Home care best for Aids

Researchers now believe that the number of patients dying with advanced HIV/Aids can be cut down if governments in Africa invest in improving the patients’ home care and adopt low-cost interventions.

In a clinical trial conducted in Dar es Salaam and Lusaka, Zambia, the researchers compared the quality of healthcare given to the HIV/Aids patients at clinics, with that offered to them in their homes by community lay workers.

The new findings reveal that a majority of the patients died while receiving treatment at clinics, unlike those who were started on treatment and sent homes, where they could be closely monitored through weekly visits by nurses.

The trial, whose findings were published in The Lancet journal, show that deaths among patients receiving the additional screening for cryptococcal meningitis and home visits are 28 per cent lower than those who solely receive healthcare at clinics.

During the trial, about 2,000 HIV/Aids patients were enrolled and immediately screened for TB before being put on ARVs.

The researchers from the UK and Tanzania, experimentally offered these patients different forms of care—and found that the new approach could improve HIV treatment in Tanzania and Zambia and reduce deaths by almost a third.

According to lead researcher, Prof Shabbar Jaffar, from the London School of Hygiene and Tropical Medicine, the findings were a proof that lay workers could be used to reduce the burden faced by medical doctors in Aids treatment centres in the countries studied and Africa in general.

He says: “If this intervention were to be scaled-up by governments, the cost of the lay-workers plus the screening would be even lower than the $30-70 in our trial, meaning it should be even more highly cost-effective than what our study suggests.”

The biggest challenge to healthcare delivery in Africa is the severe shortage of clinically-qualified healthcare workers, he said, noting that such low-cost interventions involved trained lay-workers, thus reducing the burden onto doctors and nurses.