Improvement of service capabilities following the establishment of an electronic database to evaluate AIDS in Central Africa
Background: HIV care and treatment scale up has, in some instances, resulted in the development of electronic health records that have improved service delivery in resource-constrained settings. The International Epidemiological Databases to Evaluate HIV/AIDS (IeDEA) has enabled the establishment of a network of local site investigators and solid research infrastructure in participating regions through the creation of an international research consortium to address unique and evolving research questions in HIV/AIDS currently unanswerable by single cohorts.
Objectives: We provide an example of how establishing an electronic database to evaluate HIV/AIDS in the Central Africa region has improved service capabilities and patient care.
Methods: The IeDEA Central Africa region cohort includes adult data from 10 HIV treatment centers and pediatric data from four treatment centers in Burundi, Cameroon, and the Democratic Republic of Congo (DRC). Three research tools were developed while establishing the cohort: data collection forms, an electronic data management system and an accompanying reporting instrument.
Results: Data have been collected from 19,200 HIV-positive adults and from 470 HIV-positive children. Though unintended by research objectives, many participating health facilities independently decided to adopt the IeDEA Central Africa region research forms and accompanying electronic data management system (DMS) as their routine patient medical record system.
Conclusions: The creation of clinical data forms, an electronic data management system and an accompanying reporting instrument have improved patient management, continuity of care and capability to fulfill reporting requirements. The establishment of the IeDEA Central Africa region database has enabled physicians and researchers in this region to establish adult and pediatric cohorts for the purpose of describing regional trends in HIV/AIDS, quickly identify populations at risk for dropping out of care and treatment, and has provided data needed to develop strategies for addressing gaps in behavioral implementation science.