Adaptation of a general primary care package for HIV-infected adults to an HIV centre setting in Gaborone, Botswana
Davis, S.; Patel, P.; Sheikh, A.; Anabwani, G.; Tolle, M.A.
Tropical Medicine and International Health Tm and Ih 18(3): 328-343
2013
ISSN/ISBN: 1365-3156 PMID: 23289364 DOI: 10.1111/tmi.12041Document Number: 572265
As life expectancy of HIV-infected patients improves due to antiretroviral treatment (ART) and the importance of associated co-morbidities and chronic diseases increases, preventive care will become increasingly important. Adaptation of existing preventive guidelines to local environments will become a priority for HIV treatment programmes. Guidance from the World Health Organization, a focused evidenced-based literature review, Botswana national guidelines, Botswana-specific morbidity and mortality data and centre-specific data were used to adapt a published general primary care package for limited-resource areas to our centre's specific setting. The preventive care package contains recommendations on tuberculosis prevention, malnutrition, depression, cervical and breast cancer, hepatitis B coinfection, cardiovascular risk factors, external injury prevention, domestic violence screening, tobacco and substance-abuse counselling, contraception and screening and treatment of sexually transmitted infections. This preventive care package addresses the comprehensive health needs of HIV-infected adults in the FMC in an evidence-based manner. The process of combining clinic-specific prevalence data, national guidelines, regional literature and assessment of public-sector resources to adapt an existing general package could be utilised to develop similar guidelines in other resource-limited locales.