Medication Adherence and its Determinants Among Patients on Concomitant Tuberculosis and Antiretroviral Therapy in South West Ethiopia

Background: To benefit from therapy and to avoid contracting treatment resistant strains, the individuals must adhere to medications. Aim : The study was designed to assess the degree of drug adherence and its determinants in patients living with HIV/AIDS and TB comorbidity. Materials and Methods: A cross-sectional study was conducted to assess the degree of drug adherence and its determinants with the help of self-administered questionnaires in Tercha District Hospital in South Ethiopia. Result : A total of 24 patients were included in the study. The majority were females (54.2%) and the mean age was 32.4 (SD±9.6) years. Adherence level was 95.8% for Antiretroviral (ARV) medications and 79.2% for anti TB medications. Educational status was associated with anti TB (P=0.021) medication adherence. The reason for the missed doses were mostly lack of money for transport (23.7% for antiretroviral therapy (ART), 26.0% for TB treatment) and forgetting to take medications (18.4% for ART, 17.4% for TB treatment. Conclusion: The adherence level obtained for both ARV and anti-TB where high. Transportation costs for patients could be reduced by bringing the services close to where they live

Knowledge, Attitude and Practice of Adverse Drug Reaction Reporting among Health Professionals in Southwest Ethiopia

AIM: Adverse drug reaction is noxious and unwanted reaction to drugs at dose used in humans for diagnosis, treatment or prophylaxis. Adverse drug reaction monitoring is an area of drug information that has been given little attention yet. Spontaneous reporting is currently the major back bone for the detection of adverse drug reactions. The objective of this study was to assess the knowledge, attitude and practices of adverse drug reaction reporting among health professionals in selected health facilities in southwest Ethiopia. METHOD: A cross-sectional study design was used among health professionals in selected health facilities in January 2010. Prescribers other than physicians, junior pharmacy technicians and also health assistants were excluded. Data was collected using self administered questionnaires from volunteered physicians (Medical interns and above), nurses (Diploma and above) and Pharmacy professionals (Diploma and above) and analyzed using SPSS version 16.0. RESULTS: A total of 82 health professionals were participated in the study. From those 82 participants, only 19 (23.17%) and 21 (25.61%) knew the existence of national reporting system and a yellow card of adverse drug reaction reporting form. Thirteen (15.85%) participants encountered adverse drug reaction in the past 12 months in their clinical activities, but none of them reported to responsible body. Even though the participants’ knowledge and practice were inadequate, most of the respondents 47 (57.31%) agreed that adverse drug reaction reporting is part of duty of them and important to the public in general and to the patient in particular. CONCLUSION: There was no documentation and reporting of adverse drug reaction, which might partly be explained by lack of knowledge and misconceptions about spontaneous reporting. Our study strongly suggests that there is a great need to create awareness and to promote the reporting of adverse drug reaction amongst health professionals, which will lay a solid foundation for healthcare professionals to be diligently involved in quality pharmacovigilance and spontaneous reporting in their future practices. [TAF Prev Med Bull 2012; 11(4.000): 397-406

Causes for antiretroviral regimen change among HIV/AIDS patients in Addis Ababa, Ethiopia

Highly active antiretroviral therapy has markedly decreased the morbidity and mortality due to HIV/AIDS. Once antiretroviral therapy (ART) is initiated, patients generally remain on medications indefinitely. A switch in the antiretroviral regimen is often necessary because of both acute and chronic toxicities, concomitant clinical conditions, and development of virologic failure. The objective of this study was to assess the causes of initial highly active antiretroviral therapeutic regimen changes among patients on ART in Addis Ababa, Ethiopia. This was a retrospective cross-sectional study conducted from January 1 to March 1, 2010 in two primary hospitals and one health centre in central Ethiopia. Information cards of HIV/AIDS patients who have had their antiretroviral regimen switched were reviewed. Data from patients below 18 years old and those who did not switch HAART regimen were excluded. Data were then analyzed using SPSS for windows version 16.0. A total of 300 patients’ information card was reviewed and the mean age of the patients was 38.6±7 years. Females accounted for 59% (177) of the total patients. The most common first regimen before first switch was D4T/3TC/NVP (63%) and D4T/3TC/EFV (18%). The main reasons for modification were toxicity (65%), comorbidity (25%), pregnancy (5%) and treatment failure (3%). The main types of toxicities observed were peripheral neuropathy (39%), rash (20%) and anaemia (13.33%). Drug toxicity was the main reason for modification of initial antiretroviral regimen and initial Efavirenz-based regimens are less likely to be changed. The occurrence of drug toxicity should be assessed early among patients commencing HAART and health professionals should be empowered to make appropriate regimen changes

Management of common adverse effects in the era of highly active antiretroviral therapy in south east Ethiopia

Background: The combination of antiretroviral therapy is the corner stone of management of patients with human immune deficiency virus infection. Although antiretroviral therapy can reduce viral load to undetectable level, improve the immunity and prolong survival of patients, antiretroviral drugs are associated with many adverse effects that may be severe and affect patient adherence and quality of life. Aims : The aim of this study was to assess management strategies under taken in patient′s experienced common adverse effects of highly active antiretroviral therapy in Goba Hospital antiretroviral clinic. Patients and Methods: A cross sectional study of patient record chart of patients who had follow-up during data collection period was done followed by patient interview. Data was filled on well structured questionnaire and analyzed using SPSS for window version 16.0. Results: The common adverse effects were Rash (48.8%), Peripheral neuropathy (36.9%) and Anemia (20.24%). The rate of management was 39.3%. Pyridoxine (36.8%) was commonly prescribed drug for management of Peripheral neuropathy. Chlorphenarimine gel and Iron gluconate were common drugs for management of Rash and Anemia respectively. Use of traditional healers (57.7%) was leading reason for non-management. Conclusion: Rate of management for common adverse effect is low. Education should be given on adverse effects for patients