ART MENTORING TRAINING PRACTICALS Mazabuka

Group 1

Introduction
ART Clinic at Kaonga Urban Health

Centre
Saw 49 patients in total 4 were paediatrics Adults 29 female

16 males

Teaching moments
Through out the visit we strove not

to miss any teaching moments and we had to call the lone Clinical Officer to find out why certain things are done the way they were and see how both could understand the situation at hand.

The Patients
First patient with possible treatment

failure Today presented with no complaints Diagnosed for HIV on 14th September 2009 Enrolled on ART on 21st October 2009 Started ART on 31st December 2009 Initial CD4 was 178 on 18/09/09 Current cd4 was 218 (3/02/10)

The Patients cont

The clinician seeing the patient then did a

CD4 profile Date 18/07/09 30/09/09 22/12/09 28/12/10 02/03/11

CD4 178 237 229 261 218

The Patients cont

As a team we discussed

treatment failure at length and decided to send the client for viral load and was given a week for review

The Patients cont

The second client
Female 28 Diagnosed for HIV on 28/06/11 Enrolled in ART on 28/06/11 Initial CD4 07 (27/07/11)

Patient started Septrin on 28/06/11

The Patients cont

On the eligibility visit the patient was prescribed

ABC/3TC/EFV But patient declined treatment saying she had no enough food at home On this visit the patient was explained to that it was okay to be on the above treatment without having any problems

The Patients cont

After a critical look at the file the TB form was not

completed. We felt a patient with such a low CD4 should be properly screened for OIs before ART is prescribed to avoid severe forms of IRIS.

The Patients cont

The last client had a pyronychia who had put

some herbal medicine (green herbs, cow dung and soil) right on the sore it self. We gave the client health education and asked her to wash off the medicine.

Feed back
In the afternoon we gave feed back to

the Sister In-Charge who also gave us her own feelings.

The ART clinic was adopted by the

province but there has never been any support to that effect ever since the adoption.
There has never been DBS for over

Thank You