Introduction

Psychosocial support addresses the ongoing psychological and social problems of HIV infected individuals, their partners, families and caregivers.

Psychosocial support is important because: - HIV infection affects all dimensions of a person’s life: physical, psychological, social and spiritual. This calls for holistic care of the patients and can only be achieved through psychosocial support to these patients. -Given that HIV infection can result into stigma and fear for those living with the virus, including those who care for them, psychosocial support assist patients and care-givers to make sound decisions about the status of their health. - Long term treatment of HIV and other coninfections would require adherence to medication. This can be best achieved through a strong psychosocial support to all clients at KNH CCC.

It is in the backdrop of this, that this article is written to show the progress made so far and the areas needing more attention in this quarter.

This article analyses the month of April, May, and June of this year 2018.

The data

The data used for this analysis has been drawn from the IQCARE health Management information system. The data was mined using a standard SQL query and read and analysed in R. The dataset is a dataframe and has dimensions as shown in the code chunk below:

## [1] 20552   105

The dataframe has 20552 observations and 105 variables. This is a list of clients ever registered in the facility.

We shall only be interested in clients who made their visit in the months of April, May and June.

## [1] 6866  105

Patient Characterists

Age and Gender Distribution

From the above, 6866 Clients were seen in the period under review; April to June of 2018. Below is their distribution in Age and Gender:

## Warning: package 'ggplot2' was built under R version 3.4.4
## Warning: Ignoring unknown parameters: sub

##    Min. 1st Qu.  Median    Mean 3rd Qu.    Max. 
##    0.90   33.00   42.10   40.64   50.00   88.00

The oldest Client visiting the clinic was aged 88 years while the youngest client was aged 0.9 years respectively. Median age of visiting clients was 42.1 years. 25% of the clients who came were aged below 33 while 75% of clients who came were aged below 50 years.

## Female   Male 
##   4365   2501
## [1] 63.57413
## [1] 36.42587

There were 4365(64%) females and 2501(36%) males attending clinic in that period.

Attendance Trend

The chart below shows the attendance trend for the period under review

##    LastVisitDate Freq
## 1     2018-04-03   50
## 2     2018-04-04   56
## 3     2018-04-05   79
## 4     2018-04-06   84
## 5     2018-04-07    6
## 6     2018-04-09   69
## 7     2018-04-10   80
## 8     2018-04-11  108
## 9     2018-04-12  121
## 10    2018-04-13   91
## 11    2018-04-14   19
## 12    2018-04-16   96
## 13    2018-04-17  102
## 14    2018-04-18  156
## 15    2018-04-19  102
## 16    2018-04-20   99
## 17    2018-04-21    2
## 18    2018-04-23   81
## 19    2018-04-24   94
## 20    2018-04-25  161
## 21    2018-04-26  128
## 22    2018-04-27  128
## 23    2018-04-28    3
## 24    2018-04-30   88
## 25    2018-05-02   67
## 26    2018-05-03  111
## 27    2018-05-04  102
## 28    2018-05-05    3
## 29    2018-05-06    1
## 30    2018-05-07   76
## 31    2018-05-08  106
## 32    2018-05-09  131
## 33    2018-05-10  139
## 34    2018-05-11  143
## 35    2018-05-12   16
## 36    2018-05-14  117
## 37    2018-05-15  129
## 38    2018-05-16  131
## 39    2018-05-17  133
## 40    2018-05-18  148
## 41    2018-05-19   18
## 42    2018-05-21   76
## 43    2018-05-22   93
## 44    2018-05-23  148
## 45    2018-05-24  146
## 46    2018-05-25  134
## 47    2018-05-26   25
## 48    2018-05-27    1
## 49    2018-05-28   96
## 50    2018-05-29   84
## 51    2018-05-30  100
## 52    2018-05-31  155
## 53    2018-06-01    3
## 54    2018-06-02    1
## 55    2018-06-04   45
## 56    2018-06-05   65
## 57    2018-06-06   97
## 58    2018-06-07  144
## 59    2018-06-08  134
## 60    2018-06-09   14
## 61    2018-06-11  119
## 62    2018-06-12  133
## 63    2018-06-13  177
## 64    2018-06-14  131
## 65    2018-06-15    2
## 66    2018-06-18  107
## 67    2018-06-19   94
## 68    2018-06-20  151
## 69    2018-06-21  138
## 70    2018-06-22  113
## 71    2018-06-23   19
## 72    2018-06-24    1
## 73    2018-06-25   94
## 74    2018-06-26  103
## 75    2018-06-27  134
## 76    2018-06-28   91
## 77    2018-06-29  110
## 78    2018-06-30   14

## [1] 177
## [1] 1

The line graph shows a maximum attendance of clients of 177 per day and a minimum of 1 per day. The days that we have few clients below 10 are basically weekends. It is however curious to note that some clients were seen on Sunday!!

