Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115954

Yvonne Mulenga, Ms, Project Concern International, P.O. Box 32320, Lusaka, 10101, Zambia, 260-1256-736, yvonne@pcizambia.org.zm and Beatrice Chola, Mrs, Bwafwano Home Based Care Organization, P.O. Box 33155, Lusaka, 10101, Zambia.

Background: Direct Observed Therapy Short Course (DOTS) has proved to be a successful intervention for long therapies such as Tuberculosis (TB) treatment in poor-resource settings. Taking a cue from DOTS, a program in Zambia (where the HIV prevalence rate stands at 16%) is implementing an intervention where thousands of patients on HIV/AIDS treatment, Anti Retroviral Therapy (ART) are followed up by volunteer caregivers to ensure adherence, which if left unchecked could lead to treatment failure and drug resistance. Methods: The program trains community caregivers with a background in home-based care giving and TB DOTS in basics of ART adherence. The caregivers then supplement the work of health personnel by conducting monitoring home visits using a prescribed schedule to ensure that patients are adhering to treatment. Patients found not to be adhering are supported by the caregivers and are visited daily until they start adhering. The caregivers also refer patients with suspected side effects to the health centres and they also follow up on patients missing clinic appointments. Results: In this pilot program, from the 2552 patients registered, 90% are successfully adhering to therapy and 1058 patients who had missed clinic appointments have so far been traced and referred back to clinic where they have been put back on therapy. The caregivers have also referred 140 patients with potential side effects to the clinic. Conclusion: The integration of home based care DOTS strategies in ART programs in poor-resource settings improves both drug and clinic appointment adherence.

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