Table 1
HIV testing in medical wards and advanced HIV disease test data for KCH inpatients (January to December).
| 2017 | 2020 | |
|---|---|---|
| Admissions | 6645 | 3340 |
| Early death | 880 (13.2%) | 390 (11.7%) |
| Early discharge | 391 (5.9%) | 302 (9.0%) |
| On previous ART | 1614 | 638 |
| Eligible for testing | 3760 | 2010 |
| Tested | 3389 (90.1%) | 1549 (77.1%) |
| HIV positive | 240 (7.1%) | 69 (4.5%) |
| CD4 done | 583 | 460 |
| CD4 < 200 | n.a. | 245 (53.3%) |
| CD4 < 100 | 230 (39.4%) | 147 (31.9%) |
| CrAg test done | 185 | 238 |
| CrAg positive | 20 (10.8%) | 39 (16.4%) |
| LAM tests done | 298 | 219 |
| LAM positive | 69 (23.1%) | 62 (28.3%) |
Table 2
Characteristics of ART and TB patients newly starting treatment as inpatients in KCH wards (January to December).
| 2017 | 2020 | |||
|---|---|---|---|---|
| ART PATIENTS INITIATED | TB TREATMENT INITIALED | ART PATIENTS INITIATED | TB TREATMENT INITIALED | |
| Total | 274 | 306 | 117 | 201 |
| Male | 124 (45.2%) | 173 (56.6%) | 54 (46.2%) | 116 (57.7%) |
| Female | 150 (54.8%) | 133 (43.4%) | 63 (53.8%) | 85 (42.3%) |
| Age <20 | 9 (3.2%) | 15 (4.9%) | 11 (9.4%) | 9 (4.5%) |
| 20–50 | 234 (85.5%) | 250 (81.7%) | 101 (86.3%) | 151 (75.1%) |
| >50 | 31 (11.3%) | 41 (13.4%) | 5 (4.3%) | 41 (20.4%) |
| Medical ward | 204 (74.4%) | – | 90 (76.9%) | – |
| Other ward | 70 (25.6%) | – | 27 (23.1%) | – |
| WHO stage 1/2 | 167 (60.9%) | – | 81 (69.2%) | – |
| WHO Stage 3/4 | 107 (30.1%) | – | 36 (30.8%) | – |
| PTB only | – | 86 (28.1%) | – | 26 (12.9%) |
| EPTB (+/–PTB) | – | 220 (71.9%) | – | 175 (87.1%) |
| HIV positive | – | 243 (79.4%) | – | 156 (77.6%) |
| HIV negative | – | 63 (20.6%) | – | 45 (22.4%) |
Table 3
Correlation of Urine-LAM and FASH ultrasound results in medical inpatients receiving both tests.
| FASH + | FASH – | ||
|---|---|---|---|
| U-LAM+ | 17 (12.6%) | 21 (15.7%) | 38 |
| U-LAM– | 28 (20.9%) | 68 (50.7%) | 96 |
| 45 | 89 | 134 |
[i] % of agreement: 63.23%, Cohen’s k: 0.15 (Slight agreement).
Table 4
Cost analysis of the Lighthouse inpatient AHD support program 2020.
| N | ITEM COST (USD) | ||
|---|---|---|---|
| ROOM AND EQUIPMENT (CAPITAL INVESTMENT) | TOTAL/5 YEAR PERIOD | ||
| Room | in kind Dept. of Medicine | ||
| Face lifting and security upgrade (burglar bars, new locks etc.) | 1 | 400 | $400 |
| EMRS screen, label printer | 1 | 1 063 | $1 063 |
| PIMA CD4 count analyzer | 1 | 8 995 | $8 995 |
| Other items (furniture, BP machine, scale, fan etc.) | 1 | 250 | $250 |
| Total | $10 708 | ||
| Annual subtotal | $2 142/year | ||
| STAFF SALARY | TOTAL/YEAR | ||
| LH HIV counselor (per year) | 1 | 5 800 | $5 800# |
| LH nurse (per year) | 1 | 17 000 | $17 000* |
| LH clinical officer (per year) | 0.25 | 18 800 | $4 700 |
| Subtotal | $27 500/year | ||
| TESTS | |||
| HIV rapid tests | 1549 | 1 | $1 549# |
| HIV confirmation tests | 150 | 2 | $300# |
| CD4 tests | 533 | 8.4 | $4 472* |
| CD4 PIMA beads for calibration | 2 | 59.1 | $118* |
| CrAg tests | 271 | 2.8 | $759** |
| LAM tests | 262 | 4.6 | $1 205*** |
| EDTA tubes and needles | 600 | 0.2 | $120* |
| Creatinine, potassium and FBC monitoring (twice per CM treatment) | 118 | 5 | $590& |
| Subtotal | $9 113/year | ||
| DRUGS | |||
| ART and CPT | part of long-term care (through Dept. HIV/AIDS) | ||
| RHZE and Vit B6 | part of long-term care (through Nat. TB program) | ||
| Fluconazole | part of long-term care (through Dept. HIV/AIDS) | ||
| Liposomal AmphothericinB (per course) | 59 | 186.9 | $11 027& |
| Flucytosine (per course) | 59 | 86.2 | $5 086& |
| Subtotal | $16 113/year | ||
| OTHER CONSUMABLES | |||
| Registers, stationary etc. per month | 12 | 25 | $300 |
| Total | $62 139/year (= $5.178/month) | ||
[i] # Cost of HIV testing, * cost of CD4 testing, ** cost of CrAg, *** cost of LAM, & cost of CM treatment.
Table 5
Cost of individual test and results obtained.
| TEST AND RESULT TYPE | TOTAL COST | N | COST/CLIENT |
|---|---|---|---|
| HIV test done | US$ 7 649 | 1,549 | US$ 4.9 |
| HIV positive patient identified | US$ 7 649 | 69 | US$ 110.8 |
| CD4 test done (nurse time fully excluded) | US$ 4 715 | 533 | US$ 8.8 |
| CD4 test done (nurse time fully included) | US$ 21 715 | 533 | US$ 40.7 |
| CD4 < 200 identified (nurse time fully excluded) | US$ 4 715 | 275 | US$ 17.1 |
| CD4 < 200 identified (nurse time fully included) | US$ 21 715 | 275 | US$ 78.9 |
| Positive serum CrAg result | US$ 759 | 41 | US$ 18.5 |
| Positive urine LAM result | US$ 1 205 | 69 | US$ 17.5 |
| CM Patient treated w AmpB/FluC | US$ 16 703 | 59 | US$ 283.1 |