Year: 2012
Type: article
Study design: Observational Study
Abstract: A weak state health infrastructure and a disparate system of rural clinics render the delivering of treatment and care of HIV/AIDS patients in sub-Saharan Africa extremely difficult. Furthermore, because patients living in remote areas do not have access to lab facilities, we developed a decentralized strategy based on bringing the needed services closer to the people, through the use of Therapeutic Mobile Units (TMU) as potentially useful means to follow up adults and children undergoing antiretroviral treatment. Using the TMU of the National Public Health Laboratory of the Cameroon Ministry of Health, we conducted several cross-sectional surveys on epidemiological, biological and clinical features of HIV/AIDS in young and elderly patients in Cameroon. The screening of HIV-specific antibodies was carried out using rapid tests. Indeterminate or positive samples were immediately retested. People diagnosed as HIV-infected were provided free biological monitoring and referred to health care centres. The TMU was also equipped with the Auto40 cytometer for CD4 determination. A FACSCalibur cytometer was used as reference method. From April 2005 to July 2011, 120 campaigns were organised in Cameroon (average of 277 volunteers tested per day). Out of 32, 970 volunteers who received a pre-test counselling, 32, 869 (20,937 males; 11,932 females) tested for HIV (acceptance rate of 99.69%). Their average age was 31 years. Amongst those, 32,569 (99.08%) received post-test counselling. The overall HIV prevalence was 6.06% [with higher rates in women, data not shown]. CD4 testing was performed using the Auto40 cytometer and gave a perfect correlation with the reference method (FASCSCalibur) [mean±SD CD4 T cell count was 1041±317 cells/ml by Auto40, and 1032±294 cells/ml by FACSCalibur; r2=0.982]. For patients receiving ART, our medical staff provided support in monitoring treatment, recording information about patient's medical status, resolving the barriers to drug adherence and others factors that may affect a patient ART therapy (data not shown). With nearly eighty percent of patients not receiving appropriate care in Sub Saharan Africa, TMU likely constitutes a useful tool in providing large scale up HIV testing, biological monitoring, treatment and care and should be integrated into national HIV control programmes.
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,900
OpenAlex ID: W2331190161