Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jun 7;8(6):e65653.
doi: 10.1371/journal.pone.0065653. Print 2013.

HIV drug resistance early warning indicators in Namibia for public health action

Anna Jonas  1 , Justice Gweshe, Milner Siboleka, Michael Deklerk, Michael Gawanab, Alfons Badi, Victor Sumbi, Dawn Pereko, Abraham Blom, Samson Mwinga, Michael R Jordan, Logan Jerger, Kiger Lau, Steven Y Hong
Affiliations

HIV drug resistance early warning indicators in Namibia for public health action

Anna Jonas et al. PLoS One. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: All authors above have no conflicts of interests except one author is employed by ‘Abt Associate Inc’. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Geographic location of antiretroviral therapy sites.
Adapted from original map available at: http://d-maps.com/carte.php?num_car=4824&lang=en.
See this image and copyright information in PMC

References

    1. UNAIDS. (2012) Together We Will End AIDS. Available: http://www.unaids.org/en/resources/campaigns/togetherwewillendaids/index.... Accessed 20 November 2012.
    1. Coffin J (1995) HIV population dynamics in vivo: implications for genetic variation, pathogenesis, and therapy. Science 267(5197): 483. - PubMed
    1. Bennett DE, Bertagnolio S, Sutherland D, Gilks CF (2008) The World Health Organization’s global strategy for prevention and assessment of HIV drug resistance. Antivir Ther 13(2): 1. - PubMed
    1. Bennett DE, Jordan MR, Bertagnolio S, Hong SY, Ravasi G, et al. (2012) HIV drug resistance early warning indicators in cohorts of individuals starting antiretroviral therapy between 2004 and 2009: World Health Organization global report from 50 countries. Clin Infect Dis 54 Suppl 4S280–9. - PMC - PubMed
    1. Jordan MR (2011) Assessments of HIV drug resistance mutations in resource-limited settings. Clin Infect Dis 52(8): 1058–60. - PubMed

Publication types

Substances