Directorate of Special Programmes, Republic of Namibia Ministry of Health and Social Services, Windhoek, Namibia.
PLoS One. 2013 Jun 7;8(6):e65653. doi: 10.1371/journal.pone.0065653. Print 2013.
HIV drug resistance (HIVDR) testing is not routinely available in many resource-limited settings, therefore antiretroviral therapy (ART) program and site factors known to be associated with emergence of HIVDR should be monitored to optimize the quality of patient care and minimize the emergence of preventable HIVDR.
In 2010, Namibia selected five World Health Organization Early Warning Indicators (EWIs) and scaled-up monitoring from 9 to 33 ART sites: ART prescribing practices, Patients lost to follow-up (LTFU) at 12 months, Patients switched to a second-line regimen at 12 months, On-time antiretroviral (ARV) drug pick-up, and ARV drug-supply continuity.
Records allowed reporting on three of the five selected EWIs. 22 of 33 (67%) sites met the target of 100% initiated on appropriate first-line regimens. 17 of 33 (52%) sites met the target of ≤20% LTFU. 15 of 33 (45%) sites met the target of 0% switched to a second-line regimen.
EWI monitoring directly resulted in public health action which will optimize the quality of care, specifically the strengthening of ART record systems, engagement of ART sites, and operational research for improved adherence assessment and ART patient defaulter tracing.
在许多资源有限的环境中，HIV 耐药性（HIVDR）检测并不常规提供，因此应监测与 HIVDR 出现相关的抗逆转录病毒治疗（ART）计划和地点因素，以优化患者护理质量并最大程度地减少可预防的 HIVDR 的出现。
2010 年，纳米比亚选择了五个世界卫生组织早期预警指标（EWI），并将监测范围从 9 个扩大到 33 个 ART 点：ART 处方实践、12 个月时失访的患者、12 个月时转为二线方案的患者、按时取抗逆转录病毒（ARV）药物，以及 ARV 药物供应的连续性。
33 个站点中的 22 个（67%）达到了 100%开始使用适当的一线方案的目标。33 个站点中的 17 个（52%）达到了失访率≤20%的目标。33 个站点中的 15 个（45%）达到了无患者转为二线方案的目标。
EWI 监测直接导致了公共卫生行动，这将优化护理质量，特别是加强 ART 记录系统、参与 ART 站点，以及开展操作研究，以改善依从性评估和 ART 患者逃检者的追踪。
