Realizing the significance to provide
holistic care & support for PLHA’s, there is a need for ART drug initiation & treatment for
PLHA’s. Here, DAPCU, North Tripura, has put an emphasis on providing attention to the subject. This has been observed that there are many clients,
do not reach ART & FI-ART, every month or on time to take medicine & CD4 tests remains pending to assess their present status. Even, this
has been observed that newly detected client doesn’t reach to ICTC & FI-ART to do their confirmation
tests & link to ART System. So, this is a chronic issue realizing the care for PLHIV’s & DAPCU, North Tripura
has made significance on that.
With the increasing number of persons living with the Human Immunodeficiency Virus
(HIV), there is a need to have a comprehensive strategy to reduce the number of
dropouts from the anti-retroviral (ART) therapy.
HIV infection is not the
end of life. People can lead a healthy life for a long time with
appropriate medical care. Anti-retroviral therapy (ART) effectively
suppresses replication, if taken at the right time. Successful viral
suppression restores the immune system and halts onset and progression of the disease as well as reduces the chances of getting opportunistic infections – this
is how ART is aimed to work. Medication thus enhances both qualities of life and
longevity.
Adherence to ART is
Critical & LFU’s have been divided into two categories as PRE ART LFU &
On-ART LFU’s.
Adherence to the ART regimen
is, therefore, very vital in this treatment. Any irregularity in the prescribed
regimen can lead to resistance to HIV drugs, and thus can weaken or negate
its effect.
As
the number of HIV+ve detection keep on rising Tripura State AIDS Control
Society established LAC in the undivided North Tripura in the year 2008 and the
FI-ART was established at Dharmanagar Dist. Hospital, North Tripura in the April’
2015. Earlier HIV+ve detected was asked to go to Agartala
(State Capital of Tripura) For CD4 testing before starting the ART. As most of
the +ve detected were from poor economic background, many were not able to go to
Agartala as it was about 190 km with steep hill terrain and poor transport
connectivity, so to avail the facility,
few strategies have been taken. Intervention by DAPCU:-
Ø Reason for not attending
at ART:- DAPCU has made various teams
& through dividing the team visited at different spots & directly
interacted with PLHA’s & family members. I tried to know the reason for not
attending. All socio-demographic and clinical factors
associated with antiretroviral therapy adherence. Illiteracy & ignorance
was common factors for Lost to Follow up. Male drivers were lost to follow-up
To a greater extent, male patients were serodiscordant. In a few cases,
Migration led to drop patients. Other essential factors leading to loss to
follow up were: death in the family, side effects of drugs, and family disturbance.
Alcoholism was the cause of male patients. In a few cases, very poor economic condition
lies the most importance. CONCLUSION AND RELEVANCE: Migration,
illiteracy, alcoholism, discordant couples, death in family, low socio-economic
Status, resorting to alternative therapies, were the prominent factors that
directly influenced and aggravated the problem of non-adherence. Targeting
these variables will cause a definite reduction in lost to follow-up cases.
Ø Strategy have been taken through
collecting Blood Sample at FI-ART, where clients can easily reach out & Sent
To AGMC, ART. With this approach, Since 2016, FI-ART Campaign is going on & On
29th December at FI-ART, Dharmanagar, 2016 total 57 blood sample
have been collected for CD4 testing with
collective approach of AGMC, Agartala,
TSACS, Agartala, ART-Agartala, DAPCU, North Tripura, CMO, North Tripura,
MS-DH, Dharmanagar, FI-ART-Dharmanagar, TI & Non-TI. In the year,2019, on 28-29th
April 2019, CD4 Campaign has been organized at Dharmanagar
Dist Hospital & LAC, Kailashahar. A total of 31 Samples collected.
Ø Few
pockets to be created where at least 15-20 clients can be gathered &
collection of Blood Sample for pending & Baseline CD4 clients through
Mobile ICTC, as in every month, M-ICTC visits in the district.
Ø Mobilization & sensitization for CD4 testing in Capacity
Building Workshop with.
Ø Outreach & Counseling to them as the
message can be reached to them & they may be aware regarding the significance of
their lives.
Ø 25th
June,2019 ,DPM,DAPCU & other TI’s
etc conducted Cd4 campaign &
Initiation of ART at Damcherra. Total of 15 samples collected & initiated for
ART drugs.
Ø Visits with Community member, ASHA
facilitator, MPS, MPW to trace them.
Ø In the current month, (
September 2019) DAPCU did drive for
FI-ART initiation campaign at Damcherra PHC & Khedacherra PHC. In this
team, DIS, DAPCU, MO-FI-ART & Counselor, Lab Tech-Panisagar SA ICTC, visited
at PHC’s to make spot initiation with check-up with the help of TI, N-TI’s. On
17th Sep 2019 visited at Damcherra & there was linked 12 New
Cases & 4 LFU.Similarly on 21st September 2019 at Khedacherra
PHC, there was bound 5 New Cases & LFU. There we made a screening campaign
too. DIS, DAPCU made a home visit with N-TI & Vihaan to counsel them & we
succeeded.
Similarly DPM, DAPCU
with the help of N-TI visited in various
places of the district to conduct home visits & those clients back to FI-ART.
Ø In future planning
DAPCU will take integrated camp with HIV Screening & Spot ART Initiation to
reduce LFU’s. Thus, many clients have access to ART drugs & reduced LFU’s
consequently.
&
Similarly, DAPCU will continue the practice considering the LFU’s in the
Specified Area. Here, this is very much necessary to mention the whole
the procedure has been achieved through the extreme effort of Chief Medical Officer, North
Tripura, Tripura SACS, FI-ART, TI, N-TI’s, Vihaan & relevant Health institutions.
Photos:
Fig:ART
drug initiation campaign at Khedacherra
In September,2019.
Fig: Meeting with CMO,North Tripura regarding
LFU minimize in June,2019
Fig: Home visit by DPM,DAPCU with N-TI at Kumarghat in August,2019.
Fig:Home visit by DIS,DAPCU at Jalabassa in August,2019.
Fig: ART
drug initiation campaign at Damcherra
In June,2019.
Fig:Home visit by DIS,DAPCU at Khedacherra in
September,2019
