20th International AIDS Conference - Melbourne, Australia


MOAE0105LB - Oral Abstract

Utilizing available HIV/AIDS infrastructure as a gateway to effective case finding and management of non-communicable diseases (NCDS) including hypertension, diabetes and mental disorders at Mildmay, Uganda

Presented by Barbara Namata Mbogga Mukasa (Uganda).

B. Namata Mbogga Mukasa1, E. Kawuma1, R. Nakigudde1, Y. Karamagi1, M. Sonko1, D. Mwehire1, M. Odiit1, S. Yaya2, C. Macleod1, E. Mills2

1Mildmay Uganda, Kampala, Uganda, 2University of Ottawa, Ottawa, Canada

Background: Uganda, like other countries with a high burden of HIV infection is facing burgeoning epidemics of non communicable diseases. The population of patients with HIV infection achieving viral suppression on combination ART is growing, aging, and experiencing a widening spectrum of non-AIDS diseases. HIV and NCD care both require ongoing attendance at appointments, adherence to tests and medications, healthy living and self-management. Mildmay Uganda, fully integrated NCD screening and management in 2013 to identify risk factors for cardiovascular disease among, people living with HIV enrolled in care and to provide medical and behavioral interventions.
Description: A review of physical and electronic longitudinal data was conducted to improve clarity on diagnosis by the clinicians and tracking of clients with NCD in the Mildmay Uganda (MUg) system. Data collection tools were developed to capture NCD specific data from the clients including basic demographics, associated hereditary factors, alcohol or nicotine use, results of clinical assessments, laboratory assessments, treatment and referral plans. Standard operating procedures have been developed for diagnosis and management of NCDs at MUg. Clients who miss their routine appointments are followed up through telephone calls or home visits as necessary. Medical records/ files for HIV positive clients with hypertension or other NCDs have been tagged and clinicians sensitized on management of HIV- NCD co-morbidity. To maximize clinic outcomes including support for client education, since 69% of those with HIV- NCD co-morbidity are also elderly Tuesday has been designated as NCD/ elderly clinic day.
Lessons learned: The existing HIV care and treatment infrastructure provides a viable platform for screening and managing NCD especially for a population aging with HIV. The diagnosis, tracking and management of NCDs, particularly Hypertension, diabetes, cardiovascular disease and mental health as part of routine HIV care have improved markedly. Overall, out of 10,285 active clients in care at MUg Main site, 1058 have been identified with Hypertension; 12.7% of whom have mental disorders, including depression, mania and epilepsy while 8% have diabetes, 34% are aged over 60 years while 69 % are females and 73% are on ART.
Conclusions/Next steps: Scaling up the implementation to all 16 Mildmay supported districts in central Uganda.

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