Marseille 2007
Marseille 2007
Abstract book
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Abstract #171  -  Cotrimoxazole Prophylaxis: Very High Unit Cost and Very Poor Adherence threatening its success.
Session:
  26.54: Posters B (Poster) on Tuesday   in  Chaired by
Authors:
  Presenting Author:   Dr Abdallah Nkoyooyo - The IIDS Support Organisation(TASO), Uganda
 
  Additional Authors:  Dr Francis Kizito,  
Aim:
In 2006, a study was conducted in The Aids Support Organization (TASO), Uganda to establish the cost and assess the adherence patterns and side effects of Cotrimoxazole prophylaxis amongst TASO clients.
 
Method / Issue:
This was a cross-sectional study where 411 client files were selected for review. All costs incurred on drugs, logistics and human resources were aggregated for all clients and then an average cost was determined. The allocation percentages were based on the proportion of estimated time deployed on the activity during a clinic day in the year
 
Results / Comments:
The actual cost of providing Cotrimoxazole prophylaxis by TASO is 20,147 shillings ($11.20) per client per year while the expected cost would be 26,509 shillings ($14.70) Over the last three years, TASO has spent only 17.6% of the expected annual requirement for Cotrimoxazole drug purchases. The number of clients who do not collect their refills from service delivery points is increasing year after year and there is not enough evidence to suggest that these clients collect their refills from other service organizations. The non adherence to the prophylaxis has been mainly attributed to failure of clients to collect drugs from the service centres due to several reasons and lack of a follow up system for defaulters. Very few side effects attributable to Cotrimoxazole prophylaxis have been reported.
 
Discussion:
The strategy is expensive and requires more resource mobilization in addition to strengthening referral systems. The community programs (not outreaches) should be strengthened such that more Cotrimoxazole is provided to community for improved access. An effective follow up mechanism should be designed to track defaulters and support adherence.
 
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