Implementation of a standardized HIV patient monitoring system in Guyana.
OBJECTIVE
To describe the process used to implement a comprehensive, standardized, and reliable national system for data collection for HIV care and treatment in Guyana; to provide examples of the program-level data resulting from implementation; and to highlight the monitoring benefits for national programs.


METHODS
In 2007, Guyana's Ministry of Health and other key stakeholders adapted the World Health Organization's generic HIV care and antiretroviral therapy (ART) patient monitoring guidelines to fit the Guyana context, which included modifying the patient chart, patient registers, and cross-sectional and cohort reports. Following initial training and feedback from clinical staff, a national patient monitoring system (PMS) was finalized, piloted, and implemented at all care and treatment sites. Thereafter, sites received monthly supportive supervisory visits to review data collection and validate reports.


RESULTS
Implementation of the PMS enabled analysis of cohort data for patients on ART. After 12 months, 79% of a combined national cohort of all 50 patients who started ART in June 2007 were alive and on first-line ART regimens. After six years, 58% of the first (April 2002) cohort of ART patients in the country were alive and on ART, with only two (8%) patients on second-line regimens.


CONCLUSIONS
Implementation of a national PMS for standardized data collection and reporting across multiple clinical sites ultimately provided important and reliable information on utilization of services, patient outcomes, and survival rates on treatment. These data are used at the national level to monitor the efficacy of the HIV care and treatment program. Successful implementation requires early inclusion of all committed stakeholders and a dedicated human resource team to ensure sustainability of the system.
Halpern
Mina
M
U.S. Centers for Disease Control and Prevention, Global AIDS Program Guyana, Georgetown, Guyana. mina.halpern@gmail.com
Lachmansingh
Bendita
B
Minior
Thomas
T
Hasbrouck
La Mar
LM
Persaud
Nicholas
N
Foo
Astrid
A
D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003625:Data Collection; D005568:Forms and Records Control; D006172:Guyana / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000628:therapy; D006291:Health Policy; D006292:Health Priorities; D006801:Humans; D008499:Medical Records / Q000592:standards; D009313:National Health Programs / Q000458:organization & administration; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000458:organization & administration*; D010175:Pan American Health Organization; D011159:Population Surveillance / Q000379:methods*; D014944:World Health Organization