of HIV drug resistance (HIVDR). We examined cross- and within-region performance on HIVDR EWIs for selected HIV care and treatment clinics (CTCs) in five regions of southern Tanzania. We retrospectively abstracted EWI data from 50 CTCs for the January to December 2013 period. EWIs included the following: on time ART pick-up, retention on ART, ARV stockouts, and pharmacy prescribing and dispensing practices. Data for pediatric and adult people living with HIV were abstracted from source files, and frequencies and proportions were calculated for each EWI overall, as well as stratified by region, facility, and age group. Across and within all regions, on average, on-time pick-up of pills (63.0%), retention on ART (76.0%), and pharmacy stockouts (69.0%) were consistently poor for the pediatric population. Similarly, on-time pill pick up (66.0%), retention on ART (72.0%) and pharmacy stockouts (53.0%) for adults were also poor. By contrast, performance on pharmacy prescribing and dispensing practices were as desired for both pediatric and adult populations with few facility-level exceptions. In this study, regions and facilities in the southern highlands of Tanzania reported widespread presence of HIVDR risk factors, including sub-optimal timeliness of pill pickup, retention on ART, and drug stockouts. There is an urgent need to implement the WHO EWIs monitoring to minimize the emergence of preventable HIV drug resistance and to maintain the effectiveness of first and second-line ART regimens. This is particularly critical in the context of new ART drug roll-out such as dolutegravir during the COVID-19 pandemic when resultant HIV service disruptions require careful monitoring, and for virologic suppression as countries move closer to epidemic control. Public Library of Science 2023-03-30 /pmc/articles/PMC10062592/ /pubmed/36996096 http://dx.doi.org/10.1371/journal.pgph.0000929 Text en https://creativecommons.org/publicdomain/zero/1.0/This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Khamadi, Samoel A.
Mavere, Caroline
Bahemana, Emmanuel
Lwilla, Anange
Mizinduko, Mucho
Bwigane, Seth
Peter, Adela
Makando, Joy
Peter, Benjamin
Agaba, Patricia
Shah, Neha
Julu, Boniphase
Ganesan, Kavitha
Coakley, Peter
Lee, Elizabeth H.
Early warning indicators of HIV drug resistance in the southern highlands region of Tanzania: Lessons from a cross-sectional surveillance study
title Early warning indicators of HIV drug resistance in the southern highlands region of Tanzania: Lessons from a cross-sectional surveillance study
title_full Early warning indicators of HIV drug resistance in the southern highlands region of Tanzania: Lessons from a cross-sectional surveillance study
title_fullStr Early warning indicators of HIV drug resistance in the southern highlands region of Tanzania: Lessons from a cross-sectional surveillance study
title_full_unstemmed Early warning indicators of HIV drug resistance in the southern highlands region of Tanzania: Lessons from a cross-sectional surveillance study
title_short Early warning indicators of HIV drug resistance in the southern highlands region of Tanzania: Lessons from a cross-sectional surveillance study
title_sort early warning indicators of hiv drug resistance in the southern highlands region of tanzania: lessons from a cross-sectional surveillance study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062592/
https://www.ncbi.nlm.nih.gov/pubmed/36996096
http://dx.doi.org/10.1371/journal.pgph.0000929
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