Dosis® är en digital doseringsask från Victrix AB som med hjälp av en inbyggd datorenhet kan ställas in för att påminna patienter om doseringstillfällen genom alarm, röstmeddelande och vibration. För att vidareanpassa Dosis® till patienter med kognitiva nedsättningar vill Victrix AB implementera en låsfunktion till doseringsfacken. Facken skall endast kunna öppnas under doseringstillfällen för att undvika felmedicinering. Detta arbete fokuserar på att skapa underlag för utvecklingen av denna låsfunktion till Dosis®. Genom att bryta ned låsets funktion i delfunktioner har koncept strategiskt kunnat utvecklas. Genom ett morfologiskt schema har utvalda konceptfragment från alla låsets delfunktioner slutligen kombinerats till sex potentiella lösningar. / Dosis® is a digital pill box from Victrix AB which has a built in computer unit that can be set to remind patients of when it’s time to take their medicine through alarm, voice messages and vibrations. To adapt Dosis® for patients with cognitive dysfunctions Victrix AB wants to implement an automated locking system. The locking system is supposed to prevent patients from opening pill compartments outside of the pre-set time for medication. By doing this Victrix AB hopes to decrease the risk of these patience overdosing. This work is focused on producing a basis from which an automated locking system could be designed. The function of the locking system was broken down into sub functions, making it possible to strategically develop new solutions. Through a morphological schedule chosen concept fragments where combined from all sub functions to finally produce six potential solutions.

No description available.

This study aims to understand the Red Pill movement as displayed on YouTube, by exploring mechanisms used to convey these ideologies, and the extent to which these, if at all, legitimize and encourage violent acts. Netnography along with observation and transcription was used for visual and oral data collection. Thematic analysis was utilized for the analysis which was based on Sykes and Matza’s together with Cohen’s neutralization techniques. Although these techniques were found in the data, they could not effectively link to violence. Instead, three new neutralization techniques, denial of agency, appeal to biology, and appeal to greatness could be linked to violence. While the connection between cause and effect is far more complex, this study provides an insight of the neutralization techniques used within this community. The use of these techniques may weaken individual’s social controls, radicalize them, and effectively lead them to legitimize violence specifically against women.

To tackle the problem of poor adherence to medication, pill boxes are manufactured to help patients store and organise their pills. Unfortunately, pill boxes alone cannot aide people with memory difficulties to improve their adherence to medication. A solution to this problem is to improve pill boxes by integrating technology. Technology makes it possible to have audio signals, as well as light signals, in a pill box, which can remind the users of their dosing times. The purpose of this report is to design a pill box unit, which together with an already designed watch unit from the company Victrix AB, will form a lockable dosing system. The pill box unit itself should be able to facilitate medication intake for people with disabilities in their hands, among other disabilities and diagnoses, as well as for the visually impaired. Interviews were conducted with potential users of a dosing system to identify the product requirements of a pill box. These requirements were used to generate different concepts. From the concepts developed, two were chosen for further development and design in CAD. The results from the study were Dosis, a pill box with an automatic locking function, and Medix, a pill box with a manual locking function, which together meet all the set requirements. Due to the limitations imposed on the design, in correlation with the requirements that were set, the study could not design a concept of a pill box that could solely meet all the requirements. / För att förhindra underdosering vid medicinering av läkemedel tillverkas dosetter, ett förvaringsutrymme för tabletter. Dessvärre hjälper inte endast ett förvaringsutrymme för att människor med minnessvårigheter ska komma ihåg att inta sin medicinering. En lösning till detta problem är doseringssystem, vilket påminner användare om deras doseringstillfällen med hjälp av en ljudsignal. Syftet med denna rapport är att konstruera en pillerdosaenhet, som tillsammans med en redan formgiven klockenhet från företaget Victrix AB, ska bilda ett låsbart tablettdoseringssystem. Pillerdosaenheten i sig ska kunna underlätta tablettintag för personer med, bland annat, handikapp i händerna och för synskadade. Intervjuer med potentiella användare för ett tablettdoseringssystem genomfördes för att identifiera de krav som ställs på en dosett. Kraven användes sedan för att generera olika koncept. Utifrån de framställda koncepten valdes två, ett med manuell låsfunktion och ett med en automatisk låsfunktion, för att vidareutvecklas och sedan konstrueras i CAD. Resultatet blev Dosis med automatisk låsfunktion och Medix med manuell låsfunktion, som tillsammans kan uppfylla alla ställda krav på produkten. På grund av begränsningar som sattes på konstruktionen, i samband med kravställningen, kunde studien inte komma fram till en enskild pillerdosa som kunde uppfylla samtliga krav.

