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Home  Comprehensive HIV and AIDS Care Clinic Programme |
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Comprehensive HIV and AIDS Care Clinic Programme |
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In September 2006 Topsy established its Comprehensive HIV and AIDS Care Clinic (CHACC) at the Topsy Sanctuary, which serves to provide care and treatment, specifically involving antiretroviral therapy to identified and eligible members of the community. The clinic team consists of medical staff and social workers, all of whom have received the appropriate, specialised training.
The Topsy Foundation has secured support from Right to Care (a South-African based NGO supported by PEPFAR). As an NGO Partner, the support for Topsy extends to the direct costs for patients on ART, as well as part contributions to salaries, supplies, patient transport and VCT. A Service Level Agreement has been signed with the Mpumalanga Department of Health which has facilitated the provision of ARV therapy and medicines for opportunistic infections.
Families caring for children are visited daily for at least one month upon commencing treatment during which the trained field-workers ensure that the care-giver administers the medication correctly. Each dosage given must be charted. After that they are visited regularly to follow up. This enables the Topsy Foundation to deal with all social and medical problems as soon as they arise. On the first visit to the clinic the medical professional will make sure all relevant results are available and stage the client according to WHO staging. The client will be referred to the social worker to start readiness counselling. The social worker then will determine when the client is ready for ART after at least 3 sessions. During this time Topsy provides prophylaxis for opportunistic infections, as well as treatment for any acute infections.
Once a client has been selected, the following tests are done as part of the screening:
* Clinical examination, including height and weight.
* HIV ELISA; PCR (if ELISA undetermined); CD4 count; Viral Load; FBC (Full blood count).
The client is seen by a medical professional and social worker every two weeks (or monthly thereafter) for the first 3 months. Adherence checks are undertaken, e.g. pill count and the checking of medical charts. The social worker does adherence counselling. All of which is documented.
If the client is adherent and the viral load has dropped to below 400 copies per ml blood, the client will receive treatment for 3 months. Children are required to come to the Comprehensive HIV and AIDS Care Clinic every month to receive their medication due to dosage changes according to weight.
All relevant staff members undergo training, which includes: HIV and AIDS Counselling, Laboratory testing, DOTS principle (groups), ARV (General information, Resistance, Side effects, Interaction of medication), Administration of medication, Adherence, Charting (groups), TB, Case studies (groups), Role in the community, Expectations/Fears/Opinions.
The families caring for children are visited daily for at least one month upon commencing treatment during which the trained field-workers ensure that the care-giver administers the medication correctly. Each dosage given must be charted. After that they are visited regularly to follow up. This enables the Topsy Foundation to deal with all social and medical problems as soon as they arise.
Follow up blood tests are done every three months - CD4; Viral Load; FBC and Liver Function Tests. The following rapid tests are also done in three-monthly intervals: urine dipstick, glucose, cholesterol and lactate with finger prick. Additional tests are done if the clinical picture raises the suspicion of side-effects developing. In doing this, the efficacy of the drugs is monitored as well as the possible development of side effects and / or resistance.
Since the start of the Comprehensive HIV and AIDS Care Clinic, Topsy has supported mothers who are pregnant. Topsy formalised its Prevention of Mother To Child Transmission (PMTCT) project in 2007.
Topsy also offers PEP, post-exposure prophylaxis to staff and community members exposed to HIV due to needle-stick injury or other exposure. This service includes pre- and post-test counselling, the provision of medication and after-care. |
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