Medicine treatment patterns of HIV/AIDS patients at a rural district hospital in the North West province
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Globally an estimated 33.4 million people were living with HIV/AIDS by 2008 (UNAIDS, 2009a:7). One of the main challenges facing the Republic of South Africa (RSA) today is the HIV/AIDS epidemic (NSP, 2007:17). By mid-year 2011 an estimated 5.38 million people (10.6% of the total population) were living with HIV/AIDS in the RSA (Statistics South Africa, 2011:2). Currently South Africa has the largest number of people enrolled in the Highly Active Antiretroviral Treatment programme (HAART) in the world (WHO, 2008:59). The objective of this study was to determine retrospectively the medicine treatment patterns of HAART at a district hospital in the North West Province of South Africa. The study was conducted at Thusong hospital in the Ditsobotla sub-district of the North West Province of South Africa. A non-experimental, retrospective, cross-sectional, drug utilisation research methodology was used to obtain the data. The target population included patients of all ages who visited Thusong hospital pharmacy during the data collection period, which commenced on 01 February 2012 and ended on 31 March 2012. The data of three hundred and ninety nine (N=399) adult and one hundred and sixty one (N=161) paediatric patients on HAART were used. The adult female patients accounted for almost 70% (n=276, 69.17%) and the adult male patients for only 30% (n=123, 30.83%). The male paediatric patients represented just over 60% (n=97, 60.25%), whereas the female paediatric patients comprised less than 40% (n=64, 39.75%). The majority of adult patients were unmarried (n=323, 80.95%) and this group of patients were also the youngest group (μ=36.38 ± 8.98 years) on ARV treatment. Almost 86% (85.96%, n=343) of adult patients were registered as unemployed. Ninety two (n=92, 23.06%) adult patients and fifty eight (n=58, 36.03%) paediatric patients defaulted treatment during the defined period. The investigation into the adult medicine treatment patterns revealed that more than half (52.38%, n=209) of all the adult patients were receiving regimen 1atn (EFV, TDF and 3TC), followed by 20.80% (n=83) on regimen 1a (EFV, D4T and 3TC). Most paediatric patients (n=73, 45.34%) were on regimen P1c (EFV, D4T and 3TC) and the second most (n=45, 27.95%) were on regimen P1a (D4T, 3TC and LPV/r). The average weight of adult female patients was 57.18kg (± 15.78kg) and the average adult male patient weighed 55.87kg (± 10.17kg) on initiation of HAART. The average adult male patient was initiated on HAART with a CD4 count of 130cells/mm3 (± 99.45cells/mm3), while for adult female patients it was 160cells/mm3 (± 96.52cells/mm3). The average male child was initiated with a CD4 count of 509.1cells/mm3 and the average female paediatric patient with 477.3cells/mm3. The average viral load for adult female patients on initiation of HAART was 103046copies/mm3 (± 189146copies/mm3) and for adult male patients it was 416600copies/mm3 (± 439746copies/mm3). The difference between the viral load of adult female and male patients were described as statistically (p=0.0006) and practically (d=0.713) significant. The average viral load for female paediatric patients on initiation of HAART was 242207copies/mm3 (± 709133copies/mm3) and for male paediatric patients it was 329734copies/mm3 (± 674532copies/mm3). Adult patients that received HAART at more than 12 consultations revealed an average weight gain of 3.43kg (± 8.11kg) from initiation of treatment. This group also showed an average increase of 214.71cells/mm3 (± 248.24cells/mm3) in CD4 count and an average reduction in viral load of 170944copies/mm3 (± 191854.69copies/mm3) from the day they started HAART up to the last date of receiving treatment. The paediatric patients on treatment for more than 12 consultations showed an average weight gain of 6.56kg (± 3.75kg) from initiation of ARV treatmentup to the last date of receiving treatment. They also showed an average increase in CD4 count of 396.63cells/mm3 (± 594.53cells/mm3) and a very encouraging average decrease of 538369.37copies/mm3 (± 948634.46copies/mm3) in the viral load.
- Health Sciences