Introdução: A prescrição da pílula anticoncepcional passa a ser realizada no Brasil a partir de 1962. Sua prática trouxe transformações políticas e sociais ao país: a pílula passa a ter grande aceitabilidade das mulheres e permanece como o método anticoncepcional mais utilizado por elas até a atualidade. Seu uso influenciou na queda da taxa de fecundidade e compõe, atrelada a uma série de outros fatores, um conjunto de transformações que modifica a formulação de políticas públicas referentes à saúde reprodutiva e à saúde sexual feminina. Objetivo: Compreender como a prescrição da pílula anticoncepcional por médicos ginecologistas era realizada no Brasil na época em que começa a ser utilizada no país. Metodologia: Trata-se de uma pesquisa qualitativa, tendo como material empírico as narrativas de seis médicos ginecologistas que atuaram na década de 1960, no estado de São Paulo. Resultados e Discussão: A partir das entrevistas, foram identificados quatro eixos temáticos de análise, que contemplaram a descrição Introdução: A prescrição da pílula anticoncepcional passa a ser realizada no Brasil a partir de 1962. Sua prática trouxe transformações políticas e sociais ao país: a pílula passa a ter grande aceitabilidade das mulheres e permanece como o método anticoncepcional mais utilizado por elas até a atualidade. Seu uso influenciou na queda da taxa de fecundidade e compõe, atrelada a uma série de outros fatores, um conjunto de transformações que modifica a formulação de políticas públicas referentes à saúde reprodutiva e à saúde sexual feminina. Objetivo: Compreender como a prescrição da pílula anticoncepcional por médicos ginecologistas era realizada no Brasil na época em que começa a ser utilizada no país. Metodologia: Trata-se de uma pesquisa qualitativa, tendo como material empírico as narrativas de seis médicos ginecologistas que atuaram na década de 1960, no estado de São Paulo. Resultados e Discussão: A partir das entrevistas, foram identificados quatro eixos temáticos de análise, que contemplaram a descrição sobre o primeiro contato dos médicos com a pílula, seguido das diferentes formas de utilização da pílula anticoncepcional como uma nova tecnologia. Também foi identificada a relação entre a prescrição médica e a indústria farmacêutica, assim como o uso da pílula anticoncepcional e a construção do discurso médico sobre o corpo feminino. Esses achados foram analisados à luz dos estudos sobre medicalização do corpo feminino, e como a sua prescrição foi sendo incluída na clínica médica a partir da década de 1960. Considerações Finais: O uso da pílula anticoncepcional apresentou-se como uma nova tecnologia de controle da reprodução e dos corpos femininos. Compreender a história da prescrição da pílula é levar em consideração os múltiplos agentes, interesses e práticas que ainda se inscrevem sobre os corpos das mulheres / Introduction: The prescription of the contraceptive pill began in Brazil in 1962. This practice brought political and social changes to the country: the pill becomes highly accepting of women and remains the contraceptive method most used by them until nowadays. The pill use has influenced the fall in fertility rate and, based on a series of other factors, is a set of transformations that modifies the formulation of public policies regarding reproductive health and female sexual health. Goal: To understand how the prescription of the contraceptive pill happened in Brazil, carried by gynecologists at the time when it begins to be used in the country. Methodology: This is a qualitative research, having as empirical material the narratives of six gynecologists who worked in the 1960s, at São Paulo state. Results and Discussion: From the interviews, four thematic axes of analysis were identified, which included the description of the first contact of the doctors with the pill, followed by different ways of using the contraceptive pill as a new technology. Also, were identified the relationship between medical prescription and the pharmaceutical industry, as well as the use of the contraceptive pill and the construction of the medical discourse about the female body. These findings were analyzed in light of the studies on medicalization of the female body, and how the contraceptive pill prescription was included in the medical clinic from the 1960s. Final Considerations: The use of the contraceptive pill was presented as a new technology for the control of Reproduction and of female bodies. Understanding the history of pill prescription is to take into account the multiple agents, interests, and practices that are still inscribed on women\'s bodies

