Post on 04-Jan-2016
description
ICAP-supported HIV care and treatment services in Tanzania
35
29 2926 26
0
5
10
15
20
25
30
35
40
Total number offacilities
Testing &counseling
PMTCT Care & treatment TB screeningamong HIV pts
Type of activity
Nu
mb
er o
f fa
cili
ties
Source: ICAP Tanzania Site Census, August 2007
Number of ICAP-supported facilities by USG-funded activity, Tanzania
1,583 1,701
3,723
5,456
8,299
10,134
12,048
17,996
21,925
24,716
1,0192,102
5,0626,210
8,443
10,15311,091
4181,613
13,059
11,635
3,2334,422
5,7506,823
945948
9,704
2440
5000
10000
15000
20000
25000
30000
Jul-Sep2004
Oct-Dec2004
Jan-Mar2005
Apr-Jun2005
Jul-Sep2005
Oct-Dec2005
Jan-Mar2006
Apr-Jun2006
Jul-Sep2006
Oct-Dec2006
Jan-Mar2007
Apr-Jun2007
Nu
mb
er o
f p
atie
nts
HIV care (pre-ART and ART)
ART care
Cumulative and current enrollment in HIV care (pre-ART and ART) & ART care at ICAP-supported facilities, July 2004 - June 2007
ART patients retained*
Source: ICAP URS, July 2007*Includes ART patients who are not known to have died, transferred or lost to follow-up.
HIV care (pre-ART and ART)
ART care
Cumulative pediatric enrollment in ART care at ICAP-supported facilities, January 2006 - June 2007
ART patients retained*
Source: ICAP URS, July 2007*Includes ART patients who are not known to have died, transferred or lost to follow-up.
210 237
375
565
749
934
1,089
1,687
1,994
2,205
119216
468547
746858
946
51
208
1,071
945
294401
523591
9895
813
190
500
1000
1500
2000
2500
Jul-Sep2004
Oct-Dec2004
Jan-Mar2005
Apr-Jun2005
Jul-Sep2005
Oct-Dec2005
Jan-Mar2006
Apr-Jun2006
Jul-Sep2006
Oct-Dec2006
Jan-Mar2007
Apr-Jun2007
Nu
mb
er o
f p
atie
nts
Number of ICAP-supported care and treatment facilities reporting, July 2004 – June 2007
22
24
11
6
11 12 12
17
5
11
0
5
10
15
20
25
Jul-Sep2004
Oct-Dec2004
Jan-Mar2005
Apr-Jun2005
Jul-Sep2005
Oct-Dec2005
Jan-Mar2006
Apr-Jun2006
Jul-Sep2006
Oct-Dec2006
Jan-Mar2007
Apr-Jun2007
Nu
mb
er
of
facil
itie
s
Source: ICAP URS, July 2007
1
3
15
5
00
5
10
15
0% 1-5% 6-10% 11-99% 100%
Percentage of pediatric patients among all HIV care patients
Nu
mb
er
of
facil
itie
sPediatric (<15) enrollment in HIV care (% of total patients) at
ICAP-supported facilities as of June 2007 (n=24)
Source: ICAP URS, July 2007
Actual versus targeted HIV care enrollment to February 2008 at ICAP-supported care and treatment facilities as of June 2007
15,095
7,620
13,059
24,716
0
10,000
20,000
30,000
HIV care ART
Nu
mb
er o
f p
atie
nts
Target enrollment Actual enrollment
Source: ICAP Tanzania Site Census, August 2007
28% 32%
62% 61%60%
30%
10% 8% 9%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Pre-ART ART All patients
Num
ber
of p
atie
nts
Women 15+ Men 15+ Children <15
Cumulative enrollment in pre-ART and ART care by age and sex at ICAP-supported facilities as of June 2007
(Total in care = 24,716)
n=24,716 n=13,059 n=11,657
Source: ICAP URS, July 2007
30%
23%
17% 14%10%
26%
53%
68%60%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Pre-ART ART All patients
Num
ber
of p
atie
nts
Ages 0-1 Ages 2-4 Ages 5-14
Cumulative pediatric (<15) enrollment in pre-ART and ART care by age at ICAP-supported facilities as of June 2007
(Total in care = 2,205) n=2,205 n=1,071 n=1,134
Source: ICAP URS, July 2007
Adults 15+ (%)n=6,170
Children <15 (15)n=453
1st line regimen
d4T-3TC-NVP4396
(71 %)117
(26%)
d4T-3TC-EFV541
(5%)14
(3%)
ZDV-3TC-NVP722
(12%)283
(62%)
ZDV-3TC-EFV 506(8%)39
(3%)
2nd line regimen5
(<1%)0
(0%)
Unknown0
(0%)0
(0%)
