An audit assessing data quality, viral suppression, and transition to dolutegravir among children and adolescents with HIV in care at eThekwini Municipality, South Africa
This audit shows that while there is complete transition to dolutegravir-based ART among children and adolescents, there are notable gaps in viral suppression and data quality that need to be addressed.
Where it sits
this study against the rest of the ll-37 corpusSummary and findings
This audit assessed the uptake of dolutegravir-based ART and viral suppression among children and adolescents with HIV in eThekwini, South Africa. Among 3379 reviewed files, 100% were on dolutegravir-based ART, but 10% had a viral load ≥1000 copies/mL. Data discrepancies were identified in 28% of cases regarding ART regimens and recent viral loads.
Abstract
ABSTRACT Background The 2023 South African antiretroviral therapy (ART) guidelines recommend dolutegravir-based ART for children and adolescents with HIV (CAWH) >4 weeks old, including transition to dolutegravir-based ART if previously taking another regimen. Objectives We audited uptake of dolutegravir-based ART, viral load (VL) testing, and viral suppression among CAWH in care in eThekwini, South Africa. We also aimed to assess and improve the quality of routinely collected ART and VL data in the national HIV electronic register (TIER.Net) in this population. Methods We used TIER.Net line lists to identify CAWH aged ≤19 years in care in 54 eThekwini Municipality clinics between February and July 2025. CAWH who had died, transferred out, or were lost to follow-up were excluded. We reviewed clinical files and TIER.Net records simultaneously to compare all recorded ART regimens and recent (last 12 months) VL results. High or missing VLs were flagged for medical review, and data discrepancies were corrected. Results Among 3838 eligible CAWH, we reviewed files of 3379 (88%). 1991 (59%) were female and 2812 (83%) were aged 10-19 years. All 3379 (100%) were receiving dolutegravir-based ART. 193 (6%) had no recent VL result. Of those who did, 303 (10%) had a last VL ≥1000 copies/mL. We identified 941 (28%), 438 (13%), and 199 (6%) TIER.Net data capture errors for ART regimens, ART regimen start/stop dates, or recent VLs, respectively. Conclusion This audit at 54 facilities showed complete transition to dolutegravir among reviewed files of CAWH in care, but highlighted gaps in viral suppression and documentation.
Background
Not reported in abstract.
Methods
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Results
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Interpretation
Not reported in abstract.
Limitations
Not reported in abstract.