Introdução: A prescrição da pílula anticoncepcional passa a ser realizada no Brasil a partir de 1962. Sua prática trouxe transformações políticas e sociais ao país: a pílula passa a ter grande aceitabilidade das mulheres e permanece como o método anticoncepcional mais utilizado por elas até a atualidade. Seu uso influenciou na queda da taxa de fecundidade e compõe, atrelada a uma série de outros fatores, um conjunto de transformações que modifica a formulação de políticas públicas referentes à saúde reprodutiva e à saúde sexual feminina. Objetivo: Compreender como a prescrição da pílula anticoncepcional por médicos ginecologistas era realizada no Brasil na época em que começa a ser utilizada no país. Metodologia: Trata-se de uma pesquisa qualitativa, tendo como material empírico as narrativas de seis médicos ginecologistas que atuaram na década de 1960, no estado de São Paulo. Resultados e Discussão: A partir das entrevistas, foram identificados quatro eixos temáticos de análise, que contemplaram a descrição Introdução: A prescrição da pílula anticoncepcional passa a ser realizada no Brasil a partir de 1962. Sua prática trouxe transformações políticas e sociais ao país: a pílula passa a ter grande aceitabilidade das mulheres e permanece como o método anticoncepcional mais utilizado por elas até a atualidade. Seu uso influenciou na queda da taxa de fecundidade e compõe, atrelada a uma série de outros fatores, um conjunto de transformações que modifica a formulação de políticas públicas referentes à saúde reprodutiva e à saúde sexual feminina. Objetivo: Compreender como a prescrição da pílula anticoncepcional por médicos ginecologistas era realizada no Brasil na época em que começa a ser utilizada no país. Metodologia: Trata-se de uma pesquisa qualitativa, tendo como material empírico as narrativas de seis médicos ginecologistas que atuaram na década de 1960, no estado de São Paulo. Resultados e Discussão: A partir das entrevistas, foram identificados quatro eixos temáticos de análise, que contemplaram a descrição sobre o primeiro contato dos médicos com a pílula, seguido das diferentes formas de utilização da pílula anticoncepcional como uma nova tecnologia. Também foi identificada a relação entre a prescrição médica e a indústria farmacêutica, assim como o uso da pílula anticoncepcional e a construção do discurso médico sobre o corpo feminino. Esses achados foram analisados à luz dos estudos sobre medicalização do corpo feminino, e como a sua prescrição foi sendo incluída na clínica médica a partir da década de 1960. Considerações Finais: O uso da pílula anticoncepcional apresentou-se como uma nova tecnologia de controle da reprodução e dos corpos femininos. Compreender a história da prescrição da pílula é levar em consideração os múltiplos agentes, interesses e práticas que ainda se inscrevem sobre os corpos das mulheres / Introduction: The prescription of the contraceptive pill began in Brazil in 1962. This practice brought political and social changes to the country: the pill becomes highly accepting of women and remains the contraceptive method most used by them until nowadays. The pill use has influenced the fall in fertility rate and, based on a series of other factors, is a set of transformations that modifies the formulation of public policies regarding reproductive health and female sexual health. Goal: To understand how the prescription of the contraceptive pill happened in Brazil, carried by gynecologists at the time when it begins to be used in the country. Methodology: This is a qualitative research, having as empirical material the narratives of six gynecologists who worked in the 1960s, at São Paulo state. Results and Discussion: From the interviews, four thematic axes of analysis were identified, which included the description of the first contact of the doctors with the pill, followed by different ways of using the contraceptive pill as a new technology. Also, were identified the relationship between medical prescription and the pharmaceutical industry, as well as the use of the contraceptive pill and the construction of the medical discourse about the female body. These findings were analyzed in light of the studies on medicalization of the female body, and how the contraceptive pill prescription was included in the medical clinic from the 1960s. Final Considerations: The use of the contraceptive pill was presented as a new technology for the control of Reproduction and of female bodies. Understanding the history of pill prescription is to take into account the multiple agents, interests, and practices that are still inscribed on women\'s bodies

