ICAP-supported HIV care and treatment services in Tanzania
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![Page 1: ICAP-supported HIV care and treatment services in Tanzania](https://reader035.fdocuments.us/reader035/viewer/2022081603/568137a0550346895d9f46a3/html5/thumbnails/1.jpg)
ICAP-supported HIV care and treatment services in Tanzania
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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
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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.
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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*
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Program and Facility Characteristics Tracking System
(P-FaCTS)
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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
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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
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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
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PMTCT Services
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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
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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