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On July 24, 2022 at 3:32:46 PM UTC, Chimwemwe Mkandawire:
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t | 13 | "metadata_modified": "2022-07-24T15:04:35.360300", | t | 23 | "metadata_modified": "2022-07-24T15:32:46.480319", |
14 | "name": "malawi-integrated-hiv-program-report-2020-q2", | 24 | "name": "malawi-integrated-hiv-program-report-2020-q2", | ||
15 | "notes": "__COVID-19 Disruptions to the HIV Program__\r\n\r\nThe | 25 | "notes": "__COVID-19 Disruptions to the HIV Program__\r\n\r\nThe | ||
16 | first cases of COVID-19 in Malawi were confirmed on 2nd April 2020, | 26 | first cases of COVID-19 in Malawi were confirmed on 2nd April 2020, | ||
17 | one week before the scheduled start of integrated HIV program | 27 | one week before the scheduled start of integrated HIV program | ||
18 | supervision for Q1 2020. Early epidemiological models predicted rapid | 28 | supervision for Q1 2020. Early epidemiological models predicted rapid | ||
19 | spread and severe impact of COVID-19 in Malawi. Fragile health | 29 | spread and severe impact of COVID-19 in Malawi. Fragile health | ||
20 | services were not well prepared to prevent infections and deal with | 30 | services were not well prepared to prevent infections and deal with | ||
21 | cases. \r\n\r\nThe DHA therefore decided to suspend the established | 31 | cases. \r\n\r\nThe DHA therefore decided to suspend the established | ||
22 | quarterly supportive supervision activity in April 2020 in\r\norder | 32 | quarterly supportive supervision activity in April 2020 in\r\norder | ||
23 | not to contribute to transmission at visited health facilities and to | 33 | not to contribute to transmission at visited health facilities and to | ||
24 | protect staff. The following report is based on data collected during | 34 | protect staff. The following report is based on data collected during | ||
25 | the following supervision round in July 2020, which combined the Q1 | 35 | the following supervision round in July 2020, which combined the Q1 | ||
26 | and Q2 reporting periods. This combined quarterly supervision round | 36 | and Q2 reporting periods. This combined quarterly supervision round | ||
27 | was extended by one week (13-31 July) to cope with the added workload | 37 | was extended by one week (13-31 July) to cope with the added workload | ||
28 | and the service disruptions. However, considerable challenges have | 38 | and the service disruptions. However, considerable challenges have | ||
29 | affected the usual completeness and\r\nquality of service data. | 39 | affected the usual completeness and\r\nquality of service data. | ||
30 | \r\n\r\nThe DHA issued 3 editions of a circular to all HIV service | 40 | \r\n\r\nThe DHA issued 3 editions of a circular to all HIV service | ||
31 | delivery sites (on 3rd, 17th April and 15th June) with specific | 41 | delivery sites (on 3rd, 17th April and 15th June) with specific | ||
32 | infection prevention guidance for COVID-19, and policy recommendations | 42 | infection prevention guidance for COVID-19, and policy recommendations | ||
33 | aimed at decongesting facilities, and reducing travel and contact | 43 | aimed at decongesting facilities, and reducing travel and contact | ||
34 | exposure for patients and health workers. This included a temporary | 44 | exposure for patients and health workers. This included a temporary | ||
35 | suspension of non-essential services: routine scheduled viral load | 45 | suspension of non-essential services: routine scheduled viral load | ||
36 | monitoring for stable adult patients; VMMC; active index partner | 46 | monitoring for stable adult patients; VMMC; active index partner | ||
37 | tracing; new initiation of IPT and PrEP; Teen clubs and other ART | 47 | tracing; new initiation of IPT and PrEP; Teen clubs and other ART | ||
