Scale-up of Kenya’s national HIV viral load program: Findings and lessons learned

• DOI: 10.1371/journal.pone.0190659
• Publication Date: 2018-01-11T19:27:46Z
• Authors: Matilu Mwau; Catherine Akinyi ...; Maureen Adhiambo; Priska Bwana; Lucy Kithinji; Joy Mwende; Laura Oyiengo; Martin Sirengo; Caroline E. Boeke
• Keywords: Turnaround time

Objectives Kenya is one of the first African countries to scale up a national HIV viral load monitoring program. We sought assess program using database and identify areas for systems strengthening. Methods Data from January 2012 March 2016 were extracted Kenya's database. Characteristics 1,108,356 tests assessed over time, including reason testing, turnaround times, test results, treatment regimens, socio-demographic information. Results The number facilities offering testing increased ~2,000 with >40,000 being conducted per month by 2016. By 2016, most (84.2%) routine purposes time facility-level sample collection result dispatch lab was 21(24) [median (IQR)] days. Although proportions repeat volumes lower than expected. Elevated much more common in pediatric adolescent patients (0-<3 years: 43.1%, 3-<10 34.5%, 10-<20 36.6%) adults (30-<60 13.3%; p<0.001). Conclusions Coverage dramatically >50% on antiretroviral therapy (ART) early represents relatively efficient laboratory system. However, strengthening patient tracking mechanisms utilization may be necessary further improve Additional focus needed paediatric/adolescent suppression these groups. has demonstrated its usefulness assessing programs, trends characteristics, scale-up new policies identifying problem investigation.