TY - JOUR
T1 - Preparedness of HIV care and treatment clinics for the management of concomitant non-communicable diseases
T2 - A cross-sectional survey
AU - Leung, Claudia
AU - Aris, Eric
AU - Mhalu, Aisa
AU - Siril, Hellen
AU - Christian, Beatrice
AU - Koda, Happiness
AU - Samatta, Talumba
AU - Maghimbi, Martha Tsere
AU - Hirschhorn, Lisa R.
AU - Chalamilla, Guerino
AU - Hawkins, Claudia
N1 - Funding Information:
This study was funded by the Infectious Disease Society of America Medical Scholar program. The sponsor of this study had no role in the collection, analysis, or interpretation of the data.
Publisher Copyright:
© 2016 The Author(s).
PY - 2016/9/21
Y1 - 2016/9/21
N2 - Background: In Sub-Saharan Africa, epidemiological studies have reported an increasing burden of non-communicable diseases (NCD) among people living with HIV. NCD management can be feasibly integrated into HIV care; however, clinic readiness to provide NCD services in these settings should first be assessed and gaps in care identified. Methods: A cross-sectional survey conducted in July 2013 assessed the resources available for NCD care at 14 HIV clinics in Dar es Salaam, Tanzania. Survey items related to staff training, protocols, and resources for cardiovascular disease risk factor screening, management, and patient education. Results: 43 % of clinics reported treating patients with hypertension; however, only 21 % had a protocol for NCD management. ECHO International Health standards for essential clinical equipment were used to measure clinic readiness; 36 % met the standard for blood pressure cuffs, 14 % for glucometers. Available laboratory tests for NCD included blood glucose (88 %), urine dipsticks (78 %), and lipid panel (57 %). 21 % had a healthcare worker with NCD training. All facilities provided some form of patient education, but only 14 % included diabetes, 57 % tobacco cessation, and 64 % weight management. Conclusions: A number of gaps were identified in this sample of HIV clinics that currently limit the ability of Tanzanian healthcare workers to diagnose and manage NCD in the context of HIV care. Integrated NCD and HIV care may be successfully achieved in these settings with basic measures incorporated into existing infrastructures at minimal added expense, i.e., improving access to basic functioning equipment, introducing standardized treatment guidelines, and improving healthcare worker education.
AB - Background: In Sub-Saharan Africa, epidemiological studies have reported an increasing burden of non-communicable diseases (NCD) among people living with HIV. NCD management can be feasibly integrated into HIV care; however, clinic readiness to provide NCD services in these settings should first be assessed and gaps in care identified. Methods: A cross-sectional survey conducted in July 2013 assessed the resources available for NCD care at 14 HIV clinics in Dar es Salaam, Tanzania. Survey items related to staff training, protocols, and resources for cardiovascular disease risk factor screening, management, and patient education. Results: 43 % of clinics reported treating patients with hypertension; however, only 21 % had a protocol for NCD management. ECHO International Health standards for essential clinical equipment were used to measure clinic readiness; 36 % met the standard for blood pressure cuffs, 14 % for glucometers. Available laboratory tests for NCD included blood glucose (88 %), urine dipsticks (78 %), and lipid panel (57 %). 21 % had a healthcare worker with NCD training. All facilities provided some form of patient education, but only 14 % included diabetes, 57 % tobacco cessation, and 64 % weight management. Conclusions: A number of gaps were identified in this sample of HIV clinics that currently limit the ability of Tanzanian healthcare workers to diagnose and manage NCD in the context of HIV care. Integrated NCD and HIV care may be successfully achieved in these settings with basic measures incorporated into existing infrastructures at minimal added expense, i.e., improving access to basic functioning equipment, introducing standardized treatment guidelines, and improving healthcare worker education.
KW - HIV
KW - Health system strengthening
KW - Integration
KW - Non-communicable diseases
KW - Tanzania
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U2 - 10.1186/s12889-016-3661-1
DO - 10.1186/s12889-016-3661-1
M3 - Article
C2 - 27655406
AN - SCOPUS:84988353041
VL - 16
JO - BMC Public Health
JF - BMC Public Health
SN - 1471-2458
IS - 1
M1 - 1002
ER -