WEAE0202 - Oral Abstract Session
A laboratory-based approach to reduce loss to follow-up of HIV-positive clients
Presented by Chioma Onyinye Nwuba (Nigeria).
C.O. Nwuba1, T. Dagunduro1, C. Umenyi1, B. Peters2, F. Afolayan3, O. Abolarin4
1Management Sciences for Health, Prevention Organizational Systems, AIDS, Care and Treatment, Ilorin, Nigeria, 2Children Specialist Hospital, Laboratory Unit, Ilorin, Nigeria, 3General Hospital, Laboratory Unit, Omuaran, Nigeria, 4Specialist Hospital, Laboratory Unit, Offa, Nigeria
Nigeria, the progressive loss of patients at every stage in antiretroviral
therapy (ART) programs especially at the point of uptake of CD4 monitoring
poses a threat to the achievement of treatment targets. Long waiting time coupled with the burden of traveling long distances for blood draw and receipt of CD4 results has led to attrition
in the number of clients who test positive to HIV versus the number who
eventually commence ART.
order to increase uptake of CD4 monitoring and reduce loss to follow up (LTFU)
at three USAID/MSH supported HIV care and treatment clinics, the following
interventions were instituted .
shifting to data clerks to fill laboratory request forms for CD4 monitoring
instead of clinicians who complain of heavy workload.
escort services from the point of enrollment to the laboratory to ensure that
clients access laboratory investigations on the same day.
shifting to laboratory technicians on the use of automated CD4 equipments after
consistent onsite training and supervision.
point of care sample collection for CD4 estimation.
commenced daily CD4 investigations (Monday to Friday) ensuring that clients
attending clinics from long distances access CD4 monitoring on any day of the
6. Commenced 24 hours turnaround
time for release of CD4 result to ensure rapid initiation of eligible
clients on ART.
12 months, number of clients accessing CD4 investigations increased from 53.8%
to 93.3% while number of clients LTFU reduced from 58.7% to 10.7%. Turnaround time for CD4 results decreased from
7 days to 24 hours. Average client waiting time reduced from 4 hours to 1hour 30mins.
laboratory systems helps increase uptake of CD4 investigations, shorten client
waiting time and ultimately reduces LTFU especially among clients attending
clinics from hard to reach communities with difficult terrains.
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