A Society Based Research to Assess Adherence of Antiretroviral Therapy

Access Adherence to Antiretroviral Therapy. A community-based antiretroviral (ART) drugs adherence study was conducted in Kolkata, India beginning in January and concluding in March 2011. This study was designed to explore the level of adherence as well as factors influencing adherence to ART by those who are receiving treatment through a public health care delivery system. This health care system is implemented through the National AIDS Control Program in the state of West Bengal, India. The research findings showed a high degree of non-adherence, between 48-52%, among the ART recipients. The analysis highlights a number of key factors negatively influencing adherence including long waiting time at the ART center, distance from residence to ART Centre, travel related expenditure, and fear of being identified as HIV + to family members and neighbors. Some positive influences were identified in the data as well. If a person is a member of a positive people network there is a greater chance for adherence as well as if an individual self-identifies as positive to others. However, no single factor, rather a combination of several factors, proved to be responsible for influencing ART adherence among recipients. &nbsp

Establishment of reference CD4+ T cell values for adult Indian population

<p>Abstract</p> <p>Background</p> <p>CD4+ T lymphocyte counts are the most important indicator of disease progression and success of antiretroviral treatment in HIV infection in resource limited settings. The nationwide reference range of CD4+ T lymphocytes was not available in India. This study was conducted to determine reference values of absolute CD4+ T cell counts and percentages for adult Indian population.</p> <p>Methods</p> <p>A multicentric study was conducted involving eight sites across the country. A total of 1206 (approximately 150 per/centre) healthy participants were enrolled in the study. The ratio of male (N = 645) to female (N = 561) of 1.14:1. The healthy status of the participants was assessed by a pre-decided questionnaire. At all centers the CD4+ T cell count, percentages and absolute CD3+ T cell count and percentages were estimated using a single platform strategy and lyse no wash technique. The data was analyzed using the Statistical Package for the Social Scientist (SPSS), version 15) and Prism software version 5.</p> <p>Results</p> <p>The absolute CD4+ T cell counts and percentages in female participants were significantly higher than the values obtained in male participants indicating the true difference in the CD4+ T cell subsets. The reference range for absolute CD4 count for Indian male population was 381-1565 cells/μL and for female population was 447-1846 cells/μL. The reference range for CD4% was 25-49% for male and 27-54% for female population. The reference values for CD3 counts were 776-2785 cells/μL for Indian male population and 826-2997 cells/μL for female population.</p> <p>Conclusion</p> <p>The study used stringent procedures for controlling the technical variation in the CD4 counts across the sites and thus could establish the robust national reference ranges for CD4 counts and percentages. These ranges will be helpful in staging the disease progression and monitoring antiretroviral therapy in HIV infection in India.</p

Gap analysis between provisional diagnosis and final diagnosis in government and private teaching hospitals: A record-linked comparative study

Aims: 1. To identify the extent of clinical gaps at the context of knowledge, practice and systems. 2. To formulate necessary intervention measures towards bridging the gaps. Settings and Design: Comparative, cross-sectional and non-interventional study. Methods and Material: It is retrospective, record-based study conducted upon inpatients (n = 200) of major disciplines of two teaching hospitals. Major outcome variables were to observe the matching and un-matching of final and provisional diagnosis by using ICD-10 criteria. Statistical Analysis Used: Comparative analysis of specific and selective gaps were estimated in terms of percentage (%). Results: Pilot observation showed the existence of gaps between provisional and final diagnosis in both private and government institution. Both knowledge and skill gaps were evident in caregivers and gap in documentation was existent in medical records. Conclusions: The pilot data is may be an eye-opener to public and private governance systems for understanding and revising the process service planning and service delivery. Necessary intervention measures may be contemplated towards enhancing diagnostic skill of doctors for quality hospital care

A society based research to assess adherence of antiretroviral therapy

Access Adherence to Antiretroviral Therapy. A community-based antiretroviral (ART) drugs adherence study was conducted in Kolkata, India beginning in January and concluding in March 2011. This study was designed to explore the level of adherence as well as factors influencing adherence to ART by those who are receiving treatment through a public health care delivery system. This health care system is implemented through the National AIDS Control Program in the state of West Bengal, India. The research findings showed a high degree of non-adherence, between 48-52%, among the ART recipients. The analysis highlights a number of key factors negatively influencing adherence including long waiting time at the ART center, distance from residence to ART Centre, travel related expenditure, and fear of being identified as HIV + to family members and neighbors. Some positive influences were identified in the data as well. If a person is a member of a positive people network there is a greater chance for adherence as well as if an individual self-identifies as positive to others. However, no single factor, rather a combination of several factors, proved to be responsible for influencing ART adherence among recipients.&nbsp;&nbsp

A society based research to assess adherence of antiretroviral therapy

Access Adherence to Antiretroviral Therapy. A community-based antiretroviral (ART) drugs adherence study was conducted in Kolkata, India beginning in January and concluding in March 2011. This study was designed to explore the level of adherence as well as factors influencing adherence to ART by those who are receiving treatment through a public health care delivery system. This health care system is implemented through the National AIDS Control Program in the state of West Bengal, India. The research findings showed a high degree of non-adherence, between 48-52%, among the ART recipients. The analysis highlights a number of key factors negatively influencing adherence including long waiting time at the ART center, distance from residence to ART Centre, travel related expenditure, and fear of being identified as HIV + to family members and neighbors. Some positive influences were identified in the data as well. If a person is a member of a positive people network there is a greater chance for adherence as well as if an individual self-identifies as positive to others. However, no single factor, rather a combination of several factors, proved to be responsible for influencing ART adherence among recipients.&nbsp;&nbsp

SATISFACTION LEVEL OF MEDICAL EDUCATORS WORKING IN TEACHING INSTITUTIONS : A QUESTIONNAIRE BASED CROSS-SECTIONAL STUDY

In a resource-limited and high-burden disease setting, satisfied health professional is an asset in terms of maximized productivity, efficiency and quality health care. Job Satisfaction Index is a validated measure to identify the components that influence those issues. A multi-faceted structured questionnaire study was conducted upon a cross-section of medical educators (n=160) serving two tertiary care teaching institutions under different management set-up. Multiple demographic features were independent variables whereas three (3) critical areas of satisfaction index (SI) were outcome variables. All participants were interviewed using 15 item Likert response-based, modified job satisfaction scale. It was observed that total SI scores among doctors representing the private group remained marginally higher (P<0.05) while compared to the other group. The comparative analysis of SI scores in critical areas like availability of academic supports and job security remained higher among the private doctors than that of the government ones though not significant. However the private doctors remained marginally satisfied in terms of working environment. The study outcome necessitates appropriate intervention measures at the organizational levels