Improved Health among People Living with HIV/AIDS Who Received Packages of Proven Preventive Health Interventions, Amhara, Ethiopia

Abstract

In 2009, basic care packages (BCP) containing health products were distributed to HIV-infected persons in Ethiopia who were clients of antiretroviral therapy clinics. To measure health impact, we enrolled clients from an intervention hospital and comparison hospital, and then conducted a baseline survey, and 7 bi-weekly home visits. We enrolled 405 intervention group clients and 344 comparison clients. Intervention clients were more likely than comparison clients to have detectable chlorine in stored water (40% vs. 1%, p<0.001), soap (51% vs. 36%, p<0.001), and a BCP water container (65% vs. 0%, p<0.001) at every home visit. Intervention clients were less likely than comparison clients to report illness (44% vs. 67%, p<0.001) or health facility visits for illness (74% vs. 95%, p<0.001), and had lower median illness scores (1.0 vs. 3.0, p<0.05). Participation in the BCP program appeared to improve reported health outcomes.

Integrating Household Water Treatment, Hand Washing, and Insecticide-Treated Bed Nets Into Pediatric HIV Care in Mombasa, Kenya: Impact on Diarrhea and Malaria Risk

“…Adherence to the BCP by participant households was both reported and observed to be high, which was consistent with outcomes of other evaluations that suggested an impact of BCPs on prevention of opportunistic infections 8,16 ; improvement of overall health 7 ; improvement of effective HIV care 2 ; and increases in the effectiveness of and retention in HIV care and treatment among HIV-infected persons. 21 Individual interventions included in the BCP used in HLI have been shown to reduce the risk of diarrhea 8,16 and malaria.…”

“…31 BCPs included in the HLI may have served as incentives for caregivers to participate in the program, as has been observed elsewhere. 7,17,20 …”

“…4 Episodes of acute, persistent, and recurrent diarrhea are more likely in HIV-infected children, who are at a greater risk of death from an episode of diarrhea than their immunocompetent peers. 5 Inexpensive interventions, such as household-based water, sanitation, and hygiene (WASH) programs, have been reported to reduce diarrhea and improve overall health in HIV-infected individuals 6,7 and at least 1 study of household water treatment documented decreased diarrhea in HIV-infected children less than 2 years old. 8 …”

“…2,16 Evaluations of BCPs suggest that they improve access to and use of health interventions, such as ITNs and household water treatment and storage products, 17 reduce malaria, diarrhea, and hospitalizations among people living with HIV, 2 and reduce risk of illness from any cause. 7 …”

Safe Water and Hygiene Integration with Human Immunodeficiency Virus and Antenatal Services: Leveraging Opportunities for Public Health Interventions and Improved Service Uptake

“…After this pilot program in Machinga District, the Malawi Ministry of Health developed a National Operational Plan on Household Water Treatment. Although financial constraints did not permit the assessment of health impact in this study, results of other studies demonstrating negative associations between water treatment interventions and diarrheal diseases, [29][30][31] HIV progression, 28 and health facility visits for any illness 32 raise the possibility that the population in this study likely benefited from improved health. Because it is not known whether this intervention could have had an effect on retention in HIV care and quality of life for people living with HIV/AIDS, an evaluation of these potential impacts is warranted.…”