Assessment Of Rational Use Of Antiretroviral Drugs In Health Institutions In Kano Metropolis
Assessment Of Rational Use Of Antiretroviral Drugs In Health Institutions In Kano Metropolis.
ABSTRACT
With the national prevalence of 5.0% in Nigeria, HIV infections have become one of the most dreadly medical challenges. Availability of highly active antiretroviral therapy (HAART) has given a new hope of living with somewhat terminal syndrome.
The availability, affordability and effective usage of antiretrovirals in Kano (North West Nigeria) was studied to provide a data for compliance study with the National Standard Treatment Guideline (STG) and also for comparison with other International data.
A total of 138 patients (pooled from three health institutions) were studied at random through a structured questionnaire and patient medication information record. The mean age of the patients was 35.6years with a standard deviation of 7.8 years. Antiretroviral drugs are readily available.
However, affordability among the subjects studied was 97.5% and 47.5% at a subsidized federal government rate of one thousand naira per month and at a retail price of ten thousands naira per month respectively.
Adherence to therapy was difficult with about 60% of the patients having missed at least a dose in their treatment schedule. In fact, 25% of them have missed at least a dose within a week preceding the study.
Factors responsible for non-adherence (in decreasing order) were fasting, cumbersome (indefinite) treatment period, forgetfulness, side effects (mainly skin rash), fear of stigmatization (as patients can’t take medication in others presence), unavailability and travelling.
The study also showed that 88.4% of the patients were on triple HAART with 11.6% on either dual or monotherapy. Antiretroviral drugs used in the management of HIV/AIDS were drawn from the lamivudine, Zidovudine, Stavudine, and Nevirapine group.
INTRODUCTION
When it first appeared, AIDS (clinical stage of HIV infection) was recognized only as a severe previously unseen immuno-deficiency syndrome of unknown cause.
In 1981, initial reports describe the human immuno-deficiency virus (HIV) epidemic in the U.S. as a clinical syndrome of immune deficiency well before researchers identified HIV and showed it to be the cause of the syndrome (CDC, 1981; 1988).
Human immuno-deficiency virus infection initially only recognized among homosexuals in the U.S. in 1981 resulted in an early hypothesis that AIDS resulted from a behaviour specific to gay men because at that time in 1980s, gay men sometimes inhale amyl and butyl nitrate to enhance sexual performance.
This was however dismissed when the syndrome was later observed in other population group in Europe, America and Central Africa.
The observation of symptoms among heterosexuals, bisexuals, homosexuals, hemophilics, intravenous drug users and in babies of infected mothers led to the inference that HIV was an infection process.
In 1983, HIV was isolated and was later termed HIV-1 after the discovery of HIV-2 in West African region in 1986 (CDC1988).
Recent advances in basic and clinical research in HIV disease have dramatically changed the perspective of patients, clinicians and researchers allowing them to view HIV infection as a potentially treatable and conceivably curable disease rather than one that is relentlessly progressive and inevitably fatal (Cohen, 1993).
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