Linkage to care after testing HIV positive: a comparative analysis of mobile versus health facility based models in rural settings, Mbeya-Tanzania.

Philosophiae Doctor - PhD (School of Public Health)HIV testing, linkage to HIV care and continuity of care are crucial for proper management of HIV/AIDS. There is increasing interest across sub-Saharan Africa, including in Tanzania, in accessing hard-to-reach populations and remote areas with HIV testing opportunities and linkage to HIV care. Despite the efforts being made by the Tanzanian government to address some of the challenges to improving HIV testing and subsequent linkage to HIV care and treatment services, such as increasing service outlets, linkage to care in Tanzania is still low: studies published in 2009 and 2014 reported linkage rates of 14% at four months and 28% at one year. To our knowledge, there has not been any direct, prospective comparison between mobile and facility-based models of testing in countries like Tanzania, where treatment is only available in a minority of facilities. This study aimed to describe and compare rates and determinants of linkage to care in the first six months following an HIV-positive test result between mobile and facility-based models of HIV testing in Mbeya region, Tanzania

Expectations and experiences of Hiv vaccine trial participants at the Mbeya Medical Research Programme in Mbeya, Tanzania 2006-2007

Magister Public Health - MPHA qualitative descriptive study approach was used to gather the required information. The sample for this study was drawn from an existing group of volunteers who participated in the vaccine trial at Mbeya Medical Research Centre in 2006-2007. A purposive sampling method was used to select respondents because they had had experience of being participants in a HIV vaccine trial. Twenty audio recorded in-depth interviews were conducted. The interviews were conducted at the clinic during their routine follow up visits. An open ended interview guideline was used to guide the discussion to elicit the required information from the respondents. The data was transcribed, translated and then analyzed by both content and thematic approach. Ethical procedures were observed, including getting permission from the local ethical committee in Mbeya region and participants were given an informed consent form to read and sign before starting the interview.South Afric

Linkage into care among newly diagnosed HIV-positive individuals tested through outreach and facility-based HIV testing models in Mbeya, Tanzania: a prospective mixed-method cohort study

Objective: Linkage to care is the bridge between HIV testing and HIV treatment, care and support. In Tanzania, mobile testing aims to address historically low testing rates. Linkage to care was reported at 14% in 2009 and 28% in 2014. The study compares linkage to care of HIV-positive individuals tested at mobile/ outreach versus public health facility-based services within the first 6 months of HIV diagnosis. Setting: Rural communities in four districts of Mbeya Region, Tanzania. Participants: A total of 1012 newly diagnosed HIV-positive adults from 16 testing facilities were enrolled into a two-armed cohort and followed for 6 months between August 2014 and July 2015. 840 (83%) participants completed the study. Main outcome measures: We compared the ratios and time variance in linkage to care using the Kaplan-Meier estimator and Log rank tests. Cox proportional hazards regression models to evaluate factors associated with time variance in linkage. Results: At the end of 6 months, 78% of all respondents had linked into care, with differences across testing models. 84% (CI 81% to 87%, n=512) of individuals tested at facility-based site were linked to care compared to 69% (CI 65% to 74%, n=281) of individuals tested at mobile/outreach. The median time to linkage was 1 day (IQR: 1-7.5) for facility-based site and 6 days (IQR: 3-11) for mobile/outreach sites. Participants tested at facility-based site were 78% more likely to link than those tested at mobile/outreach when other variables were controlled (AHR=1.78;95% CI 1.52 to 2.07). HIV status disclosure to family/relatives was significantly associated with linkage to care (AHR=2.64;95% CI 2.05 to 3.39). Conclusions: Linkage to care after testing HIV positive in rural Tanzania has increased markedly since 2014, across testing models. Individuals tested at facility-based sites linked in significantly higher proportion and modestly sooner than mobile/outreach tested individuals. Mobile/outreach testing models bring HIV testing services closer to people. Strategies to improve linkage from mobile/outreach models are needed

Understanding the factors influencing linkage to HIV care after testing HIV positive in rural Mbeya, Tanzania

<p>In Mbeya region of Tanzania, the rate of linkage into HIV care was estimated at 28% in 2014. This study explored the facilitators, barriers to linkage to HIV care at individual/patient, health care provider, health system, and contextual levels to inform the design of interventions to improve linkage to HIV care.</p> <p>A descriptive qualitative study was conducted between August 2014 and July 2015, nested in a cohort study following 1,012 individuals newly diagnosed HIV positive for 6 months. We conducted 8 focus group discussions and 10 in-depth interviews with recently diagnosed HIV-positive individuals from the cohort, and 20 individual interviews with healthcare providers. Transcripts were transcribed verbatim in Swahili, translated into English and analyzed through thematic content analysis supported by Atlas.ti qualitative analysis software.</p

Abstracts of Tanzania Health Summit 2020

This book contains the abstracts of the papers/posters presented at the Tanzania Health Summit 2020 (THS-2020) Organized by the Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC); President Office Regional Administration and Local Government (PORALG); Ministry of Health, Social Welfare, Elderly, Gender, and Children Zanzibar; Association of Private Health Facilities in Tanzania (APHFTA); National Muslim Council of Tanzania (BAKWATA); Christian Social Services Commission (CSSC); &amp; Tindwa Medical and Health Services (TMHS) held on 25–26 November 2020. The Tanzania Health Summit is the annual largest healthcare platform in Tanzania that attracts more than 1000 participants, national and international experts, from policymakers, health researchers, public health professionals, health insurers, medical doctors, nurses, pharmacists, private health investors, supply chain experts, and the civil society. During the three-day summit, stakeholders and decision-makers from every field in healthcare work together to find solutions to the country’s and regional health challenges and set the agenda for a healthier future. Summit Title: Tanzania Health SummitSummit Acronym: THS-2020Summit Date: 25–26 November 2020Summit Location: St. Gasper Hotel and Conference Centre in Dodoma, TanzaniaSummit Organizers: Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC); President Office Regional Administration and Local Government (PORALG); Ministry of Health, Social Welfare, Elderly, Gender and Children Zanzibar; Association of Private Health Facilities in Tanzania (APHFTA); National Muslim Council of Tanzania (BAKWATA); Christian Social Services Commission (CSSC); &amp; Tindwa Medical and Health Services (TMHS)