Assessment of knowledge and practices for disposal of unfinished, unwanted and expired medications from households in Iringa municipal council, Tanzania

Background: Patients may not consume all the medications prescribed and dispensed to them for various reasons. Practices for the unfinished medications in households are a potential to environmental pollution. Presence of medicinal contaminants in the environment has detrimental consequences to all forms of life. Household disposal practices for unused medications contribute significantly to entry of medications into the environment and have emerged worldwide environmental and public health concerns.Objective: To assess the knowledge and practices for disposal of unfinished, unwanted and expired medications from households among residents of Iringa Municipal Council, Tanzania.Methods: A cross-sectional survey was conducted in the Municipal involving 409 (186 male and 223 female) conveniently sampled participants visiting major drug dispensing outlets. Information about storage, disposal practices and knowledge of disposal methods was collected on previously tested self-administered questionnaire and analyzed using SPSS version 16.0. Descriptive analysis procedures were used.Results: Household storage was the commonest practice (94.4%) towards unfinished medications while throwing away (3.4%), sharing (1.7%) and selling (0.5%) were less practiced. Of 386 respondents reported to store medications in their households, 66.6% eventually disposed of the drugs in domestic trash in events of expiry or when drugs became unwanted. Burying (9.1%), throwing/flushing down toilets (19.7%) and burning (4.6%) were less encountered. Public awareness that improper disposal practices harm the environment was 62.1% but majority (85%) of respondents had never been informed/ educated about safe disposal practices. Public education on the subject was suggested by more than 90% of the respondents.Conclusions: Household storage of medications is common in the Municipal and is associated with poor disposal practices. The need for proper knowledge and information on safe practices for unfinished, unwanted and expired medications accompanied by formulation and dissemination of guidelines on safe drug handling practices is also imperative.Key words: Medication Disposal, Expired, Unwanted, Unfinished, Iring

Some Factors Associated with Non – Adherence to Antiretroviral Therapy (ART) in People Living with HIV/AIDS (PLHA) in Tanzania: A Case Study of Dar es Salaam Region.

Objectives: Tanzania is one of the nations that are highly affected by HIV/AIDS epidemic. Invention of ARVs (Anti –Retroviral) brought hope of extended life to people living with HIV/AIDS (PLHA). Though ARV’s are administered in several clinics particularly in Dar es Salaam, there is a problem to adherence. Some factors associated with non-adherence are investigated and ways to optimize adherence are suggested.Methods: This study was undertaken at three treatment and care clinics in Dar es Salaam. A sample of 197 individuals on ARV and 30 health care providers were interviewed. The sample comprised of 76 % females and 24% males, with mean age 34. About 74% ofindividuals on ARV were aged between 25 – 45 years. Logistic Regression and survival analysis models were used in the analysis.Results: Individuals on ARV recommended factors responsible for non-adherence as lack of awareness 63.5%, stigma 56%, side effects 53.3%, and costs 28%. Other factors were being busy 25.4%, away from home 21.3%, forgetting 12.2% and ARVs out of stock 10.2%. Proportion of PLHA lost to follow up was 26%. Awareness and side effects were found to be statistically significant, with p-values of 0.042 and 0.068 respectively (a = 0.1). The median survival time for individuals on ARV was 42 months (95% CI: 41–44) with survival rate of above 0.7. Log-rank test showed significant differences between the male and female on having a shorter time to death. Females seemed to survive longer than males suggesting that females adhere more to ART than males.Conclusion: This calls for emphasis on HIV/AIDS education to the society especially to sensitize men. Another suggestion is that when a woman gets pregnant, both the expectant mother and father should attend maternal clinic so that they both take HIV test so as to increase man’s participation.Keywords: Non-adherence, Antiretroviral, HIV/AIDS, survival, men, wome