Success with antiretroviral treatment for children in Kigali, Rwanda: Experience with health center/nurse-based care

Table 1 Traditional and modified tasks for nurses and physicians within the HIV/ART care program

	MD-CENTERED		NURSE-CENTERED
	Role MD	Role Nurse	Role MD	Role Nurse
Pre-ART care
Initial physical exam/staging	X			X
Ordering CD4 count	X	X		X
Assessment of ART eligibility	X			X
FU of non-eligible patients	X			X
CTX refill		X		-^b
Complex medical cases	X		X
ART care
Ordering lab tests	X	X		X
Interpretation of lab tests	X			X
ART initiation and FU
Non-complex cases	X			X
Complex cases^a	X		X
ART refill		X		-^b
Register keeping/reporting		X		-^b
Filing of results/medical records		X		-^b
Training/mentoring			X
Supervision			X

^a Complex cases included those with advanced HIV disease, severe/persistent opportunistic infections, severe ART side-effects, suspicion of ART failure, severe or recurrent non-adherence to ART.
^b Activities taken over from the ARV nurse by other staff.
ART: antiretroviral therapy; FU: follow-up; CTX: cotrimoxazole; MD: medical doctor

ISSN: 1471-2431