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  "name": "malawi-art-htc-program-report-2009-q4",
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  "name": "malawi-art-htc-program-report-2009-q4",
            
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  "notes": "By the end of December 2009, __198,846__ patients were 
            
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alive and on ART at __377__ ART clinics in Malawi (__279__ static 
            
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clinics and __98__ outreach / mobile clinics).\r\n\r\nOut of the 
            
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__271,105__ patients ever initiated on ART, __198,846__ (73%) were 
            
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retained alive on ART, __32,008__ (10%) had died, __39,115__ (13%) 
            
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were lost to follow-up (defaulted) and __1,136__ (<1%) were known to 
            
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have stopped ART. __79%__ of adults and __79%__ of children were 
            
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retained alive on ART 12 months after ART initiation. An estimated 
            
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__181,482__ adults and __17,364__ children (<15 years) were alive on 
            
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ART by the end of December 2009.\r\n\r\nIn the fourth quarter of 2009 
            
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(October to December) a total of __17,702__ new patients initiated 
            
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ART. The opening of 55 new ART clinics in the last 6 months resulted 
            
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in an unprecedented number of ART clinic transfers: __6,623__ ART 
            
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patients transferred between clinics (27% of the total __24,325__ new 
            
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ART clinic registrations). Among new registrations 39% were male, 61% 
            
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female; 91% were adults and 9% children.\r\n\r\nThe number of infants 
            
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starting ART in the fourth quarter of 2009 in WHO stage 1 or 2 with 
            
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confirmed HIV infection (DNA-PCR) increased from __142 to 163__, while 
            
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children under 18 months starting due to presumed severe HIV disease 
            
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increased from __97 to 127__.\r\n\r\nImproved integration of the 
            
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supervision system for the public and private sector has led to a 
            
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revision of data shown in previous monitoring reports: Patient 
            
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retention in the private sector now appears slightly lower than in 
            
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public sector clinics.\r\n\r\nThe programme has been affected by a 
            
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critical ARV drug supply shortage during Q3/Q4 due to the delayed 
            
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release of funding and the ensuing logistical complications resulting 
            
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in widespread drug re-distributions between sites. However a targeted 
            
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survey revealed that patients were affected only in isolated cases, 
            
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requiring regimen changes or short term treatment interruptions in 
            
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patients on alternative first line ARVs.\r\n\r\nIn November 2009, WHO 
            
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issued a Rapid Advice on revised guidelines for provision of ART for 
            
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adolescents and adults and for PMTCT in resource-constrained 
            
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countries. In January 2010, the Department for HIV and AIDS, in 
            
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collaboration with national stakeholders, launched the technical 
            
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review and planning process to incorporate these new guidelines into 
            
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the national programme. Revised national guidelines and new ARV drug 
            
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regimens are expected to be implemented in the first half of 2011.",
            
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sexually transmitted infections (STIs), prevention of mother to child 
            
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transmission of HIV (PMTCT), and national voluntary male medical 
            
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circumcision program (VMMC). All these HIV program sub-sections are 
            
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linked to one robust monitoring and evaluation sub-section in the HIV 
            
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and AIDS Department which technically operates under the Central 
            
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Monitoring and Evaluation Department (CMED) of the Ministry of 
            
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