The clinic-biological progress of patients on ARV under D.O.T
© Lyli et al; licensee BioMed Central Ltd. 2009
Published: 24 September 2009
Context and justification
• Cameroon is a Central African country of limited resources with about 16 M inhabitants in 10 administrative regions
• Surface area: 475 000 km2
• Prevalence: 5,5% EDSIII 2004
• PNLS .... Decentralisation (CTA, CTAFF, UPEC)
• Representing about 1/4 of the total surface area of Cameroon, the East Region is under populated, with a total population of about 945 000 h. This gives a population density of about 3 per km2. It has one CTA and 8 UPECS of which only 5 are functional. At 8,6% it has the second highest national prevalence rate of HIV in the Country.
• There are 14 landlocked health districts having as a distance unit, 100 km to undertake in about 4 to 6 hours depending on the season, which leads to the most recurrent reason given by patients to justify their poor observance of treatment.
• Resolution: D.O.T initiative
• Ameliorate the observance of patients on ARV who live far from the care units and whom distance leads to poor appointment observance and follow up of ARV and O.I.D
A - Role of sites
• Massive sensibilisation and screening for the recruitment of HIV+ patients
• Choosing patients belonging to associations
• Collection of samples to be analyzed at the appropriate CTA
• Transportation of patients eligible for ARVT to the CTA for evaluation and inclusion in the study
• Weekly sharing of ARV and O.I.D
B - Role of the tutor CTA
• Receiving and analyzing samples for PTW
• Clinical evaluation of patients for eligibility and treatment of ARV according to the national directives.
• Making available Hospital Unit of ARV and MIO
• Clinical and biological follow up every 6 months
• Collection and analysis of data
• Networking the CTA and these Hospital Unit for eventual problems
• All the peripheral patients on D.O.T did their two bi-annual workups expected during the period of study.
• No patient on D.O.T missed his appointment for supplies of ARV or drugs for prophylaxis of O.I
• No patient on D.O.T on ARVT had an O.I during the period of the study
• Total weight gain of patient on D.O.T was between 5 to 15 kg.
• The global management of PLHIV is a team and harmonious problem
The patient himself and his surroundings
To the health personnel
• The team of the tutor CTA involved in the study;
• Mme Bithé Veronica, Mme Sembong Valérie, Mme Nanga Aicha
• The Catholic Health Center team of Doume , more especially sister Isabella Krauss and Fr Faiseandier
• The Garoua-Boulai team (Dr Solofo and his community agents)
• The Doume DH team ( Dr Bayiha and his collaborators)
• The Doumbi Catholic Center team, especially Sister Louise SAAR.
This article is published under license to BioMed Central Ltd.