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Decentralization of antiretroviral treatment in Swaziland: outcome of nurse initiated versus doctor initiated treatment.
Dissertation (MSc)--University of Pretoria, 2014.
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| Format: | Thesis |
| Language: | English |
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University of Pretoria
2014
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| _version_ | 1867613516605685760 |
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| access_status_str | Open Access |
| author2 | Rheeder, Paul |
| author_browse | Rheeder, Paul |
| author_facet | Rheeder, Paul |
| collection | Thesis |
| dc_rights_str_mv | © 2014 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria |
| description | Dissertation (MSc)--University of Pretoria, 2014. |
| format | Thesis |
| id | oai:repository.up.ac.za:2263/40715 |
| institution | University of Pretoria (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:37:23.532Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository |
| publishDate | 2014 |
| publishDateRange | 2014 |
| publishDateSort | 2014 |
| publisher | University of Pretoria |
| publisherStr | University of Pretoria |
| record_format | dspace |
| source_str | UPSpace — University of Pretoria Institutional Repository |
| spelling | oai:repository.up.ac.za:2263/40715 Decentralization of antiretroviral treatment in Swaziland: outcome of nurse initiated versus doctor initiated treatment. Rheeder, Paul vuyomazz@yahoo.co.uk Mazibuko, Sikhathele Antiretroviral therapy (ART) Patients Nurse Quality of care Methods Results HIV positive patients UCTD Dissertation (MSc)--University of Pretoria, 2014. Introduction: Decentralization of antiretroviral therapy (ART) services faces decreasing quality when increasing ART coverage. This study compares nurse initiated and managed patients to doctor managed patients under these circumstances, using retention in care as a crude measure of quality of care. Methods: This was an observational retrospective cohort study. A simple data abstraction tool was used to collect baseline patient data from medical records of HIV positive patients (N=871) initiating ART at Mbabane Government Hospital and four of its outreach clinics, between 1st January and 30th June 2011. Descriptive summary statistics and comparison of the two cohorts using multivariate analysis was done. Results There was no statistically significant difference in retention rates between the doctors and nurses cohorts at 69.1% and 70.9%, respectively (P was 0.56). After adjusting for sex, haemoglobin, CD4 cell count, weight and WHO stage, the odds of being retained in care were similar between the two groups, adjusted OR: 1.11(95% CI: 0.72, 1.69), with a p value of 0.64. Haemoglobin and weight were positively associated with retention in care, while male sex was negatively associated with retention in care. Discussion: The similar retention rates between the two cohorts suggest that in terms of retention in care the service provided by the nurses was comparable to that provided by doctors. This is important to ART program managers as they scale-up ART decentralization. Conclusion: Task-shifting of ART initiation from doctors to nurses is feasible as nurse initiated and managed antiretroviral therapy is comparable to doctor initiated and managed treatment. gm2014 Clinical Epidemiology unrestricted 2014-07-11T06:23:57Z 2014-07-11T06:23:57Z 2014-04-25 2014 Dissertation Mazibuko, S 2014, Decentralization of antiretroviral treatment in Swaziland: outcome of nurse initiated versus doctor initiated treatment., MSc dissertation, University of Pretoria, Pretoria, viewed yymmdd <http://hdl.handle.net/2263/40715> E14/4/275/gm http://hdl.handle.net/2263/40715 en © 2014 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria application/pdf University of Pretoria |
| spellingShingle | Antiretroviral therapy (ART) Patients Nurse Quality of care Methods Results HIV positive patients UCTD Decentralization of antiretroviral treatment in Swaziland: outcome of nurse initiated versus doctor initiated treatment. |
| title | Decentralization of antiretroviral treatment in Swaziland: outcome of nurse initiated versus doctor initiated treatment. |
| title_full | Decentralization of antiretroviral treatment in Swaziland: outcome of nurse initiated versus doctor initiated treatment. |
| title_fullStr | Decentralization of antiretroviral treatment in Swaziland: outcome of nurse initiated versus doctor initiated treatment. |
| title_full_unstemmed | Decentralization of antiretroviral treatment in Swaziland: outcome of nurse initiated versus doctor initiated treatment. |
| title_short | Decentralization of antiretroviral treatment in Swaziland: outcome of nurse initiated versus doctor initiated treatment. |
| title_sort | decentralization of antiretroviral treatment in swaziland outcome of nurse initiated versus doctor initiated treatment |
| topic | Antiretroviral therapy (ART) Patients Nurse Quality of care Methods Results HIV positive patients UCTD |
| url | http://hdl.handle.net/2263/40715 |