Integrated Hypertension And Diabetes Mellitus Type Ii Treatment And Care Among People Living With Hiv/Aids Attending Care And Treatment Center In Dar Es Salaam, Tanzania In 2020

Objective: Persons living with HIV/AIDS (PLHIV) now live longer due to the advancement of HIV care rendering them at increased risk of developing Non-Communicable diseases (NCDs). Despite having strong HIV/AIDS care programs, Tanzania lacks effective integration of NCDs care among PLHIV. This project aimed at implementing and evaluating hypertension (HTN) and Type-2 diabetes mellitus (T2DM) prevention, treatment, and care efforts among PLHIV attending care and treatment clinic. Design and method: The project was a facility-based intervention that included a collection of demographic, clinical, and laboratory data. A STEPwise approach of the STEPS surveillance tool for NCDs from the WHO was used to collect information from participants. A cohort of patients diagnosed with HTN and T2DM was created and followed up for four months to ascertain for disease control rates. Patient follow-up included health education, medical checkup, and consultation. Descriptive, bivariate, and multivariate logistic regression analyses were done to determine the association between hypertension and risk factors. A paired t-test was done to see the significance of the intervention. Results: A total of 335 patients were included in the assessment for the risk factors for hypertension and T2DM in which the prevalence was found to be 21.32% and 2.70% respectively. With multivariate analysis, obesity (AOR = 4.04 95%CI 1.72–9.52) and diabetes (AOR 5.58 95%CI 1.05–29.53) were the risk factors for having hypertension. Being employed in private or government organization and Stage 4 four of HIV disease at diagnosis were found to be at reduced risk of getting hypertension. A paired T-test showed significance difference in mean systolic blood pressure (t = 3.07 w/df = 81, p < 0.01) and diastolic blood pressure (t = 2.91 w/df = 81, p < 0.01) while there was no difference in mean fasting blood glucose level (p = 0.82) and body mass index p = 0.08). Conclusions: The magnitude of NCD risk factors is significantly higher among PLHIV and there was a significant change in HTN after three months of project implementation. NCDs integration among PLHIV is possible and should be initiated and strengthened.