000			05708nam a22003137a 4500
001			CUHAS/MD/4002383/T/18
003			CUHAS/MD/4002383/T/18
005			20240305194005.0
008			231028b |||||||| |||| 00| 0 eng d
028			_bPhone: +255 28 298 3384
028			_b Fax: +255 28 298 3386
028			_b Email: vc@bugando.ac.tz
028			_b Website: www.bugando.ac.tz
035			_aCUHAS/MD/4002383/T/18
040			_cDDC
041			_aEnglish
041			_aKiswahili
100			_a Lenard Busanya _dCUHAS/MD/4002383/T/18
245			_aAcceptance of Dolutegravir Based Treatment and Perception among Patients Transitioned From Efavirenz Regimen at Sekou-Toure Regional Hospital
260			_aMwanza, Tanzania: _bCatholic University of Health and Allied Sciences [CUHAS – Bugando]: _c ©2023
300			_a39 Pages
300			_aIncludes References and Appendicies
520			_a1.0 INTRODUCTION 1.1 Background information HIV/AIDS is a leading cause of morbidity and mortality in sub Saharan Africa (1). 49.7 million HIV infection occurred in 1999 globally, 72% were in sub-Saharan Africa. 84% of AIDS death 91% of child HIV infection and 84% of child AIDS death globally have occurred in Africa (2). With around 5.3 million people living with HIV/AIDS, south Africa has the greatest number of HIV-infected people in the world, accounting for 25% of burden of HIV infection in sub-Saharan Africa (3). The highest number of infections in sub-Saharan Africa can be explained by the relationship between socioeconomic status and health, there is a substantial evidence that more affluent people do better on most health-related indicators such as nutrition, morbidity and mortality and healthcare use. As part of sub-Saharan Africa, HIV remains the public concern in Tanzania. It was estimated that 1.4 million people were living with HIV in Tanzania in 2013 (4). The prevalence of HIV in the general population in Tanzania is estimated to be 5.1%. There is strong evidence that the prevalence of HIV is higher in large urban areas than in rural area, while the size of the difference varies widely between countries (5) Antiretroviral therapy (ART) expansion during the past ten years has resulted in an unprecedented number of HIV-positive individuals receiving treatment, which has reduced HIV related morbidity, mortality and further transmission. However, the ART coverage is still low. 2 million people in low- and middle-income countries were receiving ART in 2006, but this was only 26% of those estimated to be in urgent need of it (6). There is an increase in the ART coverage in sub-Saharan Africa with 47.6% increment. With Nigeria recording highest increase in ART coverage (72%) while Ethiopia had the least (30%). Tanzania has experienced a surge with over 70% increment from 2015 to 2020 )48% to 82% respectively) (7,8). Therapy failure can be brought about by the ineffective drug combinations, poor treatment compliance, broken supply chains for ARVs, the spread of drug-resistance viruses and the development of resistance to therapy (9). Adherence to ART is the key factor in viral suppression, which lowers the risk of HIV transmission by 96% in people living with the infection and stops the emergence of HIV drug resistance. Barriers to adherence levels include poverty, stigmatization, poor access to ARVs and traditional beliefs (9). Higher adherence levels have been shown repeatedly to correlate with longer efficiency of first line regimen. The world Health Organization (WHO) revised and published guidelines recommending dolutegravir (DTG) based ART as the first line in HIV treatment following evidence from clinical trials showing that DTG-based ART had superior patient’s outcome compared to alternative combinations (such as those containing efavirenz) (9). Our aim is to determine the acceptance of dolutegravir based regimen and perception among patients transitioned from efavirenz regimen at Sekou Touré regional hospital. 1.2 Problem Statement Tanzania introduced a dolutegravir (DTG) based regimen as the preferred first line for managing HIV among adults in 2019 (10). Dolutegravir is highly preferred due to its high genetic barrier to resistance. However, initially dolutegravir has been shown to be associated with increased risk of neural tube defects in infants born to women using dolutegravir during conception and who were obese (11). We would like to assess whether that has affected their acceptance and perception towards dolutegravir based regimen. 1.3 Rationale of The Study Findings from this study will be useful in informing the public and policy makers to facilitate rollout among women, it will also provide recommendations to improve doctor-patient communication better understanding of treatment plan. 1.4 Research Question What is the acceptance of dolutegravir based treatment and perception among patients transitioned from efavirenz regimen at Sekou Touré regional hospital? 1.5 Research Objectives 1.5.1 Broad Objectives To determine the acceptance and perception of dolutegravir based treatment among patients transitioned from efavirenz regimen at Sekou Touré regional hospital 1.5.2 Specific Objectives 1. To determine the acceptance of dolutegravir based treatment among patients transitioned from efavirenz regimen at Sekou Touré regional hospital. 2. To determine perception of dolutegravir based treatment among patients transitioned from efavirenz regimen at Sekou Touré regional hospital.
600			_xInternal Medicine
600			_xBiochemistry
700			_a Samuel Elias Kalluvya
700			_aFelix Tarimo
942			_2ddc _cCR
999			_c22908 _d22908