Objective: The study was conducted to assess clients' satisfaction with PMTCT services on privacy, waiting time and counselling in PMTCT of HIV /AIDS in Dodoma Rural district. Methods: A cross sectional study was conducted to 208 women assessing Reproductive Child Health (RCH) and PMTCT of HIV services. Data collection method involved both client exit interviews and focus group discussions (FGD) with women attending RCH services. Systematic random sampling technique was used to obtain the required sample of 208 clients for the exit interviews. A total of five FGDs were conducted each with eight to ten people. The data obtained were analysed using Epi Info Settings: Dodoma Rural district, central Tanzania Results: Of 113 clients' who accessed PMTCT services, 75.2% were satisfied with the counselling provided. A significant difference (P = 0.02) was observed between clients with no formal education as compared to those with primary level of education and above. Nearly a quarter of the clients who accessed PMTCT of HIV services were not satisfied with the privacy in the settings providing the service. It was also found that 71.7% of clients accessing PMTCT of HIV service was satisfied with the waiting time spent for the service; however a difference was observed (P = 0.001) between clients who accessed services at health centre (77.6%) and hospital (33.3%). Conclusion: A quarter of the clients were not satisfied either with the counselling they received on PMTCT of HIV, privacy or waiting time they spent while accessing services. Some of the reasons contributing to dissatisfaction included inadequacy in individual counselling, inadequate on site test supplies and equipment and cost incurred when travelling to seek for PMTCT service from a referral or satellite health facility.

The primary objective of this study was to examine the effect of vitamin supplementation on healthrelated quality of life and the risk of elevated depressive symptoms comparable to major depressive disorder (MDD) in HIV-positive pregnant women in Dar es Salaam, Tanzania. MethodsFrom April 1995 to July 1997, 1078 HIV-positive pregnant women were enrolled in a randomized controlled trial. We examined the effects of vitamin supplementation on quality of life and the risk of elevated depressive symptoms, assessed longitudinally every 6-12 months. ResultsA substantial prevalence of elevated depressive symptoms (42%) was observed in HIV-positive pregnant women. Multivitamin supplementation (B-complex, C and E) demonstrated a protective effect on depression [relative risk (RR) 5 0.78; P 5 0.005] and quality of life [RR 5 0.72 for social functioning (P 5 0.001) and vitality (P 5 0.0001); RR 5 0.70 for role-physical (P 5 0.002)]; however, vitamin A showed no effect on these outcomes. ConclusionsMultivitamin supplementation (B-complex, C and E) resulted in a reduction in risk of elevated depressive symptoms comparable to MDD and improvement in quality of life in HIV-positive pregnant women in Tanzania.Keywords: depression, HIV, quality of life, Tanzania, vitamin supplementation IntroductionOf the 38.6 million individuals with HIV infection worldwide, approximately 64% (24.5 million) are from subSaharan Africa [1]. Despite the fact that sub-Saharan Africa bears the largest burden of HIV infection, access to antiretroviral (ARV) therapy for HIV remains limited, with only 310 000 patients receiving treatment by the end of 2004 [2]. This has resulted in dramatic decreases in life expectancy in some sub-Saharan African countries [3], largely as a result of premature mortality from untreated HIV infection. Limited access to ARV therapy has also resulted in excess morbidity from opportunistic infections as well as transmission of HIV, including mother-to-child transmission [2].Given the excess morbidity and mortality related to HIV infection in resource-poor settings, there is a great need to identify strategies to improve the quality of life and related psychosocial outcomes of HIV-infected patients. Major depression has been shown to be highly prevalent among HIV-positive individuals [4][5][6] and has been associated with significant reductions in quality of life for these however, the studies in which these findings were obtained were largely cross-sectional and performed in HIVnegative populations [18][19][20][21][22]. Multivitamin supplementation (vitamins B-complex, C and E) has shown a protective effect on disease progression and HIV-related mortality in HIV-positive pregnant women in Dar es Salaam, Tanzania [23]. Provision of the multivitamins at the doses described in that trial may delay the need for antiretrovirals (ARVs), prolonging the 'healthy' phase of HIV disease. Promoting pre-ARV therapy, such as chemoprophylaxis, multivitamins and early treatment of opportunistic infections, can also increase access to servic...

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