Abstract
In 2009, basic care packages (BCP) containing health products were distributed to HIV-infected persons in Ethiopia who were clients of antiretroviral therapy clinics. To measure health impact, we enrolled clients from an intervention hospital and comparison hospital, and then conducted a baseline survey, and 7 bi-weekly home visits. We enrolled 405 intervention group clients and 344 comparison clients. Intervention clients were more likely than comparison clients to have detectable chlorine in stored water (40% vs. 1%, p<0.001), soap (51% vs. 36%, p<0.001), and a BCP water container (65% vs. 0%, p<0.001) at every home visit. Intervention clients were less likely than comparison clients to report illness (44% vs. 67%, p<0.001) or health facility visits for illness (74% vs. 95%, p<0.001), and had lower median illness scores (1.0 vs. 3.0, p<0.05). Participation in the BCP program appeared to improve reported health outcomes.
Highlights
Diarrhea and other opportunistic infections are important causes of morbidity and mortality among people living with HIV/ AIDS (PLHIV) [1,2,3,4,5]
Findings of this study, which was the first to attempt to ascertain the health impact of a program to provide basic care packages (BCP) to PLHIV, suggested that recipients of the BCP were likely to have a lower illness score derived from self-reported illnesses, health facility visits, and hospitalizations than PLHIV who did not receive the BCP
Rates of reported diarrheal illness, and health facility visits or hospitalizations for diarrhea among intervention clients were lower than in comparison clients, but disease rates were too low to provide the power to conclude that the differences were statistically significant
Summary
Diarrhea and other opportunistic infections are important causes of morbidity and mortality among people living with HIV/ AIDS (PLHIV) [1,2,3,4,5]. The US President’s Emergency Plan for AIDS Relief (PEPFAR) authorizes use of program funds to procure and distribute proven health interventions (e.g., insecticide treated bednets, condoms, household water treatment products, soap) as part of HIV care and support programs [16]. Among the interventions shown to reduce the risk of diarrhea in PLHIV is household water treatment using a locally produced sodium hypochlorite solution and safe water storage using a narrow-mouth container with tap [5,7]. In June 2009, with PEPFAR funding provided though the United States Agency for International Development (USAID) program, the Ministry of Health of Ethiopia and Population Services International (PSI) began a program to distribute basic preventive care packages (BCPs) [18,19] to HIV-infected persons receiving antiretroviral therapy (ART). All products contained in the BCP, except for the water storage container, were available on the market in Ethiopia before the BCP program began
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