title: Database-supported teleconferencing: an additional clinical mentoring tool to assist a multinational company HIV/AIDS treatment program in Africa.
abstract: BACKGROUND
  The lack of human resources for health is presently recognized as a major factor limiting scale-up of antiretroviral treatment (ART) programs in resourcelimited settings. The mobilization of public and private partners, the decentralization of care, and the training of non-HIV specialist nurses and general practitioners could help increase the number of HIV-infected patients receiving ART. In addition to other forms of training, scheduled teleconferences (TCs) have been organized to support a comprehensive HIV treatment program delivered by a private company's health team.
  
  
  OBJECTIVE
  To describe the role of the TC as an additional tool in mentoring a company's health care workers (HCWs).
  
  
  METHODS
  For this study, all TC reports were retrospectively reviewed and the questions classified by topic. Participating Heineken physicians evaluated the technical quality and scientific relevance of the TCs through an anonymous survey.
  
  
  RESULTS
  From October 2001 to December 2003, 10 HCWs working in 14 operating companies in 5 African countries raised 268 problems during 45 TCs. A total of 79 questions (29%) were asked about antiretroviral (ARV) therapy, 53 (20%) about the diagnosis and treatment of opportunistic infection, 43 (16%) about ARV toxicity, 40 (15%) about care organization and policy, 32 (12%) about laboratory or drug supply, and 21 (8%) about biological parameters. The mean TC attendance rate was 70%. The level of satisfaction among local company physicians was 65% for logistics, 89% for scientific relevance, 84% for applicability of advice, and 85% overall. The most common complaints concerned the poor quality of the telephone connection and language problems for francophone participants.
  
  
  CONCLUSIONS
  Database-supported teleconferencing could be an additional tool to mentor company HCWs in their routine care of HIV-infected workers and family members. The role and costeffectiveness of telemedicine in improving health outcomes should be further studied.
authors.affiliation: PharmAccess Foundation, Amsterdam, The Netherlands. clevenberghph@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Clevenbergh
authors.forename: S F M
authors.initials: SF
authors.lastname: Van der Borght
authors.forename: K
authors.initials: K
authors.lastname: van Cranenburgh
authors.forename: V
authors.initials: V
authors.lastname: Janssens
authors.forename: C
authors.initials: C
authors.lastname: Kitenge Lubangi
authors.forename: L
authors.initials: L
authors.lastname: Gahimbaza
authors.forename: J M A
authors.initials: JM
authors.lastname: Lange
authors.forename: T F
authors.initials: TF
authors.lastname: Rinke de Wit
authors.forename: H
authors.initials: H
authors.lastname: Rijckborst
mesh_terms: D000349:Africa; D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D019992:Databases as Topic / Q000706:statistics & numerical data*; D006678:HIV; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D019538:Health Care Surveys; D006269:Health Facilities, Proprietary / Q000592:standards / Q000706:statistics & numerical data*; D006282:Health Personnel / Q000193:education; D006801:Humans; D015397:Program Evaluation / Q000592:standards / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013685:Telecommunications / Q000706:statistics & numerical data*
chemical_list: D044966:Anti-Retroviral Agents