A global approach to the management of EMR (Electronic Medical Records) of patients with HIV/AIDS in Sub-Saharan Africa: the experience of DREAM Software
Open accessAbstract
Background: The DREAM Project operates within the framework of the national health systems of several sub-Saharan African countries and aims to introduce the essential components of an integrated strategy for the prevention and treatment of HIV/AIDS. The project is intended to serve as a model for a wide-ranging scale-up in the response to the epidemic. This paper aims to show DREAM's challenges and the solutions adopted. One of the solutions is the efficient management of the clinical data regarding the treatment of the patients and epidemiological analyses. Methods: Specific software for the management of the patients' EMR has been created within the DREAM programme in order to deal with the challenges deriving from the context in which DREAM operates. Setting up a computer infrastructure in health centres, providing a power supply, as well as managing the data and the project resources efficiently and reliably, are some of the questions that have been analysed in this study. Results: Over the years this software has proved that it is able to respond to the need for efficient management of the clinical data and organization of the health centres. Today it is used in 10 countries in sub-Saharan Africa by thousands of professionals and by now it has reached its fourth version. The medical files of over 73,000 assisted patients are managed by this software and the data collected with it have become essential for the epidemiological research that is carried out to improve the effectiveness of the therapy. Conclusion: Sub-Saharan Africa is the region hardest hit by HIV and AIDS in the world. However, the resources and responses adopted so far, to confront the epidemic, have at times been rather minimalist. The DREAM project has faced the battle against the epidemic by equipping itself with qualitative standards comparable to Western ones. The experience of DREAM has revealed that it is indeed possible to guarantee levels of excellence in developing countries, also in the sphere of ICT (Information and Communication Technology), thus making the intervention even more effective and contributing to bridging the digital divide.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The Millennium Development Goals Report
(2018) · Human Rights Documents online · doi:10.1163/2210-7975_hrd-9927-2015002 · Cited by 3,611 · see citing works
The World Health report 2006 1 : Working together for health 2
Guilbert, J.-J. (2006) · Education for Health · doi:10.1080/13576280600937911 · Cited by 2,657 · see citing works
The Millennium Development Goals Report 2014
United Nations, U. N. (2016) · Human Rights Documents online · doi:10.1163/2210-7975_hrd-9927-2014005 · Cited by 2,270 · see citing works
Häyrinen, K., Saranto, K., & Nykänen, P. (2008) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2007.09.001 · Cited by 1,303 · see citing works
Health information systems – past, present, future
Haux, R. (2005) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2005.08.002 · Cited by 739 · see citing works
Health information systems: Failure, success and improvisation
HEEKS, R. (2006) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2005.07.024 · Cited by 654 · see citing works
The Regenstrief Medical Record System: a quarter century experience
McDonald, C. J., Overhage, J. M., Tierney, W. M., Dexter, P. R., Martin, D., Suico, J. G., Zafar, A., Schadow, G., Blevins, L., Glazener, T. T., et al. (1999) · International Journal of Medical Informatics · doi:10.1016/s1386-5056(99)00009-x · Cited by 395 · see citing works
