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Although this presents better treatment options for HIV-infected individuals, the challenge of monitoring ART in these settings still remains.
42 The recommendations for monitoring ART in LMICs are similar to those in high-income countries.
WHO has recommended use of CD4 cell count measurements and clinical outcomes for monitoring ART in the absence of VL [ 5].
We recently reported that a targeted approach based on predictors of CD4 recovery can be a viable and cost-effective way of monitoring ART in HIV-infected children in resource-limited settings [ 18].
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Electronic drug monitors (EDM) have been instrumental in monitoring ART adherence and in defining the relationship between adherence and HIV-related clinical outcomes [ 4, 21– 23].
In Zambia, the principal challenges now are monitoring ART patients, retaining them in the treatment and support programmes, and treating treatment and HIV-induced morbidities.
Standardization in perinatal data collection and reporting will help in monitoring ART treatment practices and is consistent with the recommendations from the Global report on preterm birth and stillbirth [ 20].
The median duration of training in initiating ART was seven days, and also seven days in monitoring ART.
First, we did not have viral load assessments, a gold standard in monitoring ART outcomes, since viral load tests are costly and not regularly assessed for all HIV/AIDS patients in Vietnam.
In a national sample of health facilities that were accredited to provide ART in Uganda, 64% who prescribed ART were clinical officers, nurses or midwives, 41% of whom had not been trained in initiating ART and 64% of whom had not been trained in monitoring ART.
Although viral load monitoring is not yet widely available in RLS, it is now recommended as the preferred approach to monitoring ART success and diagnosing treatment failure in the latest WHO guidelines [ 21].
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