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The presence of CD4 counts for the management of HIV patients in East Africa

A multicentred study

Bibliographic Data

ID19442246
AuthorsR Harding (0000-0001-9653-8689, Cicely Saunders International, corresponding author), Victoria Simms (0000-0001-5664-6810, King's College London), Suzanne Penfold (0000-0003-1561-3531, London School of Hygiene & Tropical Medicine), Julia Downing (0000-0002-3450-785X, African Palliative Care Association), Richard A Powell (0000-0003-4968-3714, HealthCare Chaplaincy Network), Faith Mwangi-Powell (Open Society Foundations), Eve Namisango (0000-0001-5032-4714, African Palliative Care Association), Scott Moreland (0000-0002-5647-7786, University of North Carolina at Chapel Hill), Nancy Gikaara (African Palliative Care Association), Mackuline Atieno (African Palliative Care Association), Jeniffer Kataike (African Palliative Care Association), Clare Nsubuga (African Palliative Care Association), Grace Munene (African Palliative Care Association), Geoffrey Banga (African Palliative Care Association), Irene J Higginson (0000-0002-3687-1313, King's College London)
Year2014
Volume26
Issue5
Pages613-618
Publication date2014-05-04
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2013.844765
PMID24099416
OpenAlexW2007100589
LanguageEN
References cited18

New WHO guidance stipulates six-monthly CD4 testing and treatment initiation at CD4 less than 350. This study aimed to determine the presence of CD4 results in patient records across five care facilities in Kenya, and to identify factors associated with the presence of CD4 count. This is a cross-sectional study of consecutive outpatients. Participants completed self-reported outcomes of demographics, and both physical and mental health dimensions of quality of life and function; charts were reviewed for a CD4 count in the previous 13 months; 548 patients participated. For those diagnosed during the 13-month study period, 7.1% of the sample had no CD4 result on record. For those diagnosed prior to the study, 8.7% had no result. Multivariate logistic regression revealed that 30 days post-HIV diagnosis, facility and antiretroviral therapy use were associated with the odds of having a CD4 result on file. At six months, poverty and prevalence of multidimensional problems were associated with lack of CD4 result. For those diagnosed prior to the observation period, education level was associated with more infrequent CD4 counts, and facility and number of dependants were associated with odds of a CD4 result within six months. Our data suggest inconsistencies in CD4 results availability within and between facilities. Implementation of new guidance will require a shift in practice

Antiretroviral therapy · Antiretroviral treatment · Cross-sectional study · Family medicine · Logistic regression · Odds · Odds ratio · Pathology · Poverty · Viral load · Demography · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Pneumocystis jirovecii pneumonia detection and treatment · Internal Medicine

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Citation velocityhistorical
Highly citedNo

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