Cavicchi, C., & Vagnoni, E. (2006) · Journal of Cleaner Production · doi:10.1016/j.ijmedinf.2006.09.016 · Cited by 361 · see citing works
An electronic medical record system for ambulatory care of HIV-infected patients in Kenya
Siika, A. M., Rotich, J., Simiyu, C. J., Kigotho, E. M., Smith, F. E., Sidle, J. E., Wools‐Kaloustian, K., Kimaiyo, S. N., Nyandiko, W. M., Hannan, T., et al. (2005) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2005.03.002 · Cited by 115 · see citing works
Copying and pasting of examinations within the electronic medical record
Thielke, S. M., Hammond, K. W., & Helbig, S. (2006) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2006.06.004 · Cited by 100 · see citing works
Haux, R. (2006) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2006.05.045 · Cited by 86 · see citing works
e-Records in health—Preserving our future
Scott, R. E. (2006) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2006.09.007 · Cited by 81 · see citing works
Staroselsky, M., Volk, L. A., Tsurikova, R., Pizziferri, L., Lippincott, M. F., Wald, J. S., & Bates, D. W. (2005) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2005.10.004 · Cited by 76 · see citing works
Marazzi, M. C., Germano, P., Liotta, G., Guidotti, G., Loureiro, S., Gomes, A., Blazquez, M. V., Narciso, P., Perno, C. F., Mancinelli, S., et al. (2006) · HIV Medicine · doi:10.1111/j.1468-1293.2006.00386.x · Cited by 70 · see citing works
Self-citationHannan, T., Rotich, J., Odero, W., Menya, D., Esamai, F., Einterz, R. M., Sidle, J. E., Sidle, J., Smith, F. E., & Tierney, W. M. (2000) · International Journal of Medical Informatics · doi:10.1016/s1386-5056(00)00068-x · Cited by 59 · see citing works
Giuliano, M., Guidotti, G., Andreotti, M., Pirillo, M. F., Villani, P., Liotta, G., Marazzi, M. C., Mancini, M. G., Cusato, M. P., Germano, P., et al. (2006) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e31802c5441 · Cited by 53 · see citing works
Self-citationMarazzi, M. C., Bartolo, M., Gialloreti, L. E., Germano, P., Guidotti, G., Liotta, G., Lio, M. M. S., Mancinelli, S., Modolo, M. A., Narciso, P., et al. (2005) · Health Education Research · doi:10.1093/her/cyh039 · Cited by 29 · see citing works
Self-citationPediatric highly active antiretroviral therapy in Mozambique: an integrated model of care.
Marazzi, M. C., Germano, P., Liotta, G., Buonomo, E., Guidotti, G., & Palombi, L. (2006) · PubMed · Cited by 22 · see citing works
Self-citationMarazzi, M. C., Germano, P., Liotta, G., Guidotti, G., Loureiro, S., Gomes, A., Blazquez, M. V., Narciso, P., Perno, C. F., Mancinelli, S., et al. (2007) · European Journal of Pediatrics · doi:10.1007/s00431-006-0405-8 · Cited by 21 · see citing works
Self-citationThe guideline of the personal health data structure to secure safety healthcare
Ishikawa, K., Ohmichi, H., Umesato, Y., Terasaki, H., Tsukuma, H., Iwata, N., Tanaka, T., Kawamura, A., Sakata, K., Sainohara, T., et al. (2007) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2006.09.005 · Cited by 19 · see citing works
Building a reference functional model for EHR systems
Sumita, Y., Takata, M., Ishitsuka, K., Tominaga, Y., & Ohe, K. (2006) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2006.06.008 · Cited by 18 · see citing works
Flagged first, then by citations
Research works printed but not linked: 8
- Marazzi MC Magnano San Lio M Carbini R Germano P Guidotti G Mancinelli S Modolo MA Renzi E Brizziarelli L Improving adherence to highly active antiretroviral therapy (HAART) in Africa: results from the DREAM program in Mozambique Proceedings of the 7th IUHPE European Conference on Health Promotion and Health Education: 18-21 october 2006; Budapest 64
