Epidemiology and molecular monitoring of HIV drug resistance in Tanzania.
The prognosis of HIV/AIDS has dramatically changed after the introduction of potent anti-retroviral therapy in the mid 90’s with a more than 80 percent decrease of mortality and morbidity where anti-retroviral therapy (ART) is available. Most of the data about the out-come of patients living with HIV/AIDS (PLWHAs) under ART are generated by cohort studies in developed countries. Since 2004 the Tanzanian National HIV/AIDS Control and Treatment Plan (NACP) provides ART in Tanzania. The Chronic Diseases Clinic in Ifakara (CDCCI) at the St. Francis Designated District Hospital (SFDDH) is on of the first rural clinics accredited by and implementing the aims of NACP since May 2005. Until mid September 2008 3,003 PLWHAs were included in the NACP and 1,677 started with ART at CDCI. To our knowledge, studies on the outcome of PLWHAs cared for in rural Sub-Saharan Africa are scarce.
The Kilombero-Ulanga-Anti-Retroviral-Cohort (KUILARCO) intents to generate data on clinical out-come, behavior changes, social conditions, and adherence to ART of PLWHAs attending CDCI and thereby to fill the gap of our knowledge about the impact of the availability of ART in rural Tanzania. Based on the successful start of the cohort at CDCI of SFDHH in Ifakara, the intention is to extend the study to other sites of the Ifakara Health Institute (IHI) namely the sites in Bagamoyo, Dar es Salaam and Rufiji and to share the gained knowledge to the benefit of a more extended population of PLWHAs of the United Republic of Tanzania.
The goal of this project is to collect data on treatment outcomes of PLWHAs undert ART and adherence of ART treated at CDCI at SFDDH district level-according the NACP guidelines. In a first phase these parameters are analyzed at CDCI of SFDDH. In a second phase, the gained experience of CDCI- as one of the first and largest rural competence centres – will be made available and implemented at health care facilities in Bagamoyo, Dar es Salaam, Rufiji and other settings.