Psychosocial Assessment

We shall then look at clients who had psychosocial assessment during their visit.

##          Gender
## Adherence Female Male
##             1180  538
##         Y   3185 1963
## [1] 0.7497815

The table above, shows the number of clients disaggregated by Gender and their status of adherence. It shows a total of 5148(75%) clients had psychosocial forms filled while 1718(15%) did not have their forms filled. Of these, 3185 were females while 1963 were males.

Viremic Clients

We shall look at clients who had high viral Load against their status on psychosocial assessment.

## [1] 407 105

There was a total of 407 clients with viral loads above 1000Cp/mL attending clinic for the period under review. Let us see how many received psychosocial support.

##          Gender
## Adherence Female Male
##               34   20
##         Y    212  141
## [1] 0.8673219

The table shows that 86% of viremic clients had their psychosocial forms filled. A total of 54 clients did not have their forms filled. Below is a list of Clients who missed adherence counselling sessions and psychosocial support and had high viral Loads.

##       PatientPK AgeCurrent Gender LastVisitDate
## 363         374       49.0 Female    2018-05-03
## 2237       2256       37.0 Female    2018-06-21
## 3186       3227       56.7 Female    2018-05-11
## 5081       5293       53.5   Male    2018-04-27
## 5770       6007       36.0 Female    2018-04-24
## 6557       6836       32.1   Male    2018-06-29
## 10170     10765       49.0 Female    2018-06-14
## 12827     13965       46.4 Female    2018-05-04
## 13766     16051        9.2   Male    2018-06-14
## 13799     16242       44.5   Male    2018-06-19
## 14177     18223       38.1 Female    2018-06-05
## 14551     19931       43.1 Female    2018-06-25
## 14588     20052        9.4 Female    2018-06-14
## 15206     23720       40.1   Male    2018-05-25
## 16142     30177        4.1   Male    2018-04-05
## 16580     33113        3.6   Male    2018-06-13
## 16894     37924       42.0 Female    2018-05-25
## 17180     44318       38.5 Female    2018-06-22
## 17636     56666       30.1 Female    2018-05-11
## 18318     69685       47.8   Male    2018-05-28
## 18654     77227       30.8 Female    2018-04-23
## 18657     77492       31.6 Female    2018-06-04
## 18806     81477       25.9 Female    2018-06-18
## 18836     82156       24.1 Female    2018-05-11
## 18919     84326       29.1 Female    2018-05-18
## 18944     85132       31.5 Female    2018-05-04
## 19064     87597       26.7 Female    2018-05-14
## 19404     94340        2.1   Male    2018-06-13
## 19514     96512       34.4   Male    2018-04-26
## 19660    101558       46.1 Female    2018-05-30
## 19712    103435       29.1 Female    2018-05-11
## 19720    103809       32.6 Female    2018-05-17
## 19825    110518       36.2 Female    2018-06-11
## 19873    113826       12.2   Male    2018-04-18
## 20046    125389       45.7   Male    2018-06-11
## 20064    126022       42.1   Male    2018-06-08
## 20078    127041        5.7 Female    2018-06-11
## 20158    132835       51.0   Male    2018-05-29
## 20182    134848       35.1   Male    2018-06-22
## 20201    136346       30.1   Male    2018-06-27
## 20213    137198       26.1 Female    2018-04-05
## 20217    137999       40.1 Female    2018-06-19
## 20233    139901       52.0 Female    2018-04-27
## 20250    141142       23.1 Female    2018-06-27
## 20266    141868       28.1 Female    2018-06-29
## 20271    141888       32.8 Female    2018-05-14
## 20274    142334       45.3 Female    2018-04-20
## 20276    142633       44.0   Male    2018-05-03
## 20340    147240       60.0   Male    2018-04-26
## 20347    147293       45.1 Female    2018-04-27
## 20357    148136       25.8   Male    2018-04-20
## 20400    154216       43.8   Male    2018-05-22
## 20404    154955       23.1 Female    2018-05-25
## 20471    165808       40.3 Female    2018-06-22

Conclusion

The psychosocial team has done a commendable job in making sure that 86% of viremic clients are given support. An overall performance of 75% is a clean vote of confidence taking note of the challenges faced by the team.

A lot more can be done to raise the percentages.