Assessment of Completeness of ART Patients’ Records and Changes in CD4 Cell Counts in Zawditu Memorial Hospital Addis Ababa, Ethiopia

Abstract

Background: Implementation of antiretroviral treatment in Ethiopia has offered to those who accessed to the service priceless changes in terms of individual health, socially, psychologically and comfort for the families and communities at large. However, besides the targeted outcome, some unexpected problems can occur during rendering such massive service because of different reasons resulting in poor quality of the service. Thus the need for assessing complete patient records and ART response for proper monitoring, among others, is undoubtful. Objectives: To assess overall record completeness, proportion of those with CD4 cell count determined and the ART response. Methods: The study method is retrospective medical follow up based on data review of patients’ records on ART in Zawditu Memorial Hospital. All records of those patients registered in the clinic between September 2006 and August 2007 were used for the purpose. The data recorded in the patients’ files, the proportion of those whose CD4 cell count was determined, and the response of the ART among those who had complete CD4 cell determination were assessed. Various statistical techniques were used for data analysis and interpretations. The perspectives of health care providers at the site were assessed using a closed ended questionnaire. Results: A total of 1561 medical records of ART patients were reviewed for data. The mean age of the subjects was 35.6 years. The majority of the medical files, ranging between o.1% (ARV drugs) and 98.6% (income status) were incomplete. The mean CD4 cell count for those who had complete record was 126(SD=+/-83.2), 231(SD=+/-125.7) and 266 (SD=+/-143.3) cells/μL at initiation, six and twelve months which is statistically significant increment. Conclusion and Recommendations: The finding of the study showed increase in unrecorded data with increasing follow up time for most of the repeatedly determined variables. The overall response of patients on ART as measured by CD4 cells count at different points was found to be significant. Improving record keeping and periodic analysis of routine ART data need to be done to properly monitor the ART program.