| Peer-Reviewed

Evaluation of Adherence to Anti-Retroviral Treatment: Experience of SANRU, DRC

Received: 16 August 2018    Accepted: 3 September 2018    Published: 30 September 2018
Views:       Downloads:
Abstract

Access to antiretroviral treatment (ART) has substantially increased in the Democratic Republic of Congo (DRC) over the past 5 years. Santé Rural (SANRU), a non-governmental organization established by l’Eglise de Christ du Congo (Christ’s Church of the Congo) in the 1980s to improve rural health in the DRC, is one of the principal recipients of Global fund in DRC with around 40000 people living with HIV/AIDS (PLWHIV) receiving ART in 129 health zones in the country. The continuous success of ART critically depends on sustained ART adherence. The objective of this study was to identify the determinants of adherence among PLWHIV in SANRU managed health zones in the Democratic Republic of Congo. Two thousand five hundred eighty-six PLWHIV’s files were extracted. Eighty-two percent (82%) were adherent to ART, while 85. 5% were alive after 12 months on anti-retroviral treatment, 5.2% were lost from follow-up and 2.2% were transferred. The average age was 37 years, and predominantly women formed 65.5% of the sample. The median distance between facilities and patient’s habitat was 5 kms. Close to three-fifth of the PLWHIV were living in urban settings (64.4%). Among 2586 patient’s files retrieved, 2495 (96, 5%) were followed up in facilities with at least an HIV-care trained physician and nurses, 1566 (60.6%) were followed up in facilities with at least one HIV care trained pharmacist; 1645 (63.6%) among the PLWHIV did not report ART stock run-outs. These findings highlight the relevance of healthcare providers’ training on HIV to improve HIV patient outcomes.

Published in Central African Journal of Public Health (Volume 4, Issue 5)
DOI 10.11648/j.cajph.20180405.11
Page(s) 131-136
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