ART regimens for patients currently enrolled at ICAP-supported facilities by age, April-June 2007
Source: ICAP Tanzania URS, July 2007
Percentage of patients with CD4 counts at baseline, 6 and 12 months after ART initiation over time at ICAP-supported facilities
to June 2007*
58%
48% 49%
30%
17%
6% 7%
17%
52%49%
15%18%
0%
20%
40%
60%
80%
100%
July-Sep 2006 Oct-Dec 2006 Jan- March 2007 Apr-Jun 2007
Baseline 6 months 12 months
Number of patients
at baseline
n=n/a n=495 n=601 n=544
Source: ICAP URS, July 2007*CD4 data are for a subset of patients initiating ART
Average median CD4 count (cells/µL) after 6 and12 months of ART over time at ICAP-supported sites to June 2007*
98
136113
174176
246
191
267
130
308
277
394
0
50
100
150
200
250
300
350
400
450
July-Sep 2006 Oct-Dec 2006 Jan-March 2007 Apr-Jun 2007
Med
ian
CD
4 ce
ll co
un
t ch
ang
e at
6 a
nd
12
mo
nth
s (c
ells
/µl)
Baseline 6 months 12 months
Number of patients
at baseline
n=n/a n=495 n=601 n=544
Source: ICAP URS, July 2007*CD4 data are for a subset of patients initiating ART
Continued ART 11,091
76%
Discontinued 1,96824%
LTF 55%
Dead 37%
Stopped ART 7%
111 per 1,000 person-years
115 per 1,000 person-years
19 per 1,000 person-years
Source: ICAP URS, July 2007
*Does not include patients who transferred out
Proportion discontinuing ART at ICAP-supported facilities as of June 2007*
Program and Facility Characteristics Tracking System
(P-FaCTS)
On-site services at ICAP-supported care and treatment facilities*, Tanzania (n=17 of 26)
0
5
10
15
PMTCT VCT TB Labor anddelivery
ARTpharmacy
On
-sit
e p
rog
ram
av
ail
ab
ilit
y
5 services 94%
n=16/17 1 service 6%n=16/17n=16/17 n=16/17 n=17/17
2 service <1%
3 services <1%4 services <1%
Source ICAP Tanzania P-FaCTS, January 2007
*Includes data from 17 of 26 facilities (65%) for which a P-FaCTS assessment has been completed
Patient support services at ICAP-supported care and treatment facilities*, Tanzania (n=17 of 26)
0
5
10
15
Adherencesupport
Foodsupport for
adults
Foodsupport for
infants
Peereducatorprogram
Outreach
On
-sit
e p
rog
ram
av
ail
ab
ilit
y
2 services 35%
n=17/17 n=1/17
1 service 65%
n=5/17 n=0/17n=0/175 services <1%
3 services <1%4 services <1%
Source ICAP Tanzania P-FaCTS, January 2007
*Includes data from 17 of 26 facilities (65%) for which a P-FaCTS assessment has been completed
Median number of staff per 1000 patients on ART at ICAP-supported care and treatment facilities in Tanzania by cadre* (n=17 of 26)
0.0
1.2
7.5
0.00
2
4
6
8
Med
ian
nu
mb
er o
f p
rovi
der
s p
er 1
000
pat
ien
ts o
n A
RT
Source ICAP Tanzania P-FaCTS, January 2007
*Includes data from 17 of 26 facilities (65%) for which a P-FaCTS assessment has been completed
PMTCT Services
HIV-infected pregnant women receiving ART prophylaxis* in ANC at ICAP-supported PMTCT facilities,
April-June 2007
23% 22%
0%
24%
1%
77%
53%
0%
20%
40%
60%
80%
100%
Tanzania Total
Wo
men
rec
eivi
ng
AR
V p
rop
hyl
axis
sd-NVP AZT + sd-NVP HAART no prophylaxis
*Maternal ART prophylaxis includes: sd-NVP, AZT/sd-NVP, AZT/sd-NVP + 3TC/AZT tail, and HAART at 34 weeks
Women and infants receiving ART prophylaxis* in maternity at ICAP-supported PMTCT facilities,
April-June 2007
126
1,447
83
1,146
64
1,064
0
500
1,000
1,500
Tanzania Total
Nu
mb
er o
f p
atie
nts
HIV+ women (known/tested in maternity) Women receiving ART prophylaxis Infants receiving prophylaxis
*Maternal ART prophylaxis includes: sd-NVP, AZT/sd-NVP, AZT/sd-NVP + 3TC/AZT tail, and HAART at 34 weeks