Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Lack of pre-antiretroviral care and competition from traditional healers, crucial risk factors for very late initiation of antiretroviral therapy for HIV - A case-control study from eastern Uganda
Pan African Medical Journal, Volume 8, Year 2011
Notification
URL copied to clipboard!
Description
Background: Although WHO recommends starting antiretroviral treatment at a CD4 count of 350 cells/μL, many Ugandan districts still struggle with large proportions of clients initiating ART very late at CD4 <50 cells/μL. This study seeks to establish crucial risk factors for very late ART initiation in eastern Uganda. Methods: All adult HIV-infected clients on ART in Iganga who enrolled between 2005 and 2009 were eligible for this case-control study. Clients who started ART at CD4 cell count of <50 cells/μL (very late initiators) were classified as cases and 50-200 cells/μL (late initiators) as control subjects. A total of 152 cases and 202 controls were interviewed. Multivariate analyses were performed to calculate adjusted odds ratios and 95% confidence intervals. Results: Reported health system-related factors associated with very late ART initiation were stock-outs of antiretroviral drugs stock-outs (affecting 70% of the cases and none of the controls), competition from traditional/spiritual healers (AOR 7.8, 95 CI% 3.7-16.4), and lack of pre-ARV care (AOR 4.6, 95% CI: 2.3-9.3). Men were 60% more likely and subsistence farmers six times more likely (AOR 6.3, 95% CI: 3.1-13.0) to initiate ART very late. Lack of family support tripled the risk of initiating ART very late (AOR 3.3, 95% CI: 1.6-6.6). Conclusion: Policy makers should prevent ARV stock-outs though effective ARV procurement and supply chain management. New HIV clients should seek pre-ARV care for routine monitoring and determination of ART eligibility. ART services should be more affordable, accessible and userfriendly to make them more attractive than traditional healers. © Lubega Muhamadi et al.
Authors & Co-Authors
Muhamadi, Lubega
Uganda, Iganga
Iganga District Administration
Uganda, Kampala
Makerere University
Sweden, Stockholm
Karolinska Institutet
Uganda, Kampala
Makerere University School of Public Health
Uganda, Iganga
Institute of Health Sciences Busoga University
Mbona, Tumwesigye Nazarius
Uganda, Kampala
Makerere University School of Public Health
Kadobera, Daniel
Uganda, Kampala
Makerere University
Gaetano, Marrone
Sweden, Stockholm
Karolinska Institutet
Wabwire-Mangen, Fred
Uganda, Kampala
Makerere University School of Public Health
Pariyo, George William
Uganda, Kampala
Makerere University School of Public Health
Stefan, Peterson
Sweden, Stockholm
Karolinska Institutet
Sweden, Uppsala
Uppsala Universitet
Mia, Ekström Anna
Sweden, Stockholm
Karolinska Institutet
Sweden, Stockholm
Karolinska Universitetssjukhuset
Statistics
Citations: 20
Authors: 8
Affiliations: 7
Identifiers
Doi:
10.4314/pamj.v8i1.71155
ISSN:
19378688
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Case-Control Study
Study Locations
Uganda
Participants Gender
Male