Magister Public Health - MPH / The government of Namibia established a comprehensive HIV/AIDS treatment and care programme in 2002. This programme provides anti-retroviral treatment to all eligible HIV patients in the public health sector. The antiretroviral treatment programme in Keetmanshoop started in October 2003. Adherence to treatment regimes in HIV care is a key factor in determining clinical outcomes and is associated with improved survival among HIV and AIDS patients. Sustained high levels of adherence (95% or more) are essential for the success of highly active antiretroviral therapy (HAART). Maintaining high adherence levels is therefore a major concern in HIV/AIDS treatment programmes. This study investigated
adherence to HAART among patients in the Keetmanshoop antiretroviral therapy (ART)clinic and the factors that affect adherence.Aim of the research The aim of the research was to describe adherence to HAART and factors influencing adherence among patients in Keetmanshoop ART clinic, Namibia.Objectives: 1. To describe levels of adherence to HAART amongst clients at Keetmanshoop ART clinic. 2. To assess the changes in CD4 count and body weight of clients on HAART over a 12 month period.3. To assess factors associated with adherence to HAART.4. To analyse associations between CD4 count and adherence.
5. To analyse associations between changes in body weight and adherence. Methodology: A quantitative descriptive cross-sectional survey was used. The study population included all clients 18 years and above, who were on HAART for one year or more at the Keetmanshoop clinic. One hundred and six clients participated in the study. Data was collected through an interview with the participants and a review of clinical records. Results: Most respondents had good adherence levels; with 86.1% reporting optimal adherence levels.The respondents also showed an increase of median CD4 counts from 126 cells/μl at baseline to 304 cells/μl at 12 months and an increase in body weight from an average of 50kg at baseline to an average of 57kg at 12 months. Adherence levels were found to have an impact on CD4 cell counts and on body weight, with respondents who had sub-optimal adherence experiencing a drop in median CD4 cell counts and median body weight by 12 months.Living far from the clinic (>10km) was found to be the only factor significantly associated with sub-optimal adherence.Conclusion: The study showed a positive correlation between adherence levels and CD4 cell counts and body weight gain. In the absence of viral load, CD4 cell count testing can be used as a measure of adherence. Though most respondents appear to be adhering well to HAART, a sub-optimal adherence rate of >10% is a concern for the Keetmanshoop ART programme and will need to be addressed. There is a need for further research to determine the level of default or attrition from HAART in the programme
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uwc/oai:etd.uwc.ac.za:11394/3448 |
| Date | January 2010 |
| Creators | Njuguna, Wambui |
| Contributors | Wyk, Brian Van |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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