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Tanzania Journal of Health Research
Health User's Trust Fund (HRUTF)
ISSN: 1821-6404
Vol. 13, No. 3, 2011, pp. 1-12
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Bioline Code: th11031
Full paper language: English
Document type: Research Article
Document available free of charge
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Tanzania Journal of Health Research, Vol. 13, No. 3, 2011, pp. 1-12
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Management of HIV and AIDS at lower primary health care facility in Chalinze, eastern Tanzania
IDINDILI, BONIPHACE; JULLU, BONIFACE; MUGUSI, FERDNAND M. & TANNER, MARCEL
Abstract
Implementation of Antiretroviral Therapy (ART) services at health centres in Tanzania were
delayed due to several reasons including shortage of qualified staff, inadequate infrastructure and
logistics problems. However, patients from peripheral areas experienced difficulties in accessing ART
services due to long distances from clinics. National AIDS Control Programme (NACP) and Non-
Governmental Organizations (NGOs) embarked on ART services scale-up programme aimed at
improved ART availability and accessibility. Through this programme ART services were established at
health centres and selected dispensaries. However, no previous documented experiences existed at
country level to guide provision of services. Therefore, this study was designed to gather experiences and
share lessons learnt with other health care providers and programme implementing partners. This was a
descriptive cross-sectional study involved patients enrolled to ART services between May 2007 and April
2009. Data collection involved observation of health providers’ performance and retrospective ART and
care patients’ registers review. During the study period, 611 care and 284 ART patients were attended.
Majority of patients (85.1%; 762/895) were adults aged 25-45 years. In total 61.5% (550/895) of the patients
had CD4+T lymphocytes ≤350/μl the cut-off point for initiating ART. The frequency of symptoms was
noted to significantly decrease with increasing CD4 counts (P<0.001). Numbness, parotid enlargement
and genital discharge were not related to patient level of CD4+T-lymphocytes counts. Papular pruritic
eruptions 98/282 (34.8%), tuberculosis 86/282 (30.5%) and oesophageal candidiasis 37/282 (13.1) were the
most diagnosed AIDS defining illnesses. Sixteen patients on care died and 30 were lost to follow up.
Overall the clinical management was poorly performed. ART services can successively be provided at
health centre level and encourages HIV-infected persons to seek care. However, clinicians need regular
clinical mentorship and supportive supervision.
Keywords
HIV; AIDS; ART; management; health centre; Tanzania
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© Tanzania Journal of Health Research
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