- Pelletier C Chaussalet T Szirbik N Vasilakis C Integration of data on long-term care from heterogeneous sources for research purposes Proceedings of the MEDICON'04: Ischia, Italy 2004
- Giuliano M Guidotti G Andreotti M Liotta G Cusato M Marazzi MC Loureiro S Regazzi M Palombi L Vella S Triple therapy during pregnancy and after delivery significantly reduces breast-milk viral load: a sub-study of the DREAM program [abstract] Proceedings of the 13th Conference on Retrovirus and Opportunistic Infections (CROI): 5-9 February 2006; Denver Abstractbookp. 313 n° 727
- Palombi L Germano P Liotta G Guidotti G Ceffa S Narciso P Perno CF Bartolo M Mancinelli S Marazzi MC DREAM Program: six-months follow up of the Prevention of Mother-to Child Transmission Public Health Program (PMTCT) [abstract] Proceedings of the 13th Conference on Retrovirus and Opportunistic Infections (CROI): 5-9 February 2006; Denver Abstractbookp 311n° 723
- Marazzi MC Germano P Guidotti G Bartolo M Loureiro S Liotta G Narciso P Perno CF Bestagini P Palombi L Impact of HAART administration during pregnancy and breastfeeding on vertical transmission in sub-Saharan Africa: results from the DREAM cohort [abstract] Proceedings of the XVI International AIDS Conference: 13-18 August 2006; Toronto
- Liotta G Germano P Palombi L Buonomo E Scarcella P Magnano San Lio M Narciso P Perno CF Abdul Magid N Marazzi MC Pediatric HAART in resource-limited settings: the DREAM model of care [abstract] Proceedings of the XVI International AIDS Conference: 13-18 August 2006; Toronto
- Palombi L Liotta G Guidotti G Perno CF Lourerio S Germano P Marazzi MC CD4 cell count guided HAART interruption: is it a reliable strategy In Resource-Limited Settings? The DREAM experience [abstract] Proceedings of the XVI International AIDS Conference: 13-18 August 2006; Toronto
- Palombi L Lotta G Mancinelli S Scarcella P Germano P Marazzi MC La prevenzione della trasmissione materno-infantile dell'infezione da HIV: l'esperienza del programma DREAM Proceedings of the 42° Congresso Nazionale SITI: 27-30 ottobre 2006; Catania
Cited by
Sorted by citations
Piette, J., Lun, K., Moura, L., Fraser, H., Mechael, P., Powell, J., & Khoja, S. (2012) · Bulletin of the World Health Organization · doi:10.2471/blt.11.099069 · Cited by 188 · see citing works
Use of Electronic Health Records in sub-Saharan Africa: Progress and challenges.
Akanbi, M. O., Ocheke, A. N., Agaba, P. A., Daniyam, C. A., Agaba, E. I., Okeke, E. N., & Ukoli, C. O. (2012) · PubMed · Cited by 133 · see citing works
Benefits and challenges of EMR implementations in low resource settings: a state-of-the-art review
Jawhari, B., Ludwick, D., Keenan, L., Zakus, D., & Hayward, R. (2016) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-016-0354-8 · Cited by 106 · see citing works
Ali, M. K., Shah, S., & Tandon, N. (2011) · Journal of Diabetes Science and Technology · doi:10.1177/193229681100500310 · Cited by 67 · see citing works
Chaplin, B., Meloni, S., Eisen, G., Jolayemi, T., Banigbe, B., Adeola, J., Wen, C., Reyes Nieva, H., Chang, C., Okonkwo, P., et al. (2015) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2014.09.006 · Cited by 61 · see citing works
Matheson, A. I., Baseman, J. G., Wagner, S. H., O’Malley, G., Puttkammer, N. H., Emmanuel, E., Zamor, G., Frédéric, R., Coq, N. R. L., & Lober, W. B. (2012) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2012.01.011 · Cited by 48 · see citing works
Liotta, G., Mancinelli, S., Nielsen‐Saines, K., Gennaro, E., Scarcella, P., Magid, N. A., Germano, P., Jere, H., Guidotti, G., Buonomo, E., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0071653 · Cited by 47 · see citing works
