RESUMO
Background: HIV/AIDS remains a significant global public health problem. With approximately 56% HIV patients in India receiving treatment, adherence to drugs is a crucial element for successful management. Sustainable development goals, National Strategic plan for HIV/AIDS and STI (2017-24) and 90-90-90 target pushing towards ending of AIDS epidemic require adequate adherence and this research estimates the adherence, associated factors and reasons for non-compliance.Methods: This analytical cross sectional study was undertaken on 160 HIV patients from an ART Centre. A pre-structured, pilot tested, face validated questionnaire was used and data collected by face to face interviews, through random selection of participants from outpatient department register. Data was analysed using Epi Info software and chi squared test applied.Results: Of the 160 study subjects, 86.8% remained adherent to the treatment with forgetfulness (71.4%) being the most common cause for non-adherence. Statistically significant treatment adherence was observed to be associated with socio-economic status (p=0.021) and period elapsed since diagnosis (p=0.041).Conclusions: Improving adherence to drug therapy through intensive counselling, streamlined drug supply and increased family participation would go a long way in reducing the menace of HIV.
RESUMO
Background: Timely referral and safe transport form a crucial link for the survival and safety of sick newborn. Thus the study aimed at assessing referral and transport of sick neonates admitted to NICU of a tertiary care government hospital and the factors associated with direct referral and safe final transport. Methods: A hospital based cross-sectional study was carried out in among 450 neonates and was based on face to face interview with caregivers. The data was analyzed using proportions and mean values Chi square test of significance and independent t test were appropriately applied and p<0.05 was taken to be statistically significant. Odds ratios were calculated for dichotomous variables. Results: 72.6% of high risk pregnancies were transferred timely in utero to district hospitals. Around two thirds (65.8%) of neonates were referred by doctors. Treatment during transportation was administered to 29.6% of the neonates. 50.2% of neonates have used the services of an ambulance at some point of time during their travel. Highly significant association of direct referral was observed with earlier age at admission (2.3 days), early development of neonatal symptoms (1.45 days), lesser gestational age (33.1 weeks) and lesser total distance travelled (15.7 km). The odds of final transport of newborns in ambulance was significantly more in males (OR=1.5), rural residents (OR=1.5) and registered pregnancies (OR=4.3). Conclusions: Wide variations remain in neonatal referral and transport with some glaring gaps which need to be adequately addressed.