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Effects of an HIV-Care-Program on immunological parameters in HIV-positive patients in Yaoundé, Cameroon: a cluster-randomized trial

  • Original Paper
  • Published:
International Journal of Public Health

Abstract

Objectives

To measure the effects of an HIV-Care-Program, focusing on nutrition and lifestyle, which can be provided at scale to HIV-infected patients, on clinical and anthropometrical parameters, and health status.

Methods

A cluster-randomized trial, including 5 health facilities randomized to intervention n = 100 (HIV-Care-Program) or control n = 101 (Usual-Care). The HIV-Care-Program consisted of counseling lessons for 6 months, on: nutrition, hygiene, coping with stigma and discrimination, embedded in practical activities. Outcome variables were CD4 count after 6 months and time to antiretroviral therapy (ARV) initiation, using analysis of covariance and Kaplan–Meier method, respectively.

Results

After 6 months, CD4 count dropped by 46.3 cells (7.7 %) (intervention) and 129 (23 %) (control) (p = 0.003). Mean time to ARV; 5.9 months 95 % CI (5.9, 6.0) (intervention); 4.9 months 95 % CI (4.7, 5.2) (control) (p < 0.004). There was a partial correlation between CD4 count and initial viral load (r = −0.190, p = 0.017).

Conclusions

The intervention provides a low-cost alternative improving health status, slowing down CD4 cell decline, delaying initiation of ARV and thus freeing local ARV capacities for patients in urgent need.

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Authors and Affiliations

  1. Institute for Social Medicine, Epidemiology and Health Economics, Charité, Universitätsmedizin Berlin Center, Berlin, Germany

    Germaine N. Nkengfack, Sylvia Binting, Stephanie Roll, Peter Tinnemann & Heike Englert

  2. Muenster University of Applied Sciences, Muenster, Germany

    Germaine N. Nkengfack & Heike Englert

  3. Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon

    Germaine N. Nkengfack

  4. Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon

    Judith N. Torimiro & Jeanne Ngogang

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  1. Germaine N. Nkengfack
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  2. Judith N. Torimiro
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  3. Jeanne Ngogang
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  4. Sylvia Binting
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  5. Stephanie Roll
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  6. Peter Tinnemann
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  7. Heike Englert
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Correspondence to Germaine N. Nkengfack.

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Nkengfack, G.N., Torimiro, J.N., Ngogang, J. et al. Effects of an HIV-Care-Program on immunological parameters in HIV-positive patients in Yaoundé, Cameroon: a cluster-randomized trial. Int J Public Health 59, 509–517 (2014). https://doi.org/10.1007/s00038-014-0547-9

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  • DOI: https://doi.org/10.1007/s00038-014-0547-9

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