Study finds deaths among Zambia HIV patients on treatment underestimated, and up to 20 times higher than among patients in Europe

By on .

A study examining data from records at facilities serving more than 160,000 patients on treatment for HIV across Zambia, along with data tracking patients who stopped coming for care at the facilities found that 7 percent of all patients treatment died within two years, a figure from three-to-nine times higher than previous estimates. Those findings mean that death rates among HIV patients on treatment in Zambia are from 10-to-20 times higher than among patients on treatment in Europe, write the authors of the study, published on PLOS Medicine Thursday. More than 95 percent of the deaths were attributed to illness, rather than traffic accidents, childbirth or other causes of death that also can be higher in African countries than in Europe.

The findings indicate gaps, at some facilities more than others, in medical services that include diagnostic capacities and advanced care, the authors write. Patients treated at hospitals survived in greater numbers, as did patients being treated in settings outside of cities. While the most deaths occurred during the first few months of treatment, death rates remained high over longer periods. Death rates varied widely across facilities, indicating a need to focus on improving HIV services at site level. At a time when efforts to widen access to antiretroviral treatment include lessening the frequency of clinic visits and shifting responsibility for some HIV services from doctors to nurses and other health workers, the findings indicate the need to identify patients who need greater levels and frequency of care.

The study, conducted by the Centre for Infectious Disease Research in Zambia — CIDRZ — with the Zambia Ministry of Health, was led by Dr. Charles Holmes of Georgetown University Medical Center’s Center for Global Health and Quality, and Izukanji Sikazwe of CIDRZ.

2 thoughts on “Study finds deaths among Zambia HIV patients on treatment underestimated, and up to 20 times higher than among patients in Europe

  1. Denis LeBlanc

    This is shockingly sad news. Instead of 21 000 dead in 2016 as accounted by UNAIDS, there may be 210,000 to 420,000 deaths of AIDS in Zambia alone that year. This study must be repeated and widened to all of sub-Saharan Africa to find out the true measure of AIDS throughout Africa. Treatment must be improved and hastened as well to deal with these unacceptable deaths of individual Africans.

    Reply
  2. Michael Gwaba

    This makes really sad reading and I hope that both the Ministry of Health and CIDRZ will use the study report to plan for the gaps in service delivery identified. From a personal perspective, one of the key challenges in the delivery of ART services has been the refusal by the government to invest resources to sustain adherence support workers and TB treatment supporters who were key in the provision of adherence counselling as well as tracking patients lost to follow up on both the ART and TB Program. Congestion at the health facilities now require that we adopt differentiated models in the delivery of ART to stable patients from the community. WE have seen models that are working right here in Lusaka at CBTO in Kamanga and need to ensure that the funds earmarked for such activities in the Global Fund grant are channeled to areas where both disease burden and the population accessing services are high as opposed to areas where disease burden is low as well as the numbers accessing the services as indicated by the powers that be in their last call for proposals. Our CCM really needs to take the findings of this study report seriously and get involved in deciding where we need to channel our Global Fund grant. This informs me that the government should take the responsibility of paying health workers from taxes collected locally while the global fund grant should be channeled towards community systems strengthening by providing stipends for adherence supporters and TB treatment supporters who have been a critical but neglected resource in the fight against HIV. Lets wake up before the situation gets worse.

    Reply

Leave a Comment

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.