Strengthening Clinical and Laboratory Services at the National Referral Level to Improve HIV Prevention, Care, and Treatment in the Republic of Zambia under the President's Emergency Plan for AIDS Relief (PEPFAR)
1. CDC Project Description a. Approach: Activities Outcomes Short Term Outcomes (1-2 Years) Intermediate Outcomes (3-4 Years) Long Term Outcomes (5+ Years) CARE AND TREATMENT OF HIV INFECTED PERSONS Provide comprehensive clinical management of HIV infected persons including screening and treatment for TB, sexually transmitted infections (STIs) and opportunistic infections (OIs) and antiretroviral therapy (ART) for treating eligible persons Evaluate HIV disease stage and initiate ART for all HIV infected persons who meet national eligibility criteria Perform TB syndromic screening of HIV patients, followed by laboratory confirmation and TB treatment, as needed, and provide Isoniazid prophylaxis to TB screen negative patients Provide cotrimoxazole (CTX) prophylaxis to HIV infected persons, according to national guidelines Evaluate HIV patients for STIs or OIs and treat as needed Strengthen linkages for patient referrals within the host facility and to named primary care facilities by providing quarterly lists of referred patients to sites and requesting feedback on referral outcome and retention of patients on ART Increased number of HIV infected children initiated on ART Increased number of adults initiated on ART Increased uptake of ART initiation among HIV infected persons Increased number of HIV infected persons appropriately managed and treated for TB, STIs and OIs Improved virological suppression among HIV infected persons receiving appropriate clinical management and treatment Increased retention of patients on ART Monitor the impact of ART on individuals through viral load (VL) testing and HIV drug resistance testing for those with suspected treatment failure Implement viral load (VL) testing for all persons on ART at 6 months and 12 months, and annually thereafter, and use VL test results to adjust treatment regimens, according to national guidelines Implement HIV drug resistance (DR) testing of patients with suspected ART treatment failure Increased number of HIV infected persons on ART with VL results available according to schedule Increased number of persons with suspected treatment failure with available HIV DR test results Increased number of persons with suspected ART treatment failure on appropriate anti-retroviral (ARV) treatment regimen based on HIV DR results Increased use of effective ARV treatment regimens that lead to viral suppression Provide nutritional counseling, as appropriate, to HIV infected persons and their families Increased number of HIV infected persons receiving nutritional advice and management Reduced morbidity due to nutritional deficiencies among HIV infected persons and their families Reduced morbidity due to nutritional deficiencies among HIV infected persons and their families Assist MOH to strengthen skills of clinicians and develop guidelines to improve care and treatment of HIV/AIDS patients Increased number of clinicians mentored in other health care facilities by Partner’s staff Increased number of provinces with newly established Advanced HIV Treatment Centers to manage complicated HIV cases e.g. patients failing second line therapy, needing HIV DR testing to guide selection of ART regimen, or, with complicated co-morbidities (e.g. with advanced cardiac failure and end stage renal failure) Increased number of HIV infected persons appropriately managed and treated Improved virological suppression among HIV infected persons receiving appropriate clinical management and treatment Increased retention of patients on ART Continued under..2. CDC Project Description
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