ART, PLWHIV, Adherence, Evaluation

References
[1] Rivero-Mendez M, Suarez-Perez EL, Solis-Baez SS. Measuring Health Literacy among People Living with HIV who attend a community based Ambulatory Clinic in Puerto Rico. PR Health Sci J. 2015; 34(1): 31-37.
[2] Thida A, Tun STT, Zaw SKK, Lover AA, Cavailler P, Chunn J et al. Retention and Risk Factors for Attrition in a Large Public Health ART Program in Myanmar: A Retrospective Cohort Analysis. PLoS ONE 2014; 9(9): e108615.
[3] Shigdel R, Klouman E, Bhandari A, Ahmed LA. Factors associated with adherence to antiretroviral therapy in HIV-infected patients in Kathmandu District, Nepal. HIV/AIDS – Research and Palliative Care 2014; 6: 109–116.
[4] Hirsch JD, Gonzales M, Rosenquist A, Miller TA, Gilmer TP, Best BM. Antiretroviral Therapy Adherence, Medication Use, and Health Care Costs During 3 Years of a Community Pharmacy Medication Therapy Management Program for Medi-Cal Beneficiaries with HIV/AIDS. J Manag Care Pharm. 2011; 17(3):213-23.
[5] Jiamsakul N, Kumarasamy N, Ditangco R, Li PCK, Phanuphak P, Sirisanthana T et al. Factors associated with suboptimal adherence to antiretroviral therapy in Asia. Journal of the International AIDS Society 2014; 17:18911.
[6] Chkhartishvili N, Rukhadze N, Svanidze M, Sharvadze L, Tsertsvadze T, McNutt LA et al. Evaluation of multiple measures of antiretroviral adherence in the Eastern European country of Georgia. Journal of the International AIDS Society 2014; 17:18885.
[7] Pasternak AO, de Bruin M, Bakker M, Berkhout B, Prins JM. High Current CD4+ T Cell Count Predicts Suboptimal Adherence to Antiretroviral Therapy. PLoS ONE 2015; 10(10): e0140791.
[8] Bisson GP, Gross R, Bellamy S, Chittams J, Hislop M, Regensberg L, et al. Pharmacy refill adherence compared with CD4 count changes for monitoring HIV-infected adults on antiretroviral therapy. PLoS Med 2008; 5(5):e109.
[9] Glass TR, Cavassin M. Asking about adherence – from flipping the coin to strong evidence. Swiss Med Wkly. 2014;144 : w14016.
[10] Cooke CE, Lee HY, Xing S. Adherence to Antiretroviral Therapy in Managed Care Members in the United States: A Retrospective Claims Analysis. J Manag Care Pharm. 2014; 20(1):86-92.
[11] Protopopescu C, Raffi F, Roux P, Reynes J, Dellamonica P, Spire B et al. Factors associated with non-adherence to long-term highly active antiretroviral therapy: a 10 year follow-up analysis with correction for the bias induced by missing data. Journal of Antimicrobial Chemotherapy 2009; 64 : 599–606.
[12] Mills EJ, Nachega JB, Buchan I, Orbinski J, Attaran A, Singh S, et al. Adherence to antiretroviral therapy in sub-Saharan Africa and North America: a meta-analysis. JAMA 2006, 296(6):679-690.
[13] Landovitz RJ. What’s the best way to measure ARTadherence? Journal Watch 2011; 23 (3).
[14] Reda AA, Biadgilign S. Determinants of Adherence to Antiretroviral Therapy among HIV-Infected Patients in Africa. AIDS Research and Treatment 2012; ID 574656.
[15] Rougemont M, Stoll BE, Elia N, Ngang P. Antiretroviral treatment adherence and its determinants in Sub-Saharan Africa: a prospective study at Yaounde Central Hospital, Cameroon. AIDS Research and Therapy 2009; 6:21.
[16] Vreeman RC, Nyandiko WM, Liu H, Tu W, Scanlon ML, Slaven JE et al. Measuring adherence to antiretroviral therapy in children and adolescents in western Kenya. Journal of the International AIDS Society 2014; 17:19227.
[17] Wakibi SN, Ng’ang ZW, Mbugua GG. Factors associated with non-adherence to highly active antiretroviral therapy in Nairobi, Kenya. AIDS Research and Therapy 2011; 8:43.
[18] Sasaki Y, Kakimoto K, Dube C, Sikazwe I, Moyo C, Komada K et al. Adherence to antiretroviral therapy (ART) during the early months of treatment in rural Zambia: influence of demographic characteristics and social surroundings of patients. Annals of Clinical Microbiology and Antimicrobials 2012; 11:34.
[19] Okafor CE, Ekwunife OI. Self-reported adherence to antiretroviral therapy in sub Saharan Africa: A meta-analysis. International journal of public Health and Epidemiology 2014; 3(3) : 017-25Journal.
[20] McKinney O, Gleason PC, Modeste NN, Maynard-Tucker G, Lee JW. Determinants of Antiretroviral Therapy Adherence among Women in Southern Malawi: Healthcare Providers’ Perspectives. AIDS Research and Treatment 2014; ID 489370.
[21] Dewing SF, Mathews C, Lurie M, Kagee A, Padayachee T, Lombard CJ. Predictors of poor adherence among people on antiretroviral treatment in Cape Town, South Africa: A case-control study. AIDS Care 2015; 27(3): 342–349.
[22] Coetzee B, Kagee Q, Bland R. Barriers and facilitators to paediatric adherence to antiretroviral therapy in rural South Africa: a multi-stakeholder perspective. AIDS Care, 2015; 27(3): 315–321.
[23] Ditekemena J, Luhata C, Bonane W, Kiumbu M, Tshefu A, et al. Antiretroviral Treatment Program Retention among HIV-Infected Children in the Democratic Republic of Congo. PLoS ONE 2014;9(12): e113877.
[24] Fetzer BC, Kitetele F, Mupenda B, Golin C, Lusiama J, Behets F. Barriers to and Facilitators of Adherence to Pediatric Antiretroviral. AIDS PATIENT CARE and STDs 2011; 25 (10).
[25] Koole O, Kalenga L, Kiumbu M, Menten J, Ryder RW, Mukumbi H et al. Retention in a NGO Supported Antiretroviral Program in the Democratic Republic of Congo. PLoS ONE 2012; 7(7): e40971. doi:10.1371/journal.pone.0040971.
[26] Ayele W, Mulugeta A, Desta A, Rabito FA. Treatment outcomes and their determinants in HIV patients on Anti-retroviral Treatment Program in selected health facilities of Kembata and Hadiya zones, Southern Nations, Nationalities and Peoples Region, Ethiopia. BMC Public Health 2015; 15:826.
Cite This Article
  • APA Style

    Lukanu Ngwala Philippe, Izale Kwazimi Bibiche, Kanku Kalukusa Patrick, Balanda Musoko Freddy, Kalonji Ntumba Albert, et al. (2018). Evaluation of Adherence to Anti-Retroviral Treatment: Experience of SANRU, DRC. Central African Journal of Public Health, 4(5), 131-136. https://doi.org/10.11648/j.cajph.20180405.11

    Copy | Download

    ACS Style

    Lukanu Ngwala Philippe; Izale Kwazimi Bibiche; Kanku Kalukusa Patrick; Balanda Musoko Freddy; Kalonji Ntumba Albert, et al. Evaluation of Adherence to Anti-Retroviral Treatment: Experience of SANRU, DRC. Cent. Afr. J. Public Health 2018, 4(5), 131-136. doi: 10.11648/j.cajph.20180405.11

    Copy | Download

    AMA Style

    Lukanu Ngwala Philippe, Izale Kwazimi Bibiche, Kanku Kalukusa Patrick, Balanda Musoko Freddy, Kalonji Ntumba Albert, et al. Evaluation of Adherence to Anti-Retroviral Treatment: Experience of SANRU, DRC. Cent Afr J Public Health. 2018;4(5):131-136. doi: 10.11648/j.cajph.20180405.11

