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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Results of a community-based antiretroviral treatment program for HIV-1 infection in western Uganda
Current HIV Research, Volume 8, No. 2, Year 2010
Notification
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Description
Objective: To compare the treatment outcomes and mortality in a rural community-based ART (CBART) program with a hospital-based ART program in the same district. Methods: The study design was a non-randomized cohort study consisting of 185 persons living with HIV (PLWHIV) in the CBART cohort and 200 PLWHIV in the hospital cohort. Eligibility for both cohorts was: being HIV-infected and eligible for ART, being treatment naïve, age 18 years or older, and being a resident of Rwimi sub-county. The intervention consisted of a community-based program which included weekly home visits to patients by trained volunteers who delivered antiretroviral drugs (ARVs), monitored and supported adherence to treatment, and identified and reported adverse reactions and other clinical symptoms. Outcome variables were compared to patients in a hospital-based cohort who received the standard care delivered to all other HIV patients in the hospital. The main outcome measures were HIV-1 RNA viral load (VL), CD4 cell count and mortality after six months of treatment. Results: Successful ART treatment outcome as measured by virological suppression (VL<400 copies/ml) in the CBART cohort was similar to those in the hospital-based cohort (90.1% vs 89.3%, p=0.47). The median CD4 cell count increased significantly in both cohorts (community-based cohort 159 cells/μl vs 145 cells/μl in the hospital-based cohort). Mortality was not significantly different in both cohorts (community-based cohort 11.9%, hospital-based cohort 9.0%). Conclusion: The findings show that outcomes of a CBART intervention in a rural area compare favorably to outcomes of hospital-based care. If the study results are sustainable over a longer time period, this model could be considered for ART roll-out to impoverished rural/remote populations in Uganda and elsewhere. © 2010 Bentham Science Publishers Ltd.
Authors & Co-Authors
Kipp, Walter Eigen
Canada, Edmonton
University of Alberta
Konde-Lule, Joseph K.
Uganda, Kampala
Makerere University
Saunders, Leslie Duncan
Canada, Edmonton
University of Alberta
Alibhai, Arif A.
Canada, Edmonton
University of Alberta
Houston, Stan C.
Canada, Edmonton
University of Alberta
Rubaale, Tom K.
Uganda
Kabarole Health Department
Senthilselvan, Ambikaipakan
Canada, Edmonton
University of Alberta
Okech-Ojony, Joa
Uganda
Kabarole Health Department
Kiweewa, Francis
Uganda, Gulu
Joint Clinical Research Centre
Statistics
Citations: 43
Authors: 9
Affiliations: 4
Identifiers
Doi:
10.2174/157016210790442722
ISSN:
1570162X
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Randomised Control Trial
Cohort Study
Quasi Experimental Study
Study Approach
Quantitative
Study Locations
Uganda