Institute of Tropical Medicine Antwerp
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Operational assessment of access to ART in rural Africa: the example of Kisantu in Democratic Republic of the Congo

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Show simple item record Van Rompaey, S. Kimfuta, J. Kimbondo, P. Monn, C. Buvé, A. 2011-06-01T13:28:10Z 2011-06-01T13:28:10Z 2011
dc.identifier.issn 0954-0121
dc.identifier.other ITG-MLA
dc.identifier.other MICRO
dc.identifier.other U-HIVSTD
dc.identifier.other DOI
dc.identifier.other Abstract
dc.identifier.other UPD34
dc.description.abstract Despite the availability of large funds and considerable efforts to improve access to antiretroviral therapy (ART), coverage of treatment with ART remains low in Democratic Republic of the Congo (DRC). We identified the bottlenecks for adults' access to ART in a semi-rural health zone in DRC, compared ART coverage in the urban and rural area and described the outcomes and yield of different HIV testing settings. An operational model was used to examine bottlenecks in the flow of patients. The study period covered the start of the HIV care programme in April 2006, until December 2008. An estimated 505 People Living With HIV/AIDS (PLWHA), of whom 201 were in need of ART, lived in the health zone. The proportion of PLWHA in need of ART who were actually receiving ART was estimated at 53%. About 6451 adults were tested for HIV, 266 of them were HIV-positive and 163 accessed the HIV care programme. About 106 of the 126-159 eligible patients initiated ART. The main bottleneck was situated at HIV detection. Access to the HIV care programme for the patients testing HIV-positive was identified as the second biggest bottleneck. About 41% of the PLWHA identified in urban areas accessed the HIV care programme, versus 11% of the rural PLWHA, showing a serious inequity. The tuberculosis (TB) programme detected 75% of the total estimated 92 co-infected patients of the health zone. Only 13% of women testing positive in the Prevention of Mother-To-Child Transmission programme accessed the HIV care programme, showing that this bottleneck is greatly accentuated in this specific group. By testing all pregnant women and all TB patients in the health zone, 28% of all PLWHA could potentially be detected in a period of 33 months, showing its great potential in settings with a relatively low HIV prevalence. en
dc.language English en
dc.subject Viral diseases en
dc.subject HIV en
dc.subject AIDS en
dc.subject HAART en
dc.subject Antiretrovirals en
dc.subject Accessibility en
dc.subject Operational research en
dc.subject Assessment en
dc.subject Coverage en
dc.subject Adults en
dc.subject Barriers en
dc.subject Health care en
dc.subject Detection en
dc.subject Co-infections en
dc.subject Tuberculosis en
dc.subject Mycobacterium tuberculosis en
dc.subject Gender en
dc.subject Urban en
dc.subject Rural en
dc.subject Congo-Kinshasa en
dc.subject Africa, Central en
dc.title Operational assessment of access to ART in rural Africa: the example of Kisantu in Democratic Republic of the Congo en
dc.type Article en
dc.citation.issue 6 en
dc.citation.jtitle AIDS Care en
dc.citation.volume 23 en
dc.citation.pages 686-693 en
dc.citation.jabbreviation AIDS Care en

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