Libamba Edwin, Makombe Simon, Mhango Eustice, de Ascurra Teck Olga, Limbambala Eddie, Schouten Erik J, Harries Anthony D
Clinical HIV Unit, Ministry of Health, Lilongwe, Malawi.
Bull World Health Organ. 2006 Apr;84(4):320-6. doi: 10.2471/blt.05.023952. Epub 2006 Apr 13.
To describe the supervision, monitoring and evaluation strategies used to assess the delivery of antiretroviral therapy during nationwide scale-up of treatment in Malawi.
In the first quarter of 2005, the HIV Unit of the Ministry of Health and its partners (the Lighthouse Clinic; Médecins Sans Frontières-Belgium, Thyolo district; and WHO's Country Office) undertook structured supervision and monitoring of all public sector health facilities in Malawi delivering antiretroviral therapy.
Data monitoring showed that by the end of 2004, there were 13,183 patients (5274 (40%) male, 12 527 (95%) adults) who had ever started antiretroviral therapy. Of patients who had ever started, 82% (10 761/13,183) were alive and taking antiretrovirals; 8% (1026/13,183) were dead; 8% (1039/13,183) had been lost to follow up; <1% (106/13,183) had stopped treatment; and 2% (251/13,183) had transferred to another facility. Of those alive and on antiretrovirals, 98% (7098/7258) were ambulatory; 85% (6174/7258) were fit to work; 10% (456/4687) had significant side effects; and, based on pill counts, 96% (6824/7114) had taken their treatment correctly. Mistakes in the registration and monitoring of patients were identified and corrected. Drug stocks were checked, and one potential drug stock-out was averted. As a result of the supervisory visits, by the end of March 2005 recruitment of patients to facilities scheduled to start delivering antiretroviral therapy had increased.
This report demonstrates the importance of early supervision for sites that are starting to deliver antiretroviral therapy, and it shows the value of combining data collection with supervision. Making regular supervisory and monitoring visits to delivery sites are essential for tracking the national scale-up of delivery of antiretrovirals.
描述在马拉维全国范围内扩大抗逆转录病毒治疗规模期间，用于评估抗逆转录病毒治疗实施情况的监督、监测和评价策略。
2005年第一季度，卫生部艾滋病防治部门及其合作伙伴（灯塔诊所；比利时无国界医生组织，蒂约洛地区；以及世界卫生组织国家办事处）对马拉维所有提供抗逆转录病毒治疗的公共部门卫生设施进行了结构化监督和监测。
数据监测显示，到2004年底，共有13183名患者（5274名（40%）男性，12527名（95%）成年人）开始接受抗逆转录病毒治疗。在开始治疗的患者中，82%（10761/13183）存活并正在服用抗逆转录病毒药物；8%（1026/13183）死亡；8%（1039/13183）失访；不到1%（106/13183）停止治疗；2%（251/13183）转至另一机构。在存活且正在服用抗逆转录病毒药物的患者中，98%（7098/7258）为非卧床患者；85%（6174/7258）适合工作；10%（456/4687）有明显副作用；根据药片计数，96%（6824/7114）正确服药。发现并纠正了患者登记和监测中的错误。检查了药品库存，避免了一次潜在的药品短缺。由于监督访问，到2005年3月底，计划开始提供抗逆转录病毒治疗的设施的患者招募人数有所增加。
本报告证明了对开始提供抗逆转录病毒治疗的地点进行早期监督的重要性，并显示了将数据收集与监督相结合价值。定期对治疗地点进行监督和监测访问对于跟踪全国抗逆转录病毒治疗的推广至关重要。
