Skip Ribbon Commands
Skip to main content

Title

Clinical staging of HIV-related illness in Mozambique

Authors

Brentlinger PE, Torres JV, Martínez PM

Network Affiliation

Other

Organization

 

Journal Name

JAIDS Journal of Acquired Immune Deficiency Syndromes

Publication Date

11/1/2010

PubMed Search

http://www.ncbi.nlm.nih.gov/sites/entrez

Link to full-text

 

PMID

20562630

Abstract

INTRODUCTION: In Mozambique, clinical staging may be the primary determinant of HIV/AIDS treatment decisions, and the task of staging commonly falls to nonphysician clinicians (técnicos de medicina). Two years after the first Mozambican técnicos were trained in HIV/AIDS care, the quality of their performance in clinical staging was unknown.
METHODS: Expert clinicians observed 127 clinical encounters conducted by a randomly selected national sample of 44 técnicos and compared observed clinical staging decisions to World Health Organization and Mozambican national norms. They also reviewed relevant Mozambican in-service training curricula in HIV/AIDS care.
RESULTS: Observers agreed with fewer than half (44.1%) of the técnicos' stage-defining diagnoses. Misclassification or misdiagnosis of 3 complaints (weight loss, fever, and diarrhea) accounted for the majority of the observed errors. Review of health worker curricula determined that observed staging errors reflected content errors and omissions in the técnicos' in-service HIV/AIDS training and constraints in local laboratory and imaging capacity.
DISCUSSION: In response to these findings, the Mozambican Ministry of Health has revised the técnicos' scope of work and has developed new guidelines, curriculum materials, and training strategies to improve the quality of clinical staging and opportunistic infection diagnosis in Mozambique.

Keywords

 

Topic

Mozambique, treatment staging

Attachments

Created at 11/8/2010 11:48 AM by Mooney, Jessica L
Last modified at 11/19/2010 10:42 AM by Mooney, Jessica L