Stock-outs of antiretroviral drugs and coping strategies used to prevent changes in treatment regimens in Kinondoni District, Tanzania: a cross-sectional study

OBJECTIVES: Since 2004, the government of Tanzania has been rolling out antiretroviral treatment programs all over the country. However, the capacity of the health system to cope with the rapid scale-up of these programs is a major concern, and problems may result in drug stock-outs that force changes in treatment regimens. This study aims to explore stock-outs of antiretroviral drugs and further determine the coping strategies employed to prevent changes in treatment regimens in HIV/AIDS care and treatment clinics in Kinondoni District, Dar es Salaam, Tanzania. METHODS: A cross-sectional study was conducted in 20 HIV/AIDS care and treatment clinics. Interviews were conducted with the person in charge and a member of the pharmacy staff from each clinic using a pre-tested semi-structured interview guide. Verbal responses were transcribed, coded and analysed by thematic approach. Quantitative data were analysed using Excel spreadsheet (Microsoft Excel®, Microsoft Corporation). RESULTS: The total number of clients enrolled in the visited clinics was 32,147, of whom 20,831 (64.8%) had already been initiated onto antiretroviral therapies (ART). Stock-out of antiretroviral drugs was reported in 16 out of the 20 clinics, causing 210 patients to change their ART regimens, during the 12 months preceding the survey. Inefficient supply systems, quantification problems and short expiry duration were cited as the main causes of stock-outs. The coping strategies utilised to prevent changes in ART regimens were: shortening of the refill period, borrowing and moving patients to other clinics. CONCLUSION: Changes in ART regimens due to stock-outs of antiretroviral drugs occurred in a small but significant number of patients. This increases the risk of the emergence of drug-resistant HIV strains. Healthcare workers use various coping strategies to prevent changes in ART regimens but, unfortunately, some of these strategies are likely to increase patient-borne costs, which may discourage them from attending their routine clinics, hence leading to unplanned treatment interruptions

Conservation agriculture as practised in Tanzania : three case studies : Arumeru district, Karatu district, Mbeya district

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Conservation agriculture as practised in Tanzania : three case studies. Arumeru District, Karatu District, Mbeya District

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The Eotulelo farmer field school: Learning and promoting conservation agriculture

The Likamba village in northern Tanzania was experiencing increasing levels of soil erosion and herds of cattle were roaming the area, eating whatever they could find. The villagers came together to discuss what to do and decided to form their own self-help group (Eotulelo group) in 2001. They planted trees, built contour bunds and also found ways to earn money such as beekeeping and chicken raising. To get outside assistance they registered as a formal organization with the Selian Agricultural Research Institute (SARI). Soon afterward SARI started a project called Conservation Agriculture for Sustainable Agriculture and Rural Development Project (CA-SARD). As one of the most active self-help groups in the area SARI included the Eotulelo group in the CA-SARD project. The CA-SARD project started a farmer field school in the Eotulelo self-help group to help them implement conservation agriculture. The farmer field school has allowed the farmers to acquire considerable knowledge and problem solving skills for implementing conservation agriculture even though its only been running since July 2004. The Tanzanian Ministry of Agriculture, seeing the successful results of farmer field schools, decided to start 100 pilot farmer field schools in ten districts each with 10 groups. CA-SARD is advising the ministry on technologies to be copied and shown to farmer field schools

A study of the suitability of reduced tillage and cover crops for households under labour stress in Babati and Karatu Districts, Northern Tanzania

Metadata only recordConservation agriculture is frequently cited as having labour saving properties and as a potential solution to farm power shortages suitable in households under labour stress. However, its suitability for use by vulnerable households in sub-Saharan Africa has yet to be examined from technical, economic and social perspectives. Its adoption requires a significant change in farming practices and the use of specialist equipment, as well as a fundamental change in mindset towards cultivation practices

Prevalence, treatment, and factors associated with cryptococcal meningitis post introduction of integrase inhibitors antiretroviral based regimens among People Living with HIV in Tanzania.

ObjectiveThis study aimed to assess the prevalence of Cryptococcal Meningitis (CM), treatment practice, and the associated factors post-introduction of Tenofovir Lamivudine and Dolutegravir (TLD) regimen among People Living with HIV (PLHIV) in Tanzania.MethodsThis was an analytical cross-sectional study, and the data was collected retrospectively in three public regional referral hospitals (RRHs) in Dar es Salaam, Tanzania. A total of 405 files of the PLHIV admitted in the medical wards on the TLD regimen from January 2019 to December 2022 were reviewed. The collected information includes the patient's demographic characteristics, Cryptococcal status, CD4 level at the time of CM diagnosis, status of using ART, CM treatment approach, and outcome. Data was analyzed using SPSS software version 23.ResultsOut of 405 patients, the majority 267(65.9%) were female, 224(55.3%) were aged between 36-55 years, and 293(72.3%) were married. ART defaulters were found to be 37(9.1%). The prevalence of CM was found to be 48(11.9%), out of which 42(87.5%) received fluconazole alone. ART defaulter and marital status significantly (p-value ConclusionThe study found the prevalence of CM among PLHIV to be significantly high and the majority were treated with fluconazole alone. ART defaulters and marital status were significantly associated with one being CM positive. Responsible authorities and stakeholders should enforce guideline adherence and PLHIV should be encouraged on medication adherence