38 | support groups involving social gatherings. The DHA also recommended | 48 | support groups involving social gatherings. The DHA also recommended | ||
39 | an enhanced implementation of 6-month ARV dispensing for almost all | 49 | an enhanced implementation of 6-month ARV dispensing for almost all | ||
40 | patient groups. As the COVID-19 impact remained much lower than | 50 | patient groups. As the COVID-19 impact remained much lower than | ||
41 | initially feared, the suspended services were successively | 51 | initially feared, the suspended services were successively | ||
42 | reintroduced.\r\n\r\nThere was a noticeable reduction in some HIV | 52 | reintroduced.\r\n\r\nThere was a noticeable reduction in some HIV | ||
43 | service outputs in Q2 compared with Q1 2020:\r\n* Total HTS outputs | 53 | service outputs in Q2 compared with Q1 2020:\r\n* Total HTS outputs | ||
44 | declined by 35%\r\n* New ART initiations declined by 32%\r\n* The | 54 | declined by 35%\r\n* New ART initiations declined by 32%\r\n* The | ||
45 | number of blood units collected reduced by 23%\r\n* The number of | 55 | number of blood units collected reduced by 23%\r\n* The number of | ||
46 | routine viral load samples collected reduced by 5%\r\nHowever, program | 56 | routine viral load samples collected reduced by 5%\r\nHowever, program | ||
47 | reports showed no indication for increased ART program attrition or | 57 | reports showed no indication for increased ART program attrition or | ||
48 | lower adherence compared with previous quarters.\r\n\r\n__Scale-up of | 58 | lower adherence compared with previous quarters.\r\n\r\n__Scale-up of | ||
49 | integrated Program performance highlights by the end of June | 59 | integrated Program performance highlights by the end of June | ||
50 | 2020__\r\n\r\n* HIV services had reached the following number of | 60 | 2020__\r\n\r\n* HIV services had reached the following number of | ||
51 | sites:\r\n * __765__ static and __68__ outreach HIV testing | 61 | sites:\r\n * __765__ static and __68__ outreach HIV testing | ||
52 | sites.\r\n * __755__ (static) ART sites; __590__ of these started | 62 | sites.\r\n * __755__ (static) ART sites; __590__ of these started | ||
53 | at least one pregnant or breastfeeding woman.\r\n * __691__ sites | 63 | at least one pregnant or breastfeeding woman.\r\n * __691__ sites | ||
54 | with HIV-exposed children in follow-up.\r\n* __634,564__ persons were | 64 | with HIV-exposed children in follow-up.\r\n* __634,564__ persons were | ||
55 | tested for HIV and received their results; 107,507 __(17%)__ accessed | 65 | tested for HIV and received their results; 107,507 __(17%)__ accessed | ||
56 | HIV testing for the first time; __527,057 (80%)__ were repeat testers | 66 | HIV testing for the first time; __527,057 (80%)__ were repeat testers | ||
57 | and __21,049 (4%)__ of these received confirmatory testing (after | 67 | and __21,049 (4%)__ of these received confirmatory testing (after | ||
58 | having tested positive in the past). __18,882 (3.1%)__ clients | 68 | having tested positive in the past). __18,882 (3.1%)__ clients | ||
59 | received a positive result for the first time1.\r\n* A total of | 69 | received a positive result for the first time1.\r\n* A total of | ||
60 | __63,600__ people received __105,211__ self-test kits for either | 70 | __63,600__ people received __105,211__ self-test kits for either | ||
61 | primary or secondary use.\r\n* __16,049 (94%)__ of 17,095 blood units | 71 | primary or secondary use.\r\n* __16,049 (94%)__ of 17,095 blood units | ||
62 | collected were screened for (at least) HIV, hepatitis B and | 72 | collected were screened for (at least) HIV, hepatitis B and | ||
63 | syphilis.\r\n* __162,127 (99%)__ of 164,354 women at ANC had their HIV | 73 | syphilis.\r\n* __162,127 (99%)__ of 164,354 women at ANC had their HIV | ||
64 | status ascertained; __10,695 (7%)__ of these were HIV positive. | 74 | status ascertained; __10,695 (7%)__ of these were HIV positive. | ||
