ASSESSMENT OF THE PHARMACOLOGICAL INTERVENTIONS IN PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) OF HIV/AIDS IN NASARA TREATMENT AND CARE CENTRE, AHMADU BELLO UNIVERSITY TEACHING HOSPITAL, ZARIA-NIGERIA

ASSESSMENT OF THE PHARMACOLOGICAL INTERVENTIONS IN PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) OF HIV/AIDS IN NASARA TREATMENT AND CARE CENTRE, AHMADU BELLO UNIVERSITY TEACHING HOSPITAL, ZARIA-NIGERIA

ACKNOWLEDGEMENT

Words are very much inadequate for me to thank Prof. A.I. Mamman, the Assistant Dean Postgraduate, Faculty of Medicine, ABUTH Zaria, the staff of Nasara Treatment and Care Centre (NTCC) supported by Harvard/PEPFAR ABUTH Zaria, the Head, Department of Pharmacology and Therapeutics, and staff, Department of Pharmacy Hajia Gambo Sawaba General Hospital Kofan Gayan Zaria. vi ABSTRACT This study was undertaken in Nasara Treatment and Care Centre ABUTH Zaria, to assess the effect of pharmacological interventions in prevention of mother to child transmission (PMTCT) of HIV/AIDS. It is a combined prospective and retrospective study. The prospective component consists of participants interview which was transcribed into a structured questionnaire and retrieval of the Clients’ clinical data, forms the retrospective component. Female clients who have had at least one delivery since infection with HIV were randomly selected by convenient sampling and the seven Pharmacists working in the Centre as at the time of study were involved in the research. Of the 104 Clients interviewed, 4 were lost to follow-up. Out of the 100 Clients that participated in the study, 98% went through pharmacological intervention with antiretroviral drugs (ART). Drug combinations prescribed for participants depended on laboratory test results and clinical examination. Therapy for PMTCT was individualised and the commonly prescribed ART for PMTCT treatment in Nasara Treatment and Care Centre was found to be Zidovudine/Lamivudine/Nevirapine (AZT/3TC/NVP) while Zidovudine/Lamivudine/Efavirenz (AZT/3TC/EFV) was used as PMTCT prophylaxis. The number of