PATA REAL case submission form

PATA REAL is a quarterly webinar series for the PATA network that offers real cases that front line health providers like yourself see during routine clinical care. The objective of the webinar is to offer health providers a platform for case-based practical learning to improve paediatric and adolescent HIV service delivery. PATA REAL aims to reflect the day-to-day experiences and challenges health providers may have in case finding, testing, initiating ART, and retaining children and adolescents in care and supporting them on their treatment adherence journey to achieve viral load suppression and good health. On the webinar, we will have a panel of clinical experts who will discuss and provide expert advice on the cases presented.

If you have an interesting or difficult clinical case that you have encountered in your clinic that you would like to share with the PATA network and get the support and input from our panel of experts as well as for others to learn from your experience, please fill in the form below.

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About you

Name*
Location*
Preferred contact email*

About the case you would like to present

Include age, gender, family circumstances, disclosure status, household members living with HIV, socio-economic status, schooling/development, social engagement, safety/support network, and caregiving environment.
Describe presenting complaints, physical examination findings, opportunistic infections (OIs), or other medical conditions observed.
Provide details on when the patient was diagnosed, ART initiation date, regimen started, changes to regiment over time together with viral load and CD4 count history. This should be in this order: Date, ART Regimen, Viral Load (VL), CD4 Count, Notes.
Viral load (VL) history*
Use the table below to input viral load trends over time:
Date
ART regimen
Viral load (VL)
CD4 count
Notes
 
Summarize the medical interventions and other key lab results that may help understand history (e.g. renal function, haemoglobin, HBV status, weight, height, BMI). For medical interventions taken so far, including any treatments, procedures, or changes in management, or any additional support and referrals.

Key challenges and questions for experts

Consent*
This field is for validation purposes and should be left unchanged.