Abstract
Better quality of services is essential for the sustainability of HIV programs, in particular in rural Sub-Saharan Africa, to support the increasing number of individuals treated with combination antiretroviral therapy (cART). However, longitudinal data from rural care and treatment centers (CTC) are scarce. The objective was to assess trend in quality of care for HIV infected persons before start of combination antiretroviral therapy (pre-ART). A retrospective analysis of pre-ART registers and patient's files of 1950 patients enrolled in the Bagamoyo CTC in Tanzania between 2008 and 2010 analyzing was conducted; with parameters including year of enrollment, gender, age, CD4 cell count and WHO clinical stage at time enrollment. We noted a significant increase by 20% of total patients who had CD4 cell count performed from 69% (n=457) in 2008, 83% (n=493) 2009 to 89% (n=616) 2010 (X2= 87.014, P2= 14.945, P2= 85.028, P3. Efforts must be undertaken for more HIV testing and timely referral of HIV-infected patients to CTC.
Highlights
HIV is a major public health challenge worldwide, in particular in Sub-Saharan Africa [1]
We investigated the trend of quality of services offered to enrollees in Bagamoyo Care and Treatment Centers (CTC) by looking at documentation of various baseline parameters recommended by the National guideline including demographic information, year of enrollment, CD4 cell count and World Health Organization (WHO) clinical stage
Patients included those who primarily attended Bagamoyo CTC either for treatment or voluntary counseling and testing for HIV as well as those referred from various sections within Bagamoyo hospital (Reproductive and child health, Outpatient, Inpatients, Home based care) and people living with HIV/AIDS. 30 patients were excluded from analysis because they were either referred from other CTCs or their records missed demographic information such as gender, age or date of birth because they were not documented at the time of enrolment
Summary
HIV is a major public health challenge worldwide, in particular in Sub-Saharan Africa [1]. Scaling up is significant in sub-Saharan Africa where more than 5 million individuals are treated with cART as reported by the WHO [2]. Many HIV-programs had to be installed very rapidly with no adequate preparation, compromise programs as a result information collected may not be of high quality. A study from 15 resource limited countries showed that quality of the data collected in treatment programs are often unsatisfactory mainly because of insufficient or in adequately trained staffs [3]. Still many HIV-infected individuals are referred to Care and Treatment Centers (CTC) late in their HIV disease [4] and that data on their admission characteristics especially from rural CTC are scarce
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