65 | __138,394 (95%)__ of 145,981 at maternity had their HIV status | 75 | __138,394 (95%)__ of 145,981 at maternity had their HIV status | ||
66 | ascertained __10,075 (7%)__ of these were HIV positive.\r\n* | 76 | ascertained __10,075 (7%)__ of these were HIV positive.\r\n* | ||
67 | __18,804__ patients started ART this quarter; __88%__ were classified | 77 | __18,804__ patients started ART this quarter; __88%__ were classified | ||
68 | as asymptomatic / in WHO stage 1 and started under the \u201cTest & | 78 | as asymptomatic / in WHO stage 1 and started under the \u201cTest & | ||
69 | Treat\u201d policy.\r\n* __846,164__ patients were alive and on ART by | 79 | Treat\u201d policy.\r\n* __846,164__ patients were alive and on ART by | ||
70 | end of June 2020.2 This means that __79%__ of the estimated 1,072,534 | 80 | end of June 2020.2 This means that __79%__ of the estimated 1,072,534 | ||
71 | HIV positive population was on ART. 3 ART coverage was __75%__ | 81 | HIV positive population was on ART. 3 ART coverage was __75%__ | ||
72 | (44,355/ 58,752) for children4 and __79%__ (801,909 / ,013,782) for | 82 | (44,355/ 58,752) for children4 and __79%__ (801,909 / ,013,782) for | ||
73 | adults.\r\n* __76,921 (94%)__ of viral load results from routine | 83 | adults.\r\n* __76,921 (94%)__ of viral load results from routine | ||
74 | monitoring were <1000 copies/ml. Viral suppression rates for routine | 84 | monitoring were <1000 copies/ml. Viral suppression rates for routine | ||
75 | samples among children (0-14 years) and adults (15+ years) were | 85 | samples among children (0-14 years) and adults (15+ years) were | ||
76 | __71%__ and __95%__, respectively.\r\n* __71%__ of adults and __76%__ | 86 | __71%__ and __95%__, respectively.\r\n* __71%__ of adults and __76%__ | ||
77 | of children were retained alive on ART at 12 months | 87 | of children were retained alive on ART at 12 months | ||
78 | after\r\ninitiation.\r\n* Out of __811,825__ patients on first line | 88 | after\r\ninitiation.\r\n* Out of __811,825__ patients on first line | ||
79 | adult ART __34,256 (4%)__ were on TDF/3TC/EFV and __752,779 (94%)__ | 89 | adult ART __34,256 (4%)__ were on TDF/3TC/EFV and __752,779 (94%)__ | ||
80 | had transitioned to TDF/3TC/DTG.\r\n* __11,876 6 (>99%)__ of an | 90 | had transitioned to TDF/3TC/DTG.\r\n* __11,876 6 (>99%)__ of an | ||
81 | estimated 10,3643 HIV infected pregnant women in Malawi were on ART | 91 | estimated 10,3643 HIV infected pregnant women in Malawi were on ART | ||
82 | this quarter. __9,943 (84%)__ of these were already on ART when | 92 | this quarter. __9,943 (84%)__ of these were already on ART when | ||
83 | getting pregnant and __2,293 (24%)__ started ART during | 93 | getting pregnant and __2,293 (24%)__ started ART during | ||
84 | pregnancy/delivery.\r\n* An additional __798__ breastfeeding women | 94 | pregnancy/delivery.\r\n* An additional __798__ breastfeeding women | ||
85 | started ART in WHO stage 1 or 2.\r\n* __76%__ and __70%__ of women | 95 | started ART in WHO stage 1 or 2.\r\n* __76%__ and __70%__ of women | ||
86 | started while pregnant or breastfeeding were retained on ART at __6 | 96 | started while pregnant or breastfeeding were retained on ART at __6 | ||
87 | and 12 months__ after initiation, respectively.\r\n* __9,112 (7%)__ of | 97 | and 12 months__ after initiation, respectively.\r\n* __9,112 (7%)__ of | ||
88 | infants discharged alive from maternity were known to be HIV exposed, | 98 | infants discharged alive from maternity were known to be HIV exposed, | ||
89 | __8,808 (97%)__ of these received ARV prophylaxis (nevirapine). A | 99 | __8,808 (97%)__ of these received ARV prophylaxis (nevirapine). A | ||
90 | total of 12,413 HIV exposed children were newly enrolled for follow-up | 100 | total of 12,413 HIV exposed children were newly enrolled for follow-up | ||
