Evaluation of Adherence to Anti-Retroviral Treatment: Experience of SANRU, DRC

Lukanu Ngwala Philippe

doi:10.11648/j.cajph.20180405.11

Abstract

Access to antiretroviral treatment (ART) has substantially increased in the Democratic Republic of Congo (DRC) over the past 5 years. Santé Rural (SANRU), a non-governmental organization established by l’Eglise de Christ du Congo (Christ’s Church of the Congo) in the 1980s to improve rural health in the DRC, is one of the principal recipients of Global fund in DRC with around 40000 people living with HIV/AIDS (PLWHIV) receiving ART in 129 health zones in the country. The continuous success of ART critically depends on sustained ART adherence. The objective of this study was to identify the determinants of adherence among PLWHIV in SANRU managed health zones in the Democratic Republic of Congo. Two thousand five hundred eighty-six PLWHIV’s files were extracted. Eighty-two percent (82%) were adherent to ART, while 85. 5% were alive after 12 months on anti-retroviral treatment, 5.2% were lost from follow-up and 2.2% were transferred. The average age was 37 years, and predominantly women formed 65.5% of the sample. The median distance between facilities and patient’s habitat was 5 kms. Close to three-fifth of the PLWHIV were living in urban settings (64.4%). Among 2586 patient’s files retrieved, 2495 (96, 5%) were followed up in facilities with at least an HIV-care trained physician and nurses, 1566 (60.6%) were followed up in facilities with at least one HIV care trained pharmacist; 1645 (63.6%) among the PLWHIV did not report ART stock run-outs. These findings highlight the relevance of healthcare providers’ training on HIV to improve HIV patient outcomes.

Highlights

HIV infection is still spreading on a global scale [1]
In another study conducted in California, USA, Lukanu Ngwala Philippe et al.: Evaluation of Adherence to Anti-Retroviral Treatment: Experience of Santé Rural (SANRU), Democratic Republic of Congo (DRC)
One hundred and twenty-nine health zones were conveniently selected with those having at least 100 people living with HIV/AIDS (PLWHIV) on antiretroviral treatment (ART) and all integrated HIV care facilities with 25 or more PLWHIV on ART

Summary

Introduction

HIV infection is still spreading on a global scale [1]. As a consequence of this expansion, there has been a worldwide significant increase in the number of PLWHIV receiving ART [2, 3]. As anti-retroviral treatment becomes more readily available, the major challenge for HIV Control programs and the public sector health care practitioners will be to deliver high quality care to the patients [4]. Achieving optimal therapeutic outcomes, such as reduced viral load, reduction of drug resistance, and improved survival, require strict adherence to ART regimens [4,5,6,7,8]. The importance of adherence to ART has increased as HIV has become a chronic illness and treatment of HIV requires life-long therapy once initiated. In another study conducted in California, USA, Lukanu Ngwala Philippe et al.: Evaluation of Adherence to Anti-Retroviral Treatment: Experience of SANRU, DRC authors reported that a greater percentage of pilot than nonpilot pharmacy patients were adherent to their ART medication regimens

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