CIDRZ has been awarded a USD 4.76 million Bill & Melinda Gates Foundation grant in support of the Better Information for Health in Zambia study. Dr Charles Holmes, CIDRZ Chief Executive Officer and Dr Elvin Geng of the University of California – San Francisco are the overall co-Principal Investigators (PIs), Dr Izukanji Sikazwe, CIDRZ Deputy CEO is the lead local PI, and the study team includes multiple Zambian and other co-investigators.
The purpose of the ‘BetterInfo’ study is to systematically gain a better understanding of why some patients enrolled in antiretroviral treatment (ART) stay in care, while others are ‘lost’ from care. It is estimated that as many as 25-40% of patients in HIV care and treatment programmes are Lost-To-Follow-Up (LTFU). The ‘BetterInfo’ study will trace ART patients, learn of their outcomes, and ask questions about why they have that outcome. This information will enable the study team to more accurately estimate the treatment outcomes of patients who are lost from HIV care thereby gaining a better understanding of the percentage of patients who have chosen to disengage from ART care, those who have chosen to re-engage in ART care at a different facility, and those that have passed away. Understanding this information will allow health programmes and facilities to better meet the needs of ART patients so that they stay in care. The ‘BetterInfo’ study staff will use best practices when tracing ‘lost’ patients to protect privacy and confidentiality, and if a patient has stopped receiving treatment they will encourage them to resume ART care.
The ‘BetterInfo’ study will be conducted in 30 sites in Western, Southern, Lusaka and Eastern Provinces of Zambia over a 29-month period and will be able to provide more accurate estimates of HIV care patient outcomes at both clinic and provincial levels which will help the Zambian Ministry of Health, and Ministry of Community Development Mother and Child Health to make informed decisions about HIV care service provision.
In addition to both Zambian and International research regulatory oversight, the ‘BetterInfo’ study will also be guided by a Zambian and International Advisory Committee of health and HIV experts comprising Dr Carol Phiri, Dr Peter Mwaba, and Dr Albert Mwango of the Government of the Republic of Zambia; Dr Jonas Mwale of the Centers for Disease Control and Prevention – Zambia; Dr Virginia Bond of the London School of Hygiene and Tropical Medicine; Dr David Bangsberg of the Harvard School of Public Health; and Dr Bruce Agins Medical Director of the New York State Department of Health AIDS Institute.
‘BetterInfo’ represents collaboration between multiple investigators from CIDRZ, the University of California – San Francisco, the University of Alabama at Birmingham, and the University of North Carolina – Chapel Hill.
An integral component of the ‘BetterInfo’ study will be an in-depth process evaluation to enable the investigators to identify and understand the best implementation methods, and the resources required for implementation, so that the Ministry or other interested partners could repeat the exercise in a different setting, if desired. As per Gates Foundation grant requirements, ‘BetterInfo’ study results will be shared with the communities involved, the Government of Zambia, and other key stakeholders, as well as be provided as part of the Global Access Commitment.