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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Evaluation of antiretroviral therapy results in a resource-poor setting in Blantyre, Malawi
Tropical Medicine and International Health, Volume 10, No. 5, Year 2005
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Description
OBJECTIVE: To evaluate treatment results of the paying antiretroviral therapy (ART) clinic of Queen Elizabeth Central Hospital, a large public and teaching hospital in Blantyre, Malawi. The only ART was a fixed drug combination of stavudine, lamivudine and nevirapine. METHODS: Cross sectional study with interviews, laboratory tests (CD4 count, viral load, nevirapine plasma levels, transaminases) and data extraction from files. RESULTS: A total of 422 (59%) of the patients who started ART since 2000 were lost to follow-up. The 176 patients enrolled in the study had good virological and excellent clinical treatment results. The most common side effect was peripheral neuropathy. Nevirapine plasma levels were remarkably high and associated with successful virological treatment results. Two simple adherence questions pertaining to the use of medication in the previous 8 days corresponded well with nevirapine levels. The most important reasons for non-adherence were shortage of drugs in the hospital pharmacy and personal financial constraints. CONCLUSIONS: (1) Many patients were lost to follow-up. (2) High nevirapine levels contributed to good therapy results in those studied. (3) Simple adherence questions predicted subtherapeutic nevirapine levels. (4) Antiretroviral drug supply needs to be uninterrupted and free of charge, to prevent avoidable non-adherence. © 2005 Blackwell Publishing Ltd.
Authors & Co-Authors
van Oosterhout, Joep J.G.
Malawi, Zomba
University of Malawi
Bodasing, Neena
Malawi, Zomba
University of Malawi
United Kingdom, Stoke-on-trent
Royal Stoke University Hospital
Kumwenda, Johnstone J.
Malawi, Zomba
University of Malawi
Nyirenda, Cooper M.
Malawi, Zomba
University of Malawi
Malawi, Blantyre
Queen Elizabeth Central Hospital Malawi
Mallewa, Jane E.
Malawi, Zomba
University of Malawi
Malawi, Blantyre
Queen Elizabeth Central Hospital Malawi
Cleary, Paul
Malawi, Zomba
University of Malawi
United Kingdom, Warrington
Dental Services Warrington Pct
de Baar, Michel P.
Netherlands, Amsterdam
Primagen
Schuurman, Rob J.
Netherlands, Utrecht
University Medical Center Utrecht
Burger, David M.
Netherlands, Nijmegen
Radboud University Medical Center
Zijlstra, Eduard Evert
Malawi, Zomba
University of Malawi
Statistics
Citations: 164
Authors: 10
Affiliations: 7
Identifiers
Doi:
10.1111/j.1365-3156.2005.01409.x
ISSN:
13602276
Research Areas
Health System And Policy
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Systematic review
Study Locations
Malawi