Determination of commonly reported side effects and their management among HTV patients receiving antiretroviral drugs in Dar es Salaam region

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University of Dar es Salaam
The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) pandemic poses one of the greatest challenges to global public health. Sub Saharan Africa is the world’s most severely affected region. There were an estimated 34-46 million people living with HIV/AIDS globally in 2003. Two thirds of the global total number of people living with HIV/AIDS live in Africa. Tanzania is one of the countries affected severely by HTV/ AIDS epidemic in sub-Sahara African countries. According to the World Health Organization (WHO), it was estimated that there were 1,810,000 people living with HIV in mainland Tanzania in the year 2003. The introduction of HAART in developed countries has resulted in dramatic reduction in AIDS related morbidity and mortality among people living with HIV. However, ARV drugs are complicated and difficult for patients to follow as they can have serious side effects. Increased experience with HAART has led to detection of drug toxicities that may compromise adherence and necessitate discontinuation of treatment and alteration of effective regimens. In Tanzania, the experience with ART is very limited as there is yet no information that have been documented on patients’ experience in terms of side effects A cross sectional study was conducted in Dar es Salaam region in the three district hospital of Mwananyamala, Temeke and Amana to determine the commonly reported side effects and their management among HIV patient receiving ARV drugs. The study population involved a sample of 400 adults HIV outpatients on ARV drugs and 40 health care workers working in HIV clinics in the three district hospitals. A questionnaire consisting of open and closed ended questions was used to collect data. All HIV patients on ARV drugs and heath care workers were interviewed. Other information was collected from patient’s record forms using a checklist. Data were processed and analyzed using computer software programme Epi Info version 6. Data were analyzed by examination of distributions of frequencies of respondents’ characteristics and variables, followed by examination of strength of association of dependent and independents variables using chi-squared test for contingency tables. Results of this study revealed that the types of ARV drugs used by patients were based on standard treatment guideline. All types were first line drug regimens; however, second line drug regimens are not yet available. About 36% of HIV Patients on ARV drugs had experienced side effects. About 16% of patients experienced mild and moderate GIT side effects such as abdominal discomfort, nausea and vomiting. About 11% experienced mild moderate and severe hypersensitivity reactions presented by skin rashes, itching, and skin exfoliation. About 11% experienced peripheral neuropathy. Eighty percents of patients experienced mild and moderate CNS problems such as dizziness, insomnia nightmares. About 4% patients experienced mild and severe anemia. Few patients 5% experienced moderate and severe liver problems presented by elevation of liver enzymes and jaundice. About 5% experienced other side effects such as high fever, lipodistrophy, swelling of face and limbs, pigmentation of nails, ear problems and chest tightening. Exactly 10% of patients, who had experienced side effects, had changed their ARV drug regimen. More than 67% of patients were aware of side effects associated with ARV drugs. Most health workers were aware on management of HIV patients. This study recommends that MOH should make deliberate efforts to ensure that second line drugs are also available for alternative drugs in cases of severe side effects. Monitoring of HIV patients on ARV drugs should be improved in general for early detection of side effects and regular training should be conducted to raise health care workers’ awareness on management of HTV patients. Further studies should be conducted to investigate long term and complicated side effects, treatment failure due to drug resistance as reasons for changing ARV drugs.
Available in printed form, East Africana Collection, Dr. Wilbert Chagula Library, Class mark (THS EAF RA644.A25T34M59)
Dar es Salaam region, AIDS (Diseases), Retrovirus
Mlelwa, L. (2005) Determination of commonly reported side effects and their management among HTV patients receiving antiretroviral drugs in Dar es Salaam region.Master dissertation, University of Dar es Salaam. Dar es Salaam.