91 | this\r\nquarter; __10,417 (84%)__ of these were enrolled before age 2 | 101 | this\r\nquarter; __10,417 (84%)__ of these were enrolled before age 2 | ||
92 | months.\r\n* Out of the total 1,072,534 estimated PLHIV by end June | 102 | months.\r\n* Out of the total 1,072,534 estimated PLHIV by end June | ||
93 | 2020:\r\n * An estimated __91%__ of PLHIV knew their status | 103 | 2020:\r\n * An estimated __91%__ of PLHIV knew their status | ||
94 | (diagnosed)\r\n", | 104 | (diagnosed)\r\n", | ||
95 | "num_resources": 1, | 105 | "num_resources": 1, | ||
96 | "num_tags": 10, | 106 | "num_tags": 10, | ||
97 | "organization": { | 107 | "organization": { | ||
98 | "approval_status": "approved", | 108 | "approval_status": "approved", | ||
99 | "created": "2021-10-14T11:02:35.234558", | 109 | "created": "2021-10-14T11:02:35.234558", | ||
100 | "description": "The Department of HIV & AIDS (DHA) was established | 110 | "description": "The Department of HIV & AIDS (DHA) was established | ||
101 | in 2001, initially as a unit in the Department of Clinical Services, | 111 | in 2001, initially as a unit in the Department of Clinical Services, | ||
102 | to coordinate the biomedical HIV Program in Malawi. The department now | 112 | to coordinate the biomedical HIV Program in Malawi. The department now | ||
103 | carries responsibility for various HIV related programs including: | 113 | carries responsibility for various HIV related programs including: | ||
104 | sexually transmitted infections (STIs), prevention of mother to child | 114 | sexually transmitted infections (STIs), prevention of mother to child | ||
105 | transmission of HIV (PMTCT), and national voluntary male medical | 115 | transmission of HIV (PMTCT), and national voluntary male medical | ||
106 | circumcision program (VMMC). All these HIV program sub-sections are | 116 | circumcision program (VMMC). All these HIV program sub-sections are | ||
107 | linked to one robust monitoring and evaluation sub-section in the HIV | 117 | linked to one robust monitoring and evaluation sub-section in the HIV | ||
108 | and AIDS Department which technically operates under the Central | 118 | and AIDS Department which technically operates under the Central | ||
109 | Monitoring and Evaluation Department (CMED) of the Ministry of | 119 | Monitoring and Evaluation Department (CMED) of the Ministry of | ||
110 | Health.", | 120 | Health.", | ||
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112 | "image_url": | 122 | "image_url": | ||
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114 | "is_organization": true, | 124 | "is_organization": true, | ||
115 | "name": "dha", | 125 | "name": "dha", | ||
116 | "state": "active", | 126 | "state": "active", | ||
117 | "title": "Department of HIV & AIDS and Viral Hepatitis", | 127 | "title": "Department of HIV & AIDS and Viral Hepatitis", | ||
118 | "type": "organization" | 128 | "type": "organization" | ||
119 | }, | 129 | }, | ||
120 | "owner_org": "ca6a5fbb-31b1-44f8-9319-5da56d75a55b", | 130 | "owner_org": "ca6a5fbb-31b1-44f8-9319-5da56d75a55b", | ||
121 | "private": false, | 131 | "private": false, | ||
122 | "program_area": "Care and Treatment", | 132 | "program_area": "Care and Treatment", | ||
123 | "relationships_as_object": [], | 133 | "relationships_as_object": [], | ||
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152 | ], | 162 | ], | ||
153 | "state": "active", | 163 | "state": "active", | ||
154 | "tags": [ | 164 | "tags": [ | ||
155 | { | 165 | { | ||
156 | "display_name": "ART", | 166 | "display_name": "ART", | ||
157 | "id": "5edd9998-b4ff-40a1-9431-2a7b5b733d4d", | 167 | "id": "5edd9998-b4ff-40a1-9431-2a7b5b733d4d", | ||
158 | "name": "ART", | 168 | "name": "ART", | ||
159 | "state": "active", | 169 | "state": "active", | ||
160 | "vocabulary_id": null | 170 | "vocabulary_id": null | ||
161 | }, | 171 | }, | ||
162 | { | 172 | { | ||
163 | "display_name": "HTC", | 173 | "display_name": "HTC", | ||
