Utilizing funding through the President´s Emergency Plan for AIDS Relief (PEPFAR) this project seeks to assess the effectiveness of a subset of the new Mozambican clinical guidelines for the diagnosis, initial management, and follow-up ( \>1 follow-up visit to determine response to initial and/or second-line therapy) of common signs and symptoms in HIV-infected adult patients as used under field conditions by Mozambique-based clinicians in MOH health facilities in Zambézia province, Mozambique. The operational feasibility of the new guidelines will be described; they will be compared to the previous standard of care for the problem(s) of interest, and the clinical importance of differences between guidelines designed for Mozambican non-physician clinicians and new guidelines (also issued in late 2009) for Mozambican physicians will be described. The subset of guidelines to be addressed in the current phase of this 2-year project includes algorithms for diagnosis and management of acute fever, persistent fever, and anemia.
Study Type
OBSERVATIONAL
Enrollment
492
Inhassunge District Health Facility
Inhassunge, Mozambique
Namacurra District Health Facility
Namacurra, Mozambique
Coalane Health Facility
Quelimane, Mozambique
1. What proportion of HIV-infected adult patients with common signs and symptoms can be assigned specific, potentially treatable diagnoses or syndromic classifications when evaluated in conformity with new Mozambican algorithms?
Time frame: 6 months
2. What diagnoses or syndromic classifications are assigned to patients managed per protocol (in accordance with the new algorithms)
Time frame: 6 months
3. What are the confirmed or probable diagnoses of patients who improve when managed in accordance with the new algorithms?
Time frame: 6 months
What proportion of HIV-infected adult patients with common signs and symptoms improve clinically when evaluated and managed in conformity with new Mozambican algorithms for técnicos de medicina?
Time frame: 6 months
What is the relative prevalence of non-typhoidal salmonella (NTS) and other bacterial pathogens in febrile study subjects?
Time frame: 6 months
For each bacterial pathogen isolated in blood cultures, summarize the number and % susceptible to each antibiotic evaluated.
Time frame: 6 months
What proportion of study subjects with laboratory-confirmed P. falciparum parasitemia are also bacteremic?
Time frame: 6 months
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