Patient satisfaction with health care services provided at HIV clinics at Amana and Muhimbili hospitals in Dar es Salaam.

BACKGROUND: Since the establishment of free HIV/AIDS care and treatment services in Tanzania a lot of research has been done to assess how health care providers discharge their duties in these clinics. Little research however has been done regarding satisfaction of HIV patients with free health care services provided. OBJECTIVES: To determine satisfaction of HIV patients with health care services provided at the HIV clinics and specifically, to determine patients' satisfaction with the general physical environment of the clinic and with services offered by doctors, nurses, laboratory, and pharmacy. METHODS: A cross-sectional study was conducted at Muhimbili National Hospital (MNH) and Amana hospital. A total of 375 patients attending outpatient HIV clinics were selected randomly and interviewed using a questionnaire, after obtaining a verbal consent. Data collected was analyzed using Epi-info program version 6. RESULTS: Patients at Amana Hospital clinic were either very satisfied (44.3%) or satisfied (55.7%) and none were unsatisfied, while at MNH clinic 1.1% patients were very satisfied while (94.7%) were satisfied and (4.2%) were unsatisfied with health care services provided. Lack of privacy when consulting with doctors and the dispenser contributed to patients' unsatisfaction with the services. CONCLUSION: Most of the participants were satisfied with the services provided at the two clinics. However at MNH, a few patients were unsatisfied due to lack of privacy during consultation with doctors and with the pharmacy services.

Knowledge; Attitude and Practice of Commercial Drivers in Dar es Salaam with Regard to Medicines that Impair Driving

Purpose: The objective of this study was; first; to assess the knowledge; attitude and practice of commercial drivers in Dar es Salaam with regard to medicines that impair driving; and second; to evaluate the adequacy of antihistamine label information. Methods: Drivers were interviewed using a questionnaire after obtaining their informed consent. Labels of medicines containing antihistamines were also evaluated for information regarding driving. Results: Fifty one percent (n=303) of drivers were not aware of medicines that impair driving. Out of those who used medicines impairing driving; 56.1were not given precaution on the impairing effect of these medications by healthcare providers. Fifty two percent of the drivers did not know what to do when affected; 29.8said they would continue driving while 16.2would suspend driving. Drowsiness; fatigue and blurred vision were mentioned as the main effects that impaired driving. Cough syrups (64.7); antimalarials (49.5) and analgesics (28.7) were mentioned most as medicines affecting driving. Labels on products containing equal concentrations of antihistamines revealed inconsistency in driving information with some products having cautionary information on driving while others had none. Conclusion: This study showed that most of the drivers interviewed had taken medications which impaired their driving but did not know what to do. These drivers were not well informed about the effects of these medicines on driving. There is need; therefore; to inform the public about medications that impair driving. This may help in reducing road traffic accidents which are on the increase since one of the causal factors may be the intake of such medicines

Lack of impact of artesunate on the disposition kinetics of sulfadoxine/pyrimethamine when the two drugs are concomitantly administered.

OBJECTIVE: To determine the effect of artesunate (AT) on the disposition kinetics of sulfadoxine/pyrimethamine (SP) in humans. METHODS: In a randomized cross-over study, 16 healthy volunteers were given a dose of three SP tablets containing 500 mg of sulfadoxine (SDX) and 25 mg of pyrimethamine (PYR) (=SP group), while the second arm received three SP tablets + two AT tablets of 200 mg in total followed by 100 mg AT for the next 4 days (SP+AT group). Blood samples (100 microl) were collected by means of a finger prick and dried on filter paper. The blood spots were wrapped in polythene folders and stored at room temperature until analysis. The samples were assayed using high-performance liquid chromatographic methods. RESULTS: The peak concentration C(max)), time required to attain peak concentration (T(max)), half-life (t ((1/2))) and area under the plasma concentration-time curve (AUC) were determined. The C(max) of SDX were 92.9 and 98.9 microg/ml for the SP and SP+AT arms, respectively; for PYR, these were 0.86 and 0.79 microg/ml, respectively. The T(max) of SDX were 10 and 8 h for the SP and SP+AT arms, respectively; for PYR, these were 4.0 and 3.0 h, respectively. The AUC(0-288) of SDX were 15,840 and 18,876 microg/ml h for the SP and SP+AT arms, respectively; for PYR, they were 124 and 112 microg/ml h, respectively. The t ((1/2)) of values for SDX were 165 and 180 h for the SP and SP+AT arms, respectively; for PYR, these were 158 and 177 h, respectively. There was no statistically significant difference between the C(max), T(max), AUC(0-288) and t ((1/2)) between the two arms (p > 0.05). CONCLUSION: Taking AT concomitantly with SP does not have any impact in the disposition of SP.