Treating African HIV patients in their own homes instead of the clinic could substantially cut the number of deaths from the disease, say researchers.
 Fewer children became orphans in the study | Writing The Lancet, Kenyan researchers say they were able to cut deaths from the virus by more than 90% using antiretroviral drugs. There was also a sharp fall in the child death rate within their families. One expert on African HIV treatment said this showed that the system could work well on a larger scale. The latest antiretroviral drugs are effective at prolonging life, and are increasingly available in parts of Africa. However, in poor areas, where there are few clinics, setting up treatment programmes, which rely on regular testing and medication, can be difficult. The research team from the Centers for Disease Control in Kenya set up a study of more than 1,000 HIV positive people in rural communities in Uganda, with a network of paid staff, who were not clinically trained, who visited weekly in their own homes to re-supply them with medicines and question the patients about potential side-effects. None of those taking part was required to visit a clinic during the study. The researchers said that the fall in deaths was comparable with studies involving clinics in Europe, Haiti and other parts of Africa, and the cost was just 25 US cents (12 pence) per day per patient. Better care The programme also slashed the number of deaths of young children within the families of those treated, showing that the parents, when well-treated were better able to care for them. "Wide provision of antiretroviral treatment and care in sub-Saharan Africa could have a profound effect on prevention of mortality in people with HIV, improve the health and longevity of their children, and reduce the rate of orphanhood. "Our findings support the efforts to bring antiretroviral drugs to people with HIV throughout the world, irrespective of geographic or socioeconomic background." However, the study authors did concede that the frequency of visits by the project staff was greater than might be expected in real African health system. Eline Korenromp and Jane Kengeya Kayondo, from the Global Fund to Fight Aids in Geneva, said that this was an "important limitation". "At least two-thirds of patients received better care than can presently be expected in most African antiretroviral treatment programmes." They called for the system to be tested again on a bigger scale, and with less frequent visits. Dr Ade Fakoya, an adviser to the International HIV/Aids Alliance, said that the research was "welcome", and showed that a "community-based" treatment programme could work. "Getting HIV treatment to people who live in rural areas is difficult, and this could have an impact. This is affordable, and could be carried out on a larger scale. "And if you keep the parents healthy, you also keep their children healthy."
Email to a friend  | Print this article  |
Sponsors
if you keep the parents healthy, you also keep their children healthy 
