ABSTRACT
Background: Perception of the staff of an Anti Retroviral Therapy Center (ARTC) was explored regarding the organizational culture of the center with special reference to its effectiveness and efficiency.Methods: This qualitative exploration was conducted in the ARTC, RDGMC Ujjain. Data were collected during April 2016 and March 2018 by means of 35 self-administered-open-ended questionnaires as well as interviews (3 Focus Group Discussions and 5 Face to Face In-Depth Interviews). Data consisting of the text of the questionnaire responses and transcripts of the interview-sound files were subjected to thematic (content) analysis method.Results: Several praiseworthy features as well as deficiencies were identified, most important among them were related to counseling, behavior and management of investigations as well as treatment. Emphasis was on finding out effective and efficient ways to prevent LTFUs/ defaults/ delays. In the process of analysis of the data, three themes emerged. These are: theme 1 “general domains for attention and emphasis”; theme 2 “specific areas identified for further improvement” and theme 3 “suggestions for improvement and conclusions of the analysis of the situation”. Several measures were suggested in the interest of the PLHIV and the institution as well as for achievement of the global and national targets.Conclusions: For improvement in treatment coverage and success, escalation of certain inputs within a timeframe is essential while aiming at certain outputs is also urgently needed simultaneously. Among these, improving the staffing of the ART center in quality and quantity, the job satisfaction of the staff and patient satisfaction are extremely important.
ABSTRACT
Background: The main objective of study is to monitor and analyze the adverse drug reactions (ADRs) of ART and to assess causality and severity of the ADRs detected.Methods: It is a prospective observational study conducted in the ART centre of a tertiary care teaching hospital in central India. The data collected were recorded on standard ADR reporting forms. Causality was assessed by Naranjo’s algorithm. Severity of ADR’s was assessed by modified Hartwig and Seigel scale. Modified Shumock and Thorton criteria used for preventability assessment.Results: In twelve months duration 351 patients on ART were observed for ADRs. Total 166 ADRs detected in 96 patients. Incidence of ADRs was slightly more in female. The common systems involved were gastrointestinal 42.77% followed by nervous system 18.07%, musculoskeletal 15.06% skin/mucous membrane 07.83%, metabolic and nutritional 04.82%, red blood cell disorders 01.20 %, endocrinal 00.60 % and others 09.64%. The causality assessment as per Naranjo’s scale showed that out of 166 ADRs, 28.92% were probable and 71.08% were possible. Severity assessment by modified Hartwig and Siegel scale showed that 83.34% ADRs were mild and 15.66% were moderate. 46.39 % ADRs were probably preventable.Conclusions: Considering the magnitude of ADR related problems, there is a need for greater awareness among health care professionals, to detect and report them. These ADRs if recognized in time and managed properly can prevent treatment interruption.
ABSTRACT
The main objective of study is to compare the adverse drug reactions (ADRs) of Zidovudine and Stavudine containing regimens. It is a prospective observational study conducted in the ART centre of a tertiary care teaching hospital in central India. The data collected were recorded on standard ADR reporting forms. Standard scales were used for assessment of ADRs. In twelve months duration total 263 patients on ART were observed for ADRs. 128 patients on Stavudine based regimen and 135 patients were on Zidovudine based regimen. Total 72 ADRs detected in 68 patients. Incidence of ADRs was more in Zidovudine based regimen. Zidovudine associated with early and mild ADRs while Stavudine associated with late and distressing ADRs. Considering the magnitude of ADR related problems, results support the discontinuation of Stavudine based regimens