By the end of December 2008, there were 221 health facilities in Malawi in the public and private health sector delivering ART to HIV-positive eligible patients.
In the fourth quarter of 2008 (October to December) a total of 19,092 patients registered at ART sites in Malawi (39% male, 61% female; 91% adults and 9% children). Of those, 54% started in WHO stage 3, 11% in stage 4 and 33% based on a low CD4 count in Stage 1 or Stage 2. In the quarter a total of 30 infants started ART because of confirmed HIV infection (DNA-PCR) and 30 children under 18 months started because of presumed severe HIV disease.
By the end of December 2008, there were 223,437 patients ever registered for ART (39% male, 61% female; 92% adult, 8% children) of which 27,843 had started on ART due to TB. The 223,437 patients who had ever registered on ART include 27,069 patients who transferred-out to other ART sites, and it is understood that these patients will be counted twice in the total patients ever registered. If we deduct the number of people transferred-out the number of
people ever started on ART is 196,368.
Cumulative outcomes of all patients ever registered by end of December 2008 were: 66% alive and on ART at the site of registration, 11% dead, 11% lost to follow-up, 12% transferred out to another facility and <1% stopped treatment.
Of the 147,479 patients alive and on ART: 94% were on the first line regimen, 5% were on an alternative first line regimen, less than 1% were on second line regimen and 1% were on a nonstandard ART regimen. Non-standard regimens are not necessarily substandard regimens; they include patients continuing an ART regimen that was started outside Malawi, patients in research programmes and patients in specialist care in whom specific circumstances lead to the choice of a non-standard regimen.
By the end of December 2008 there were 28 sites with 1,001-2,000 patients alive and on treatment; 10 sites with 2,001-5,000 and 5 with over 5,000 patients alive and on treatment.