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Methods: We conducted a prospective cohort study in 226 health facitilies across Dar-es-Salaam, Tanzania. Eligible participants were pregnant women of any age with HIV, and later their infants, who enrolled in routine health-care services for the prevention of vertical transmission. We prospectively followed up mother-infant pairs at routine monthly visits until 18 months post partum and extracted data from the care and treatment clinic (CTC2) database, a national electronic database that stores patient-level HIV care and treatment clinic data. The primary outcome was time from birth to HIV diagnosis, defined as a positive infant HIV DNA PCR or antibody test from age 18 months. We used the Kaplan-Meier method to estimate cumulative risk of vertical transmission by 18 months post partum and Cox proportional hazards regression with shared frailties to account for potential clustering in health facilities to evaluate predictors of transmission.

Methods: a retrospective cohort study was conducted between July 2014 to June 2015 and July 2017 to June 2018 to determine 12 months ART retention among clients newly initiated ART prior and during universal test and treat (UTT) strategy in Geita Region, Tanzania. A total of 13,649 newly clients-initiated ART were extracted from the National AIDS control care and treatment database (CTC2 database). Among these clients 4,624 initiated ART prior the UTT strategy and clients 9,025 start ART after the rollout of UTT strategy. Chi-square test was deployed to determine the significant difference of proportion within categories for each UTT group. Kaplan-Meier curve and long rank test were used to determine significant differences of retention rate prior and during UTT program. Cox regression models were used to estimate the association between exposure variables and ART retention with 95% confidence intervals and p-value of p

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Some digital health interventions like the District Health Information System version 2 (DHIS2) have been rolled out in all districts. With others like the National Health Insurance Fund electronic system and the CTC2 database partially scaled up in some facilities in the country.

The OpenMRS CTC database is designed to be a system for HIV/AIDS clinics in Tanzania to store and analyse core data specified for collection by the National AIDS Control Programme as well as additional more detailed data.

Outcome data were obtained from the CTC electronic database which contains routinely collected clinical data for PLH accessing care at each of the participating sites. Data for sociodemographic measures, duration on ART, and all outcome variables including CD4, weight, and hemoglobin levels; as well LTFU measures were extracted from the database at 8, 16, and 24 months of follow-up.

All 450 HIV-positive participants of NAMWEZA intervention were eligible to participate. Thirty-four (7.5%) of the exposed participants had absent or incomplete clinical information and were dropped from the analysis. The final number of participants in the intervention group included in this study was 416 (92%). A total of 408 PLH were identified from the CTC2 database based on the same eligibility criteria.

Approval was sought from the Principle Investigators (PIs) of the main study from which this adjunct study was conducted known as; NAMWEZA-change agents study for use of this data. Likewise the use of CTC2 National database from participating sites followed the Tanzanian national guidelines of conducting research through seeking and obtaining approval from the National Institute of Medical Research (NIMR) and the District Medical office of the participating sites before the study rolled out.

Complements the CTC2 database and utilizes the Export for Analysis data file to provide detailed analyses of priority indicators to improve HIV service delivery and promote data analysis and use at the facility level.

Ciheb developed a tool called data analysis companion (DAC) that works to routinely identify eligible clients for different clinical services from the national HIV database, also known as the CTC 2 database. Healthcare providers were oriented on how to use the tool to improve service provision by generating a list of eligible clients for the required services before their clinic visit. Their charts/files were flagged with a sticker for easy identification at the different points of service that a client would attend during their clinic appointments.

i. Degree or Diploma in computer science, statistics, record management, Information technology, Health information management, Health System Management, and or related scientific discipline from a recognized university.

ii. At least two years of previous experience and knowledge working with databases.

ii. Entering numerical data, codes, and text from source documents into computer- compatible storage devices. To collaborate with CTC clinical staff and ensure the completeness of data collected and filled on the CTCs cards and registers. Document and report HIV and AIDS information systems problems to the line supervisor using integrated reporting tools

iii. To update the status of Clients every time they attend a clinical visit and or change status, e.g. TO, Death, and LTF.

iv. Assist Health care workers to generate a list of patients attending the next CTC session, LTF, Clients eligible for viral load uptake, Missed appointments, and any other requested report.

v. To compare data in the ART registers and ARV Dispensing registers if they match those entered in the CTC2 database and enter if there is any discrepancy at every visit

vi. To run the CTC2 database built-in checks for data cleaning, and solve them as required

vii. To assure that the CTC2 database and Pharmacy Module are always of the most recent version;

viii. Assure that a weekly backup is made on either a partitioned hard drive or a separate hard drive/Flash Disk;

ix. Use the CTC2 database to produce high-quality quarterly reports for the Council Medical Officer and submit these to the DACC/TACC and Data Manager, and the RACC and Regional M&E Officers.

x. To use the CTC2 database to produce daily, weekly, and monthly reports on patients

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I have often heard people talk about the unavailability of health data in African countries. I would like to share something that I witnessed, which really impressed me. Makole Health Center (and other centers that provide HIV/AIDS services) use a database called CTC2 Database for National AIDS Control Program (NACP). Data for each patient who presents to this center is inputted into the database and sent to the Ministry of Health and Social Services. The data specialist at Makole mentioned that reporting has to be completed every three months. She completed a demo on how to input data and how to generate reports. The database is extremely user friendly. Some of the challenges that she mentioned were that some dispensaries, and sometimes private hospitals, do not have a data specialist and they have to bring their charts to her in order for her to input their data in the database. Another challenge is that some of the charts that she receives could be missing an entry or an entry in the form is illegible and then she would have to track down someone from the health facility where the chart came from to correct the problem. She reiterated the importance of the nurses to complete the forms correctly and collect all the information from the patient while the patient is at the facility because they may not be able to do so once the patient leaves. The raw data is also available at the Ministry of Health and Social Services. e24fc04721