164 | "id": "6a53fcf5-e774-4295-b9c3-32da8b896f9b", | 174 | "id": "6a53fcf5-e774-4295-b9c3-32da8b896f9b", | ||
165 | "name": "HTC", | 175 | "name": "HTC", | ||
166 | "state": "active", | 176 | "state": "active", | ||
167 | "vocabulary_id": null | 177 | "vocabulary_id": null | ||
168 | }, | 178 | }, | ||
169 | { | 179 | { | ||
170 | "display_name": "PMTCT-ART", | 180 | "display_name": "PMTCT-ART", | ||
171 | "id": "83bf82ef-383c-46e2-a80c-f3431b3f99e2", | 181 | "id": "83bf82ef-383c-46e2-a80c-f3431b3f99e2", | ||
172 | "name": "PMTCT-ART", | 182 | "name": "PMTCT-ART", | ||
173 | "state": "active", | 183 | "state": "active", | ||
174 | "vocabulary_id": null | 184 | "vocabulary_id": null | ||
175 | }, | 185 | }, | ||
176 | { | 186 | { | ||
177 | "display_name": "STI", | 187 | "display_name": "STI", | ||
178 | "id": "94fb1475-9b2d-40af-b19d-c6463a0dd66d", | 188 | "id": "94fb1475-9b2d-40af-b19d-c6463a0dd66d", | ||
179 | "name": "STI", | 189 | "name": "STI", | ||
180 | "state": "active", | 190 | "state": "active", | ||
181 | "vocabulary_id": null | 191 | "vocabulary_id": null | ||
182 | }, | 192 | }, | ||
183 | { | 193 | { | ||
184 | "display_name": "Viral load", | 194 | "display_name": "Viral load", | ||
185 | "id": "141b4c03-db16-4d5c-9d36-82cc40db0a35", | 195 | "id": "141b4c03-db16-4d5c-9d36-82cc40db0a35", | ||
186 | "name": "Viral load", | 196 | "name": "Viral load", | ||
187 | "state": "active", | 197 | "state": "active", | ||
188 | "vocabulary_id": null | 198 | "vocabulary_id": null | ||
189 | }, | 199 | }, | ||
190 | { | 200 | { | ||
191 | "display_name": "anc", | 201 | "display_name": "anc", | ||
192 | "id": "1e47aae6-8e3d-41e7-9b1a-778af0d2f23a", | 202 | "id": "1e47aae6-8e3d-41e7-9b1a-778af0d2f23a", | ||
193 | "name": "anc", | 203 | "name": "anc", | ||
194 | "state": "active", | 204 | "state": "active", | ||
195 | "vocabulary_id": null | 205 | "vocabulary_id": null | ||
196 | }, | 206 | }, | ||
197 | { | 207 | { | ||
198 | "display_name": "blood safety", | 208 | "display_name": "blood safety", | ||
199 | "id": "24fd7907-18be-4ad1-80ad-ba65da6a9707", | 209 | "id": "24fd7907-18be-4ad1-80ad-ba65da6a9707", | ||
200 | "name": "blood safety", | 210 | "name": "blood safety", | ||
201 | "state": "active", | 211 | "state": "active", | ||
202 | "vocabulary_id": null | 212 | "vocabulary_id": null | ||
203 | }, | 213 | }, | ||
204 | { | 214 | { | ||
205 | "display_name": "hiv", | 215 | "display_name": "hiv", | ||
206 | "id": "43013fde-ebf4-470e-9e5d-1a3aa939d404", | 216 | "id": "43013fde-ebf4-470e-9e5d-1a3aa939d404", | ||
207 | "name": "hiv", | 217 | "name": "hiv", | ||
208 | "state": "active", | 218 | "state": "active", | ||
209 | "vocabulary_id": null | 219 | "vocabulary_id": null | ||
210 | }, | 220 | }, | ||
211 | { | 221 | { | ||
212 | "display_name": "maternity", | 222 | "display_name": "maternity", | ||
213 | "id": "cd2b6dc5-5d1f-4a03-91da-9a279e193ed2", | 223 | "id": "cd2b6dc5-5d1f-4a03-91da-9a279e193ed2", | ||
214 | "name": "maternity", | 224 | "name": "maternity", | ||
215 | "state": "active", | 225 | "state": "active", | ||
216 | "vocabulary_id": null | 226 | "vocabulary_id": null | ||
217 | }, | 227 | }, | ||
218 | { | 228 | { | ||
219 | "display_name": "viral load", | 229 | "display_name": "viral load", | ||
220 | "id": "e385a0a4-1722-431f-a657-f9616a14bf6f", | 230 | "id": "e385a0a4-1722-431f-a657-f9616a14bf6f", | ||
221 | "name": "viral load", | 231 | "name": "viral load", | ||
222 | "state": "active", | 232 | "state": "active", | ||
223 | "vocabulary_id": null | 233 | "vocabulary_id": null | ||
224 | } | 234 | } | ||
225 | ], | 235 | ], | ||
226 | "title": "Malawi Integrated HIV Program Report 2020 Q2", | 236 | "title": "Malawi Integrated HIV Program Report 2020 Q2", | ||
227 | "type": "dataset", | 237 | "type": "dataset", | ||
228 | "url": null, | 238 | "url": null, | ||
229 | "version": null, | 239 | "version": null, | ||
230 | "year": "2020" | 240 | "year": "2020" | ||
231 | } | 241 | } |