Self-citationMillard, P. S., Bru, J., & Berger, C. A. (2012) · BMJ Open · doi:10.1136/bmjopen-2011-000690 · Cited by 35 · see citing works
Kavuma, M. (2018) · JMIR Human Factors · doi:10.2196/humanfactors.9317 · Cited by 35 · see citing works
Food Security in the Context of HIV: Towards Harmonized Definitions and Indicators
Anema, A., Fielden, S. J., Castleman, T., Grede, N., Heap, A. N., & Bloem, M. W. (2013) · AIDS and Behavior · doi:10.1007/s10461-013-0659-x · Cited by 33 · see citing works
Marazzi, M. C., Luca, S. D., Palombi, L., Scarcella, P., Ciccacci, F., Ceffa, S., Nielsen‐Saines, K., Luca, A. D., Mancinelli, S., Gennaro, E., et al. (2013) · The Pediatric Infectious Disease Journal · doi:10.1097/inf.0b013e3182a0994b · Cited by 31 · see citing works
Self-citationLiotta, G., Marazzi, M. C., Mothibi, K., Zimba, I., AMANGOUA, E. S., Kuni, E. B., Bossiky, B., Robinson, P., Scarcella, P., Musokotwane, K., et al. (2015) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph121013224 · Cited by 28 · see citing works
Self-citationLiang, L., Wiens, M. O., Lubega, P., Spillman, I., & Mugisha, S. (2018) · JMIR Formative Research · doi:10.2196/formative.9658 · Cited by 24 · see citing works
Mohamed, K. G., Hunskaar, S., Abdelrahman, S. H., & Malik, E. M. (2015) · International Journal of Family Medicine · doi:10.1155/2015/716426 · Cited by 19 · see citing works
Buonomo, E., Luca, S. D., Tembo, D., Scarcella, P., Germano, P., Altan, A. M. D., Palombi, L., Liotta, G., Nielsen‐Saines, K., Erba, F., et al. (2012) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph9020421 · Cited by 15 · see citing works
Self-citationMweebo, K. (2014) · Australasian Journal of Paramedicine · doi:10.4225/75/5798297631b47 · Cited by 11 · see citing works
Orlando, S., Palla, I., Ciccacci, F., Triulzi, I., Thole, D., Sangaré, H. M., Marazzi, M. C., Nielsen‐Saines, K., Turchetti, G., & Palombi, L. (2020) · JMIR Research Protocols · doi:10.2196/19384 · Cited by 10 · see citing works
Self-citationA Markov Chain Based Model to Predict HIV/AIDS Epidemiological Trends
Nucita, A., Bernava, G. M., Giglio, P., Peroni, M., Bartolo, M., Orlando, S., Marazzi, M. C., & Palombi, L. (2013) · Lecture notes in computer science · doi:10.1007/978-3-642-41366-7_19 · Cited by 10 · see citing works
Self-citationSIDATRAT: informatics to improve HIV/AIDS care
Aragonés, C., Campos, J., Pérez, D., Martínez, A. R., & Pérez, J. (2012) · MEDICC Review · doi:10.1590/s1555-79602012000400002 · Cited by 8 · see citing works
Pry, J. M., Vinikoor, M. J., Bolton‐Moore, C., Roy, M., Mody, A., Sikazwe, I. T., Sharma, A., Chihota, B., Duran‐Frigola, M., Daultrey, H. E., et al. (2022) · PLOS Global Public Health · doi:10.1371/journal.pgph.0000124 · Cited by 8 · see citing works
International dimensions of clinical decision support systems
Magrabi, F., Cresswell, K. M., & Fraser, H. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-91200-6.00013-9 · Cited by 6 · see citing works
Liotta, G., Mancinelli, S., Nielsen‐Saines, K., Gennaro, E., Scarcella, P., Magid, N. A., Germano, P., Jere, H., Guidotti, G., Buonomo, E., et al. (2013) · PLoS ONE · doi:10.1371/annotation/9ab4708e-650e-411a-b72f-bb85e0845469 · Cited by 6 · see citing works
Self-citationTetteh, G. K. (2014) · Journal of health informatics in developing countries · Cited by 5 · see citing works
International Dimensions of Clinical Decision Support
Fraser, H., & Wyatt, J. C. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-398476-0.00008-7 · Cited by 4 · see citing works
SIDATRAT: Informatics to Improve HIV/AIDS Care
