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Apegnon Akpene is a 20 year-old mother of three: four year-old Joseph, two year-old Romance and one month-old Akou Jacqueline.

In most countries, tuberculosis (TB) services are decentralized up to the most peripheral health facilities and often into the community. On the other hand, HIV/AIDS services are generally much more centralized because scale-up of services, especially of antiretroviral therapy (ART), started only quite recently.

Changing Malaria Treatment Policy to Artemisinin-Based Combinations: An Implementation Guide This document provides guidance to countries on implementing national policy changes to ACT for first-line malaria treatment consistent with the World Health Organization's (WHO) policy recommendations.

RPM Plus works in several countries globally to help enhance pharmaceutical management systems and improve access to high-quality antimalarial medicines and commodities. Read more about RPM Plus' work in the malaria brochure.

Drawing on evidence from Malawi and Ethiopia, this article analyses the eff ects of ARTscale-up interventions on human resources policies, service delivery and general health outcomes, and explores how synergies can be maximized.

HIV/AIDS is a critical concern in South Africa, where extreme poverty and gender issues are major determinants of health. A comprehensive home-based care programme is needed to lessen the burden placed on the caregivers of those suffering from HIV/AIDS. The purpose of this study was to explore and describe the challenges faced by people who are living with HIV/AIDS and by their caregivers in resource-poor, remote South African villages.

An East African survey showed that among the few health facilities that measured adherence to antiretroviral therapy, practices and definitions varied widely. We evaluated the feasibility of collecting routine data to standardize adherence measurement using a draft set of indicators.

Adoption of the new WHO guidelines would increase the total number of patients on ART in 19 high-patient-load health centers in Addis Ababa and four regions of Ethiopia by about 30%. The shift in the CD4+ threshold for ART initiation will substantially increase the demand for ART in Ethiopia. Since under the current systems only 60% of Ethiopia’s patients in need of ART are receiving the medications, scaling up ART programs to accommodate the increased demand for drugs will not be possible unless government funding and support increase concurrently.

The Ministry of Health and Social Services in Namibia conducted a confirmatory assessment of the risk of anemia associated with zidovudine (AZT)-based highly active antiretroviral therapy (HAART) using records contained in three electronic databases. A total of 12,358 records were examined. We measured the sensitivity of the starting HAART regimen (the proportion of AZT users in the clinical record correctly identified in the electronic record), and specificity of severe anemia (the proportion of non-cases of severe anemia in the clinical records correctly identified in the electronic record). Probabilistic record linkage methods were effective for records linkage in this sub-Saharan African setting.

Of 48 surveyed hospitals and health centers in Ethiopia, 9 (19%), 9 (19%), and 10 (21%) did not have malaria, TB, or HIV drugs, respectively. Similarly, of 27 health posts, 9 (33%) and 6 (22%) did not have rapid diagnostic tests and antimalarial drugs, respectively. The findings indicated an inadequate availability of essential drugs and commodities in the surveyed facilities as well as weaknesses in human resources and training.

Low-income countries with high HIV/AIDS burdens in sub-Saharan Africa must deal with severe shortages of qualified human resources for health. This situation has triggered the renewed interest in community health workers, as they may play an important role in scaling-up antiretroviral treatment for HIV/AIDS by taking over a number of tasks from the professional health workers.

Background: The Ministry of Health in Malawi is implementing a pragmatic and innovative approach for the management of all HIV-infected pregnant women, termed Option B+, which consists of providing life-long antiretroviral treatment, regardless of their CD4 count or clinical stage. Our objective was to determine if Option B+ represents a cost-effective option.

Rationale, aims, and objectives: For a successful patient outcome, a high level of adherence to antiretroviral therapy (ART) is needed. A 2008 report in Tanzania indicated poor clinic attendance and a high lost to follow-up rate as major threats to optimal ART program effectiveness.

In developing countries, particularly in Africa, the provision of health services leans heavily towards today’s epidemics, including HIV and AIDS, malaria, tuberculosis and other infectious diseases. This calls for different approaches to the implementation of interventions from a public health perspective.

Background: Mortality and morbidity among HIV-exposed children are thought to be high in Malawi. We sought to determine mortality and health outcomes of HIV-exposed and unexposed infants within a PMTCT program.

The national scale up of antiretroviral therapy in Malawi is based on a public health approach, with principles and practices borrowed from the successful World Health Organization "DOTS" tuberculosis control framework.

Background: Maternal morbidity and mortality among HIV-infected women is a global concern. This study compared mortality and health outcomes of HIV-infected and HIV-uninfected mothers at 18–20 months postpartum within routine prevention of mother-to-child transmission of HIV (PMTCT) services in a rural district in Malawi.

Background: Mother-to-child transmission of HIV (MTCT) remains the most prevalent source of pediatric HIV infection. Most PMTCT (prevention of mother-to-child transmission of HIV) programs have concentrated monitoring and evaluation efforts on process rather than on outcome indicators. In this paper, we review service data from 28,320 children born to HIV-positive mothers to estimate MTCT rates.

Background: High quality program data is critical for managing, monitoring, and evaluating national HIV treatment programs. By 2009, the Malawi Ministry of Health had initiated more than 270,000 patients on HIV treatment at 377 sites.

Purpose of review: This review focuses on current status, progress, challenges and opportunities in global pharmacovigilance for HIV/AIDS treatment.

Objective: The objective of this review is to produce evidence on the prevalence and trends in the availability of substandard and counterfeit antimicrobials in the global market and its consequences on key public health interventions in developing countries.

In 2004, Malawi began scaling up its national antiretroviral therapy (ART) program. Because of limited treatment options, population-level surveillance of acquired human immunodeficiency virus drug resistance (HIVDR) is critical to ensuring long-term treatment success. The World Health Organization target for clinic-level HIVDR prevention at 12 months after ART initiation is ≥70%.

Treatment as Prevention (TasP) describes HIV prevention methods that use antiretroviral therapy (ART) in both HIV-positive and HIV-negative persons to decrease the risk of HIV transmission.

Positive health, dignity and prevention (PHDP) engages people who know they are living with HIV in prevention. It involves supporting HIV-positive people to learn and practice how to live healthily and minimize the risks of spreading the virus to others.

This technical brief summarizes the latest evidence on PMTCT of HIV in the Southern African region. It presents the current WHO guidance on antiretroviral use in pregnant HIV-positive women: Options A, B and B+. Option B+ is a new development, emerging from experiences in Malawi, which was the focus of much attention at the recent International AIDS Conference.

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