ICAP-supported HIV care and treatment services in Tanzania

35

29 2926 26

0

5

10

15

20

25

30

35

40

Total number offacilities

Testing &counseling

PMTCT Care & treatment TB screeningamong HIV pts

Type of activity

Nu

mb

er o

f fa

cili

ties

Source: ICAP Tanzania Site Census, August 2007

Number of ICAP-supported facilities by USG-funded activity, Tanzania

1,583 1,701

3,723

5,456

8,299

10,134

12,048

17,996

21,925

24,716

1,0192,102

5,0626,210

8,443

10,15311,091

4181,613

13,059

11,635

3,2334,422

5,7506,823

945948

9,704

2440

5000

10000

15000

20000

25000

30000

Jul-Sep2004

Oct-Dec2004

Jan-Mar2005

Apr-Jun2005

Jul-Sep2005

Oct-Dec2005

Jan-Mar2006

Apr-Jun2006

Jul-Sep2006

Oct-Dec2006

Jan-Mar2007

Apr-Jun2007

Nu

mb

er o

f p

atie

nts

HIV care (pre-ART and ART)

ART care

Cumulative and current enrollment in HIV care (pre-ART and ART) & ART care at ICAP-supported facilities, July 2004 - June 2007

ART patients retained*

Source: ICAP URS, July 2007*Includes ART patients who are not known to have died, transferred or lost to follow-up.

HIV care (pre-ART and ART)

ART care

Cumulative pediatric enrollment in ART care at ICAP-supported facilities, January 2006 - June 2007

ART patients retained*

Source: ICAP URS, July 2007*Includes ART patients who are not known to have died, transferred or lost to follow-up.

210 237

375

565

749

934

1,089

1,687

1,994

2,205

119216

468547

746858

946

51

208

1,071

945

294401

523591

9895

813

190

500

1000

1500

2000

2500

Jul-Sep2004

Oct-Dec2004

Jan-Mar2005

Apr-Jun2005

Jul-Sep2005

Oct-Dec2005

Jan-Mar2006

Apr-Jun2006

Jul-Sep2006

Oct-Dec2006

Jan-Mar2007

Apr-Jun2007

Nu

mb

er o

f p

atie

nts

Number of ICAP-supported care and treatment facilities reporting, July 2004 – June 2007

22

24

11

6

11 12 12

17

5

11

0

5

10

15

20

25

Jul-Sep2004

Oct-Dec2004

Jan-Mar2005

Apr-Jun2005

Jul-Sep2005

Oct-Dec2005

Jan-Mar2006

Apr-Jun2006

Jul-Sep2006

Oct-Dec2006

Jan-Mar2007

Apr-Jun2007

Nu

mb

er

of

facil

itie

s

Source: ICAP URS, July 2007

1

3

15

5

00

5

10

15

0% 1-5% 6-10% 11-99% 100%

Percentage of pediatric patients among all HIV care patients

Nu

mb

er

of

facil

itie

sPediatric (<15) enrollment in HIV care (% of total patients) at

ICAP-supported facilities as of June 2007 (n=24)

Source: ICAP URS, July 2007

Actual versus targeted HIV care enrollment to February 2008 at ICAP-supported care and treatment facilities as of June 2007

15,095

7,620

13,059

24,716

0

10,000

20,000

30,000

HIV care ART

Nu

mb

er o

f p

atie

nts

Target enrollment Actual enrollment

Source: ICAP Tanzania Site Census, August 2007

28% 32%

62% 61%60%

30%

10% 8% 9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pre-ART ART All patients

Num

ber

of p

atie

nts

Women 15+ Men 15+ Children <15

Cumulative enrollment in pre-ART and ART care by age and sex at ICAP-supported facilities as of June 2007

(Total in care = 24,716)

n=24,716 n=13,059 n=11,657

Source: ICAP URS, July 2007

30%

23%

17% 14%10%

26%

53%

68%60%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pre-ART ART All patients

Num

ber

of p

atie

nts

Ages 0-1 Ages 2-4 Ages 5-14

Cumulative pediatric (<15) enrollment in pre-ART and ART care by age at ICAP-supported facilities as of June 2007

(Total in care = 2,205) n=2,205 n=1,071 n=1,134

Source: ICAP URS, July 2007

Adults 15+ (%)n=6,170

Children <15 (15)n=453

1st line regimen

d4T-3TC-NVP4396

(71 %)117

(26%)

d4T-3TC-EFV541

(5%)14

(3%)

ZDV-3TC-NVP722

(12%)283

(62%)

ZDV-3TC-EFV 506(8%)39

(3%)

2nd line regimen5

(<1%)0

(0%)