(2012) · MEDICC Review · doi:10.37757/mr2012v14.n4.3 · Cited by 2 · see citing works
Bartolo, M., & Nucita, A. (2013) · IGI Global eBooks · doi:10.4018/978-1-4666-2979-0.ch006 · Cited by 1 · see citing works
Self-citationCloudStudy: A cloud-based system for supporting multi-centre studies
Tsafara, A., Tryfonopoulos, C., & Skiadopoulos, S. (2013) · IEEE International Conference on Bioinformatics and Bioengineering (BIBE) · doi:10.1109/bibe.2013.6701549 · Cited by 1 · see citing works
Peroni, M., & Ismael, F. (2018) · TELe-Health · doi:10.1007/978-3-319-72763-9_4 · Cited by 1 · see citing works
Self-citationJawhari, B. (2016) · ERA: Education and Research Archive (University of Alberta) · doi:10.7939/r34t6fb4f · Cited by 1 · see citing works
Gadabu, O. J. (2013) · Unisa Institutional Repository (University of South Africa) · Cited by 1 · see citing works
Benefits and challenges of EMR implementations in low resource settings: a state-of-the-art review
Jawhari, B., Ludwick, D., Keenan, L., Zakus, D., & Hayward, R. S. (2021) · doi:10.32920/14637135 · Cited by 1 · see citing works
Cloud-Based Data and Knowledge Management for Multi-Centre Biomedical Studies
Tsafara, A., Tryfonopoulos, C., Skiadopoulos, S., & Zervakis, L. (2015) · International Conference on Knowledge Capture · doi:10.1145/2815833.2816949
Assessment of Electronic Medical Record Applications: An Overview for Powerful EMR Estimation
Kemkar, O. S., & Kalode, P. (2015) · International Journal of Innovative Research in Computer and Communication Engineering · doi:10.15680/ijircce.2015.0301010
Giglio, P., & Bartolo, M. (2018) · TELe-Health · doi:10.1007/978-3-319-72763-9_6
Self-citationMonitoring, Evaluation, and Quality Improvement in Global Health
Mukherjee, J. S. (2021) · doi:10.1093/oso/9780197607251.003.0011
Benefits and challenges of EMR implementations in low resource settings: a state-of-the-art review
Jawhari, B., Ludwick, D., Keenan, L., Zakus, D., & Hayward, R. S. (2021) · doi:10.32920/14637135.v1
Multispecialist Teleconsultation
Bartolo, M., & Ferrari, F. (2018) · TELe-Health · doi:10.1007/978-3-319-72763-9_9
Self-citationBenefits and challenges of EMR implementations in low resource settings: a state-of-the-art review
Jawhari, B., Ludwick, D., Keenan, L., Zakus, D., & Hayward, R. S. (2022) · doi:10.32920/14637135.v2
Mudogo, C. M., Mulwa, A. S., & Kyalo, D. N. (2025) · The Electronic Journal of Information Systems in Developing Countries · doi:10.1002/isd2.70019
- Authors
- Nucita, A., Bernava, G. M., Bartolo, M., Masi, F. D. P., Giglio, P., Peroni, M., Pizzimenti, G., & Palombi, L.
- Affiliations
- University of Messina (IT)
- Azienda Ospedaliera San Giovanni Addolorata (IT)
- University of Rome Tor Vergata (IT)
- Corresponding author
- Palombi, Leonardo
- Venue
- BMC Medical Informatics and Decision Making
- Published
- 2009-09-11
- Volume
- 9
- Issue
- 1
- Pages
- 42-42
- ISSN
- 1472-6947 (ISSN-L)
- PMC
- PMC2749819
- OpenAlex
- W2051603623
- Cited by
- 40
- References
- 21
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 2 · 2018: 5 · 2016: 2 · 2015: 4 · 2014: 4 · 2013: 8 · 2012: 7
- FWCI
- 5.64
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medical Informatics and Decision Making (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- electronic health records, HIV/AIDS, DREAM project, clinical data management, health information systems, sub-Saharan Africa, health centers, disease surveillance, digital divide, HIV treatment
- MeSH terms
- Computer Systems, HIV Seropositivity, Humans, International Cooperation, Software, Medical Records Systems, Computerized, Africa South of the Sahara
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review