Early warning indicators for HIV drug resistance in Malawi.
BACKGROUND
Malawi started rapid scale-up of antiretroviral therapy (ART) in 2004 and by December 2006 had initiated over 85,000 patients on treatment. Early warning indicator (EWI) reports can help to minimize the risk of emerging drug resistance.


METHODS
Data collected during the routine quarterly supervision of 103 public sector sites was used to compile the first EWI report for HIV drug resistance (HIVDR) in Malawi, reflecting outcomes for October to December 2006.


RESULTS
All sites reach the World Health Organization (WHO) targets for prescribing practices and drug supply continuity. The target for adherence was achieved by 85% of sites and 84% achieved the target for minimizing treatment defaults; however, less than half of all sites reach the WHO target for patient retention.


CONCLUSIONS
These results emphasize the importance of defaulter tracing and initiating treatment earlier in the course of HIV infection. As part of a comprehensive HIVDR monitoring programme, the Ministry of Health plans for on-going tracking of these indicators, as well as special data collection from the private sector. Plans are also underway to gather information on other recommended indicators that are not collected during routine supervision.
Centers for Disease Control/Global AIDS Program Malawi, Lilongwe 3, Malawi. bhedt@hsph.harvard.edu
Bethany L
BL
Hedt
Nellie
N
Wadonda-Kabondo
Simon
S
Makombe
Anthony D
AD
Harries
Erik J
EJ
Schouten
Eddie
E
Limbambala
Mindy
M
Hochgesang
John
J
Aberle-Grosse
Kelita
K
Kamoto
D044966:Anti-Retroviral Agents / Q000600:supply & distribution / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D009313:National Health Programs / Q000706:statistics & numerical data; D010349:Patient Compliance; D010352:Patient Dropouts; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'; D015397:Program Evaluation; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome; D014944:World Health Organization
D044966:Anti-Retroviral Agents