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Measuring the Outcomes of a Comprehensive HIV Care Course: Pilot Test at the Infectious Diseases Institute, Kampala, Uganda

Weaver, Marcia R PhD*; Nakitto, Cecilia; Schneider, Gisela MD, MPH; Kamya, Moses R MBchB, MMed, MPH†‡; Kambugu, Andrew; Lukwago, Robinah Bpharm†§; Ronald, Allan MD; McAdam, Keith FRCP, FWACP†¶#; Sande, Merle A MD**††

JAIDS Journal of Acquired Immune Deficiency Syndromes: November 1st, 2006 - Volume 43 - Issue 3 - p 293-303
doi: 10.1097/01.qai.0000243047.42827.97
Clinical Science

Objective: To evaluate the effects of the Infectious Diseases Institute's 4-week course for African doctors on comprehensive management of HIV including antiretroviral therapy on four outcomes: (1) clinical skills, (2) clinical activities, (3) monitoring of HIV patients, and (4) training activities

Design: Clinical exam at beginning and end of course and at follow-up 3 to 4 months later, and a cross-section telephone survey.

Methods: Forty-seven doctors attending the course (October 2004, November 2004, March 2005, and April 2005) agreed to participate. A 17-item Clinical Exam Checklist was used to assess clinical skills. A telephone survey was conducted 1 month after the course to collect data in four areas: clinical activities, monitoring of HIV patients, case studies on initiation of ART, and training activities.

Results: The course improved the clinical skills of doctors. Between the beginning and end of the course, their clinical skills improved significantly in 11 of 17 areas (n = 34). Between the end of the course and follow-up, their skills improved significantly in three areas (n = 14). The trainees were practicing HIV care and training. The telephone survey (n = 46) showed that 93% of trainees treated HIV patients, 35% provided training on HIV, and 47% monitored the weight of the last HIV patient treated (patient's weight was a clinical end point to measure health status). At follow-up, everyone provided training and trained an average of 20 people per month.

From the *Department of Health Services and International Training and Education Center on HIV, (I-TECH), University of Washington, Seattle, WA; †Infectious Diseases Institute, Makerere University, Uganda; ‡Department of Medicine, Makerere University, Uganda; §Institute of Public Health, Makerere University, Uganda; ‖Department of Internal Medicine, University of Manitoba, Winnepeg, Canada; ¶Pratt Medical Group, Tufts-New England Medical Center, Boston, MA; #Department of Clinical Tropical Medicine, London School of Hygiene and Tropical Medicine, London, England; **Department of Medicine, University of Washington, Seattle, WA; and ††Academic Alliance Foundation, Arlington, VA.

Received for publication May 18, 2006; accepted August 14, 2006.

This research was supported by funding from the Puget Sound Partners for Global Health.

Reprints: Marcia R. Weaver, PhD, Department of Health Services and International Training and Education Center on HIV (I-TECH), University of Washington, 901 Boren, Suite 1100, Seattle, WA 98104 (e-mail:

© 2006 Lippincott Williams & Wilkins, Inc.