    Copy | Download

  • @article{10.11648/j.cajph.20180405.11,
      author = {Lukanu Ngwala Philippe and Izale Kwazimi Bibiche and Kanku Kalukusa Patrick and Balanda Musoko Freddy and Kalonji Ntumba Albert and Minuku Felix and Ngoma Miezi Kintaudi Leon and Ogunbanjo Gboyega Adebola},
      title = {Evaluation of Adherence to Anti-Retroviral Treatment: Experience of SANRU, DRC},
      journal = {Central African Journal of Public Health},
      volume = {4},
      number = {5},
      pages = {131-136},
      doi = {10.11648/j.cajph.20180405.11},
      url = {https://doi.org/10.11648/j.cajph.20180405.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20180405.11},
      abstract = {Access to antiretroviral treatment (ART) has substantially increased in the Democratic Republic of Congo (DRC) over the past 5 years. Santé Rural (SANRU), a non-governmental organization established by l’Eglise de Christ du Congo (Christ’s Church of the Congo) in the 1980s to improve rural health in the DRC, is one of the principal recipients of Global fund in DRC with around 40000 people living with HIV/AIDS (PLWHIV) receiving ART in 129 health zones in the country. The continuous success of ART critically depends on sustained ART adherence. The objective of this study was to identify the determinants of adherence among PLWHIV in SANRU managed health zones in the Democratic Republic of Congo. Two thousand five hundred eighty-six PLWHIV’s files were extracted. Eighty-two percent (82%) were adherent to ART, while 85. 5% were alive after 12 months on anti-retroviral treatment, 5.2% were lost from follow-up and 2.2% were transferred. The average age was 37 years, and predominantly women formed 65.5% of the sample. The median distance between facilities and patient’s habitat was 5 kms. Close to three-fifth of the PLWHIV were living in urban settings (64.4%). Among 2586 patient’s files retrieved, 2495 (96, 5%) were followed up in facilities with at least an HIV-care trained physician and nurses, 1566 (60.6%) were followed up in facilities with at least one HIV care trained pharmacist; 1645 (63.6%) among the PLWHIV did not report ART stock run-outs. These findings highlight the relevance of healthcare providers’ training on HIV to improve HIV patient outcomes.},
     year = {2018}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Evaluation of Adherence to Anti-Retroviral Treatment: Experience of SANRU, DRC
    AU  - Lukanu Ngwala Philippe
    AU  - Izale Kwazimi Bibiche
    AU  - Kanku Kalukusa Patrick
    AU  - Balanda Musoko Freddy
    AU  - Kalonji Ntumba Albert
    AU  - Minuku Felix
    AU  - Ngoma Miezi Kintaudi Leon
    AU  - Ogunbanjo Gboyega Adebola
    Y1  - 2018/09/30
    PY  - 2018
    N1  - https://doi.org/10.11648/j.cajph.20180405.11
    DO  - 10.11648/j.cajph.20180405.11
    T2  - Central African Journal of Public Health
    JF  - Central African Journal of Public Health
    JO  - Central African Journal of Public Health
    SP  - 131
    EP  - 136
    PB  - Science Publishing Group
    SN  - 2575-5781
    UR  - https://doi.org/10.11648/j.cajph.20180405.11
    AB  - Access to antiretroviral treatment (ART) has substantially increased in the Democratic Republic of Congo (DRC) over the past 5 years. Santé Rural (SANRU), a non-governmental organization established by l’Eglise de Christ du Congo (Christ’s Church of the Congo) in the 1980s to improve rural health in the DRC, is one of the principal recipients of Global fund in DRC with around 40000 people living with HIV/AIDS (PLWHIV) receiving ART in 129 health zones in the country. The continuous success of ART critically depends on sustained ART adherence. The objective of this study was to identify the determinants of adherence among PLWHIV in SANRU managed health zones in the Democratic Republic of Congo. Two thousand five hundred eighty-six PLWHIV’s files were extracted. Eighty-two percent (82%) were adherent to ART, while 85. 5% were alive after 12 months on anti-retroviral treatment, 5.2% were lost from follow-up and 2.2% were transferred. The average age was 37 years, and predominantly women formed 65.5% of the sample. The median distance between facilities and patient’s habitat was 5 kms. Close to three-fifth of the PLWHIV were living in urban settings (64.4%). Among 2586 patient’s files retrieved, 2495 (96, 5%) were followed up in facilities with at least an HIV-care trained physician and nurses, 1566 (60.6%) were followed up in facilities with at least one HIV care trained pharmacist; 1645 (63.6%) among the PLWHIV did not report ART stock run-outs. These findings highlight the relevance of healthcare providers’ training on HIV to improve HIV patient outcomes.
    VL  - 4
    IS  - 5
    ER  - 

    Copy | Download

Author Information
  • Department of Family Medicine, Protestant University of Congo, Kinshasa, DRC; Sante Rural, Kinshasa, DRC

  • Sante Rural, Kinshasa, DRC

  • Sante Rural, Kinshasa, DRC

  • Sante Rural, Kinshasa, DRC

  • Sante Rural, Kinshasa, DRC

  • Sante Rural, Kinshasa, DRC

  • Department of Family Medicine, Protestant University of Congo, Kinshasa, DRC; Sante Rural, Kinshasa, DRC

  • Family Medicine Department, Sefako Makgato University, Pretoria, South Africa

  • Sections