Tanzania – 3rd National Multisectoral Aids Conference in Tanzania
Tanzania – Arusha, 18-21 decembre 2006
ABSTRACT
Improving Adherence in HIV/Aids patients: Results from Dream programme
Erba F.* Moscatelli C.* Bartolo M.* Guidotti G.* Giglio P.* Wenderlein D.* E.Y.Mpuya**; King’ori N***.; Msuya A.****; Palombi L.
* Community sf Sant’Egidio – Italy; **RMO Iringa; *** RMO Arusha; **** DMO Arumeru (Arusha)
Objective: Ensuring high levels of adherence to highly active anti-retroviral therapy (HAART) is a priority in treating people living with AIDS.
Methods: The DREAM program (Drug Resources Enhancement against AIDS and Malnutrition), designed and run by the Community of Sant’Egidio, an international faith-based organization aims to implement HAART in sub-Saharan Africa.
DREAM also includes health education, nutritional supplementation, and advanced diagnostic support.
Everything is free-of-charge. We analyzed a cohort of 358 HIV+ patients enrolled in the new DREAM Center of Arusha, Usariver Dispensary and Iringa Town, Allamano Centre. 223 (62,2%) out of 358 patients have already started HAART. Each patient goes to the health centers for a number of different procedures: medical examinations, drugs supply, blood samples collection, food integration, medications, and check-ups.
Missing any of these appointments clearly reduces adherence in terms of drug consumption, and diagnostic and monitoring. For this reason we have assessed adherence by measuring the rate of patients’ prescribed/kept appointments:
Results: We controlled the behavior of the cohort in 7.030 prescribed accesses to the centers. The overall ratio of prescribed/kept appointments was very high: 93,2%, showing a good attitude among the population as regards following protocols and procedures. Analytical data of drug supply was highest at 98,5%. Similar values were recorded for examinations and food integration appointments (90,3% – 97,5%). As expected, there was less attendance for appointments for blood sampling, with a ratio of 91,1%. In any case, this difference was not statically significant.
The percentage of executed appointments (executed appointments rate) was 97,6% and 89,3% for the Arusha and Iringa cohorts respectively. The missed appointment rate displays a somewhat different trend in the two cohorts.
Conclusion: Overall patient adherence showed good results and a high degree of fidelity among both cohorts. The results are fully comparable with those obtained in High Resource Countries. Negative social and economic factors as well as a lack of infrastructure do not make the administration of HAART in Tanzania impossible. However, more effort to increase the capacity of the population to access the centers, especially in rural environments, would significantly improve adherence.