Somi G, Matee M, Makene C L, Van Den Hombergh J, Kilama B, Yahya-Malima K I, Masako P, Sando D, Ndayongeje J, Rabiel B, Swai R O
Ministry of Health and Social Welfare, P.O. Box 9083, Dar es Salaam, Tanzania.
Tanzan J Health Res. 2009 Jul;11(3):136-43. doi: 10.4314/thrb.v11i3.47700.
The Tanzania HIV Care and Treatment Plan was launched in October 2004 aiming at providing 440,000 AIDS patients with antiretroviral drugs (ARVs) and track disease progression in 1.2 million HIV+ persons by the end of the 2008. This paper is intended to provide information to stake holders of the achievements and challenges of the HIV Care and Treatment Plan since its inception in 2004. Facility patient reports are aggregated at district and then regional level before being sent to the national level where they are aggregated to form a national report. By December 2007, 210 health facilities were offering HIV care and treatment services in Tanzania. About 123,147 (5%) of the 2,636,785 estimated people living with HIV and AIDS were enrolled, and 71,439 (13.6%) of the estimated 527,357 AIDS cases commenced ART. More females than males started ART, F:M ratio being 3:2. Most (49%) patients were started ART due to low CD4 counts (< 200). About 6,618 patients had their initial ARV regimen changed due to starting anti-TB treatment 679 (10%), peripheral neuropathy 812 (12%), skin rash 378 (6%), and stock out 247 (4%) or other reasons (18%), while 2,653 (42%) had no reason recorded. The proportion of patients still alive and on ART at 6, 12 and 24 months after initiation of treatment was 60%, 60%, and 50%, respectively, while those collecting ARVs on schedule was 34%, 25% and 10% respectively. About 3,084 patients developed TB after starting ART, of whom 1,557 (approximately 50%) patients during the first three months of treatment. During the three years (2004-2007) of HIV care and treatment services in Tanzania, there has been an increase in the number of CTC facilities, geographical coverage of services, the number of enrolled patients and those on ART. However, the set target for ART services has not been achieved and there are significant geographical variations in these achievements, which do not correspond with either population density or disease burden. Efforts should be made to i) ensure equitable accessibility when scaling up ART services in Tanzania, ii) improve the recording and reporting system and iii) armonize the activities of various stakeholders.
坦桑尼亚艾滋病护理与治疗计划于2004年10月启动，旨在到2008年底为44万艾滋病患者提供抗逆转录病毒药物（ARV），并跟踪120万艾滋病毒阳性者的疾病进展情况。本文旨在向利益相关者提供有关艾滋病护理与治疗计划自2004年启动以来的成就和挑战的信息。医疗机构的患者报告先在地区层面汇总，然后在区域层面汇总，最后发送到国家层面进行汇总，形成国家报告。到2007年12月，坦桑尼亚有210家医疗机构提供艾滋病护理与治疗服务。在估计的2636785名艾滋病毒和艾滋病感染者中，约123147人（5%）登记在册，在估计的527357例艾滋病病例中，71439人（13.6%）开始接受抗逆转录病毒治疗（ART）。开始接受ART的女性多于男性，女性与男性的比例为3:2。大多数（49%）患者因CD4细胞计数低（<200）而开始接受ART。约6618名患者因开始抗结核治疗（679例，占10%）、周围神经病变（812例，占12%）、皮疹（378例，占6%）、药物短缺（247例，占4%）或其他原因（18%）而改变了初始抗逆转录病毒治疗方案，而2653例（42%）未记录原因。治疗开始后6个月、12个月和24个月仍存活并接受ART治疗的患者比例分别为60%、60%和50%，按时领取抗逆转录病毒药物的患者比例分别为34%、25%和10%。约3084名患者在开始接受ART治疗后患上结核病，其中1557例（约50%）患者在治疗的前三个月患病。在坦桑尼亚开展艾滋病护理与治疗服务的三年（2004 - 2007年）间，提供综合治疗与关怀服务（CTC）的医疗机构数量、服务的地理覆盖范围、登记患者数量以及接受ART治疗的患者数量均有所增加。然而，ART服务设定的目标尚未实现，这些成就存在显著的地理差异，且与人口密度或疾病负担均不相符。应努力做到：一、在坦桑尼亚扩大ART服务时确保公平可及性；二、改进记录和报告系统；三、协调各利益相关者的活动。