Unknown0

(0%)0

(0%)

ART regimens for patients currently enrolled at ICAP-supported facilities by age, April-June 2007

Source: ICAP Tanzania URS, July 2007

Percentage of patients with CD4 counts at baseline, 6 and 12 months after ART initiation over time at ICAP-supported facilities

to June 2007*

58%

48% 49%

30%

17%

6% 7%

17%

52%49%

15%18%

0%

20%

40%

60%

80%

100%

July-Sep 2006 Oct-Dec 2006 Jan- March 2007 Apr-Jun 2007

Baseline 6 months 12 months

Number of patients

at baseline

n=n/a n=495 n=601 n=544

Source: ICAP URS, July 2007*CD4 data are for a subset of patients initiating ART

Average median CD4 count (cells/µL) after 6 and12 months of ART over time at ICAP-supported sites to June 2007*

98

136113

174176

246

191

267

130

308

277

394

0

50

100

150

200

250

300

350

400

450

July-Sep 2006 Oct-Dec 2006 Jan-March 2007 Apr-Jun 2007

Med

ian

CD

4 ce

ll co

un

t ch

ang

e at

6 a

nd

12

mo

nth

s (c

ells

/µl)

Baseline 6 months 12 months

Number of patients

at baseline

n=n/a n=495 n=601 n=544

Source: ICAP URS, July 2007*CD4 data are for a subset of patients initiating ART

Continued ART 11,091

76%

Discontinued 1,96824%

LTF 55%

Dead 37%

Stopped ART 7%

111 per 1,000 person-years

115 per 1,000 person-years

19 per 1,000 person-years

Source: ICAP URS, July 2007

*Does not include patients who transferred out

Proportion discontinuing ART at ICAP-supported facilities as of June 2007*

Program and Facility Characteristics Tracking System

(P-FaCTS)

On-site services at ICAP-supported care and treatment facilities*, Tanzania (n=17 of 26)

0

5

10

15

PMTCT VCT TB Labor anddelivery

ARTpharmacy

On

-sit

e p

rog

ram

av

ail

ab

ilit

y

5 services 94%

n=16/17 1 service 6%n=16/17n=16/17 n=16/17 n=17/17

2 service <1%

3 services <1%4 services <1%

Source ICAP Tanzania P-FaCTS, January 2007

*Includes data from 17 of 26 facilities (65%) for which a P-FaCTS assessment has been completed

Patient support services at ICAP-supported care and treatment facilities*, Tanzania (n=17 of 26)

0

5

10

15

Adherencesupport

Foodsupport for

adults

Foodsupport for

infants

Peereducatorprogram

Outreach

On

-sit

e p

rog

ram

av

ail

ab

ilit

y

2 services 35%

n=17/17 n=1/17

1 service 65%

n=5/17 n=0/17n=0/175 services <1%

3 services <1%4 services <1%

Source ICAP Tanzania P-FaCTS, January 2007

*Includes data from 17 of 26 facilities (65%) for which a P-FaCTS assessment has been completed

Median number of staff per 1000 patients on ART at ICAP-supported care and treatment facilities in Tanzania by cadre* (n=17 of 26)

0.0

1.2

7.5

0.00

2

4

6

8

Med

ian

nu

mb

er o

f p

rovi

der

s p

er 1

000

pat

ien

ts o

n A

RT

Source ICAP Tanzania P-FaCTS, January 2007

*Includes data from 17 of 26 facilities (65%) for which a P-FaCTS assessment has been completed

PMTCT Services

HIV-infected pregnant women receiving ART prophylaxis* in ANC at ICAP-supported PMTCT facilities,

April-June 2007

23% 22%

0%

24%

1%

77%

53%

0%

20%

40%

60%

80%

100%

Tanzania Total

Wo

men

rec

eivi

ng

AR

V p

rop

hyl

axis

sd-NVP AZT + sd-NVP HAART no prophylaxis

*Maternal ART prophylaxis includes: sd-NVP, AZT/sd-NVP, AZT/sd-NVP + 3TC/AZT tail, and HAART at 34 weeks

Women and infants receiving ART prophylaxis* in maternity at ICAP-supported PMTCT facilities,

April-June 2007

126

1,447

83

1,146

64

1,064

0

500

1,000

1,500

Tanzania Total

Nu

mb

er o

f p

atie

nts

HIV+ women (known/tested in maternity) Women receiving ART prophylaxis Infants receiving prophylaxis

*Maternal ART prophylaxis includes: sd-NVP, AZT/sd-NVP, AZT/sd-NVP + 3TC/AZT tail, and HAART at 34 weeks