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TX PVLS

The number of ART patients with a VL result documented in the EMR within the past 12 months. If there is more than one VL result for a patient during the past 12 months, report the most recent result. Indicators include: 

  • Due for Viral load: Clients due for VL in the last 12 months- This includes clients that were alive on ART at the beginning of the reporting period, Clients initiated during the reporting period that might have dropped out of ART by the end of the reporting period. 

  • Samples Drawn: Number of samples drawn in the last 12 months 

  • Results (High > 1000 copies & Low <1000 copies). 

 


  • Beginning in Y19, this indicator moved from annual to quarterly collection. The reporting period still covers a 12-month period and may include data from the previous fiscal year (see visuals above). 

  • The report helps calculate VL coverage and VL suppression. 

EMR Implementation 

1. Patient Eligibility Criteria 

Core Requirements: 

  • Must be active on ART during the reporting period 

  • No adverse outcomes (death, transfer out, etc.) 

  • ART start date must be present 

  • Must be on ART for at least 6 months before end date 

Special Categories: 

  • Pregnant women (FP) 

  • Breastfeeding women (FBf) 

  • Patients on specific regimens (matching /P/i) 

  • New patients (<12 months on ART) 

2. Data Collection Process 

A. Initial Patient Selection 

The system executes a comprehensive query that retrieves: 

Patient Demographics 


  1. Patient ID 

  1. Age (using disaggregated_age_group function) 

  1. Gender 

  1. ARV Number 

Treatment Information 

  1. ART Start Date 

  1. Current Regimen 

  1. Treatment Status 

  1. Program State 

Monitoring Data 

  1. Latest VL Order Date 

  1. Defaulter Status 

  1. Time on ART 


B. Viral Load Results Processing 

  •  Generate temporary tables to populate TX CURR 

  • Retrieve TX CURR and 

  • Remove adverse outcomes, defaulted, started art within reporting period 

  • Get those due for VL 

  • From Those Due for VL, retrieve patient viral load 

  • Load patient in indicator 

  • Low VL 

  • High VL 

  • Sample Drawn 


3. Result Classification 

VL Categories: 

Low Viral Load: 


  • LDL (Lower than Detectable Limit) 

  • <1000 copies/mL 


High Viral Load: 


  • ≥1000 copies/mL 


Testing Reasons: 


  • Routine 

  • Targeted 


4. Performance Optimizations 

Parallel Processing 


  • Uses threading to calculate outcomes and eligibility for patients  


Temporary Tables 


  • Uses temporary tables for outcomes 

  • Implements cached reporting functionality 

Technical Considerations 

Testing Windows 


  • Standard: 12 months 

  • Special Categories: 6 months 

  • Pregnant women 

  • Breastfeeding women 

  • Special regimens 

  • New ART patients 


Data Integrity 


  • Handles missing data gracefully 

  • Validates date ranges 

  • Manages multiple VL results per patient 


Error Handling 


  • Manages null values 

  • Handles invalid dates 

  • Processes missing test results 


Dependencies 


  • ActiveRecord 

  • Parallel Processing 

  • Custom Utils Module 

  • CommonSqlQueryUtils Module 

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