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A contracepÃÃo de emergÃncia (CE) à um mÃtodo que evita a gravidez apÃs a relaÃÃo sexual. TambÃm conhecido por âpÃlula pÃs-coitoâ, esse mÃtodo utiliza progestogÃnio na forma concentrada e tem indicaÃÃo reservada Ãs situaÃÃes especiais ou de exceÃÃo, tais como falha conhecida ou presumida, uso inadequado e relaÃÃo sexual sem uso de mÃtodo contraceptivo, bem como em casos de violÃncia sexual. Descrever e analisar o nÃvel de conhecimento e a utilizaÃÃo da CE de usuÃrias do ServiÃo de Atendimento FarmacÃutico (SAC FARMA), de uma Rede de FarmÃcias ComunitÃrias em Fortaleza, CearÃ. Entre os meses de outubro de 2008 a maio de 2009, apÃs o esclarecimento de informaÃÃes sobre pÃlula pÃs-coito atravÃs do SAC FARMA, mulheres usuÃrias ou que tinham intenÃÃo de uso da CE, foram convidadas a participar da pesquisa sobre uso de CE. Para tanto, foi aplicado um questionÃrio e os dados foram incluÃdos no programa estatÃstico SPSS, versÃo 15.0. Das 54 entrevistas feitas, a maioria das mulheres estavam entre a faixa etÃria de 23 e 29 anos de idade (44,4%), solteiras (66,7%) e residentes no Estado do Cearà (66,7%). Tinham renda entre 1 e 3 salÃrios mÃnimos (48,1%) e cursavam ensino mÃdio (50,0%) e superior (42,6%). Pretendiam fazer uso ou utilizaram CE sem orientaÃÃo/prescriÃÃo mÃdica (92,6%) e a maioria (54%) obteve alguma informaÃÃo sobre CE atravÃs de amigos e familiares. Mais da metade (64,8%) afirmou que nÃo era a primeira vez de uso, sendo que 82% relataram utilizar uma ou duas vezes. Com relaÃÃo ao conhecimento sobre o risco de diminuiÃÃo de eficÃcia caso houvesse repetiÃÃo do uso, a maioria (64%) relatou desconhecer essa informaÃÃo. Relataram nenhuma reaÃÃo ou queixa (72%) e 98,1% conheciam outro mÃtodo contraceptivo, sendo o preservativo o mais conhecido (92,6%) e utilizado (84%). Um dos principais motivos para justificar a utilizaÃÃo da CE foi o sexo desprotegido (53,7%). Quando perguntadas atà quanto tempo apÃs a relaÃÃo sexual o mÃtodo pode ser utilizado, a maioria respondeu que pode ser atà 72 horas (56,3%), 25% nÃo souberam responder e 65,6% relataram que a âPÃlula do Dia Seguinteâ nÃo possui efeito abortivo. A maioria das mulheres avaliadas pretendia fazer uso ou utilizar a CE sem orientaÃÃo/prescriÃÃo mÃdica, obteve informaÃÃes sobre a pÃlula atravÃs de amigos e familiares e, alÃm disso, nÃo tinha conhecimento sobre o risco de diminuiÃÃo de eficÃcia se o uso for repetitivo. Estes fatos alertam para que se tenha uma maior preocupaÃÃo em relaÃÃo à possibilidade de uso indevido do medicamento e seu fÃcil acesso nas farmÃcias comerciais. / The emergency contraceptive pill (EC) is a method of the emergency contraception that prevents pregnancy after sexual intercourse. It is also known as the âpost coital pillâ and contains high dose progestin-hormone. The EC can be taken immediately or up to five days after sex if the woman did not use birth control, in cases of suspected birth control failure, or if she was forced to have sex. To describe the level of knowledge and use of EC by users of the Medicine Attendance Service (SAC FARMA) in a network of community pharmacies placed in Fortaleza, CearÃ. In the months October (2008) to May (2009), after each enquiry about the âpost coital pillâ, women who were using or intended to use this pill were invited to participate in a survey on the use of emergency contraception by the application of a structured questionnaire. The data were analyzed with the statistical program SPSS, version 15.0. Of the 54 women interviewed, the majority were aged between 23 and 29 years (44.4%), were single (66.7%) and resident in the State of Cearà (66.7%). (48.1%) had income between 1 and 3 minimum wages, 50,0% higher secondary education and 42.6% had higher education.). Almost all (92,6%) wished to use or have used EC without guidance/prescription and of these the majority (54%) obtained some information about EC through friends and family. More than half (64.8%) said it was not their first time of use, and 82% reported using EC once or twice previously. With respect to knowledge about the risk of loss of effectiveness if the use is repetitive, the majority (64%) were unaware of this information. Most (72%) reported no adverse reaction or other complaints. Also, 98.1% of interviewed reported that they knew other method of contraception, being the condom the most widely known (92.6%) and used (84%). One of the main reasons to justify the use of EC was unprotected sex (53.7%). When asked for how long after intercourse the method can be used, most answered within 72 hours (56.3%), 25% did not respond and 65.6% reported that "post coital pill" has no abortive effect. Most of the women studied wanted to use the EC without prescription and obtained information about EC pill from friends and family. Moreover most women had no knowledge about the risk of reduced effectiveness if the use is repetitive. These findings are of concern as they indicate the possibility of misuse of the EC given its easy access in pharmacies.

Hypertoni är en riskfaktor för allvarliga kardiovaskulära sjukdomar. Olika läkemedelsklasser används vid behandling av hypertoni. Dessa inkluderar angiotensin omvandlade enzymhämmare, angiotensin II-receptorblockerare, kalciumkanalblockerare och tiaziddiuretika. Även om nuvarande läkemedelsterapier kan vara effektiva, är det få som kan uppnå målblodtryck. De flesta patienter med hypertoni kräver minst två antihypertensiva läkemedel för att uppnå sitt målblodtryck. Detta ledde till komplicerade behandlingsmetoder som i sin tur har blivit en stor bidragande faktor till dålig patientföljsamhet. Även om ett stort antal läkemedel finns tillgängliga för behandling, är kontrollen av blodtryck dålig på grund av patienternas dåliga följsamhet till medicinering som vanligtvis är en kombination av flera substanser. Följsamheten minskar med antalet tabletter som en patient behöver ta vilket leder till en komplicerad behandlingsstrategi.  Syftet med detta examensarbete var att undersöka blodtryckssänkande effekt med en enkel tablettform Single-Pill Combination (SPC) som innehåller en kombination av flera antihypertensiva läkemedelsklasser och att undersöka patienternas följsamhet till (SPC) behandling.  Metod det här arbetet är en litteraturstudie utförd i PubMed. Olika sökord användes” single-pill combination in hypertension”, “Fixed dose combination in hypertension “, “Adherence to single-pill combination in hypertension”. Sökningen filtrerades till “Randomized controlled trial”. Nya studier valdes ut som undersökte effekten av SPC och följsamhet till behandling. Resultat Studier 1,2,3 och 4 som undersökte effekten gav positiva resultat som gynnade SPC framför standardmonoterapi och placebo. SPC kunde minska blodtrycket statiskt signifikant i alla studierna. I studie 1 blev den genomsnittliga skillnaden i SBT mellan grupperna (–6,9) mm Hg med (p-värde <0,001). I studie 2 blev skillnaden i genomsnittlig 24-timmars SBT mellan SPC- och placeboperioder (–18,7) mm Hg med p-värde <0,0001. I studie 3 blev SBT-förändringar på klinik -16,5 ± (15,5) mm Hg (p <0,001) med amlodipin/valsartan FDC och -6,9 ± (11,4) mm Hg (p = 0,012) med valsartan monoterapi medan motsvarande förändringar i DBP i Office var -9,8 ± (7,7) mm Hg (p <0,001) respektive -2,5 ± (6,6) mm Hg (p = 0,095). Resultat av studie 4 visade att andelen deltagare som uppnådde målblodtryck efter 6 månader (SBT <140, DBT <90 mm Hg) blev 69% i SPC gruppen och 55,3% i monoterapi gruppen. I studie 5 kunde ingen signifikant skillnad i följsamheten observeras mellan SPC gruppen och FEC gruppen. Följsamhetsgraden var 98% i båda grupperna. Studie 6 rapporterade signifikant resultat där PDT blev 95,1 % i SPC gruppen och 92,1% i kontrollgruppen p-värde <0,05.  Slutsats Alla resultat i studierna 1,2,3 och 4 gynnade signifikant SPC när det gäller effekten. Studie 6 visade att patienternas följsamhet till behandling var bättre i SPC gruppen än kontrollgrupp. Studie 5 kunde inte ge signifikanta resultat avseende följsamheten till SPC jämfört med FEC. Fler RCT studier behövs för att undersöka om SPC kan leda till bättre följsamhet hos hypertonipatienter / Background Hypertension is a risk factor for serious cardiovascular diseases. Different drug classes are used in the treatment of hypertension. These include angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, and thiazide diuretics. Although current drug therapies can be effective, few are able to achieve target blood pressure therefore it has become well-known that most hypertensive patients require at least two antihypertensive drugs to reach their target blood pressure. This led to complicated treatment methods, which in turn has become a significant contributing factor to poor patient compliance. When two or more drug classes are combined, this contributes to improved efficacy, as different mechanisms of action work together to block different pathways to high blood pressure. This leads to lower doses of the individual components being used, which results in a reduced likelihood of side effects. Although a large number of drugs are available for treatment, there is still poor control of blood pressure due to patients' poor adherence to medication, which is usually a combination of several substances. Adherence decreases with the number of tablets a patient needs to take, leading to a complicated treatment strategy. Lower levels of adherence are associated with poorer blood pressure control. Aim The aim of the work is to investigate the blood pressure-lowering effect with a simple tablet form "Single-Pill Combination" (SPC) that contains a combination of several antihypertensive drug classes and to investigate the patients' adherence to this form of treatment (SPC). Method This work is a literature study carried out in Pubmed. Different search terms were used: "single-pill combination for the treatment of hypertension", "Fixed dose combination in hypertension", and "Adherence to single-pill combination for hypertension". The search was filtered to "Randomized controlled trial". New studies were selected that investigated the effect of single-pill combination and blood pressure control and adherence to treatment. Results Studies 1, 2, 3, and 4 investigating the efficacy produced positive results favoring SPC over standard monotherapy and placebo. SPC was able to reduce blood pressure statically significantly in all studies. In Study 1, the primary outcome variable was the mean difference in SBT between groups (–6.9) mm Hg with (p-value <0.001). In Study 2, the difference in mean 24-hour SBT between SPC and placebo periods was (–18.7) mm Hg with a p-value <0.0001. Whereas in Study 3, in-clinic SBT changes were -16.5 ± (15.5) mm Hg (p < 0.001) with amlodipine/valsartan FDC and -6.9 ± (11.4) mm Hg (p = 0.012) with valsartan monotherapy while the corresponding changes in DBP in Office were -9.8 ± (7.7) mm Hg (p <0.001) and -2.5 ± (6.6) mm Hg (p = 0.095), respectively. The results of study 4 were that the percentage of participants who achieved target blood pressure after 6 months (SBT <140, DBT <90 mm Hg) was 69% in the SPC group and 55.3% in the monotherapy group. In study 5, no significant difference in compliance could be observed between the SPC group and the FEC group. The compliance rate was 98% in both groups. While study 6 reported significant results where PDT was 95.1% in the SPC group and 92.1% in the control group p-value <0.05. Conclusion All results in studies 1,2,3and 4 significantly favored SPC in terms of efficacy. Study 6 showed that patients’ adherence to treatment was better in the SPC group than in the control group. While study 5 which was the first RCT study in this area could not provide positive and significant results regarding the adherence to SPC compared to FEC. More RCT studies are needed to investigate whether SPC can lead to better adherence in hypertensive patients.

No description available.

Magister Public Health - MPH (Public Health) / The presence of highly effective medicines has made very little impact in reducing deaths as a result of tuberculosis (TB), a curable condition but when managed inappropriately, may result in Drug Resistant TB. TB accounts for about one in four deaths that occur in HIV positive people and HIV has been found to be a risk factor for complex unfavorable outcomes in MDR TB patients and a very strong predictor for death and default. The relationship between diabetes and TB has also been explored, with some authors identifying diabetes as a risk factor for TB, and with related poor clinical outcomes in both conditions when they co-exist. Exploring the clinical characteristics and treatment outcomes of MDR TB patients in the presence of these risk factors could present an opportunity to provide better care through increased case-detection activities, improved clinical management and better access to care for all these conditions. The aim of the study was to describe the clinical characteristics and treatment outcomes of MDR TB patients initiated on treatment at Nkqubela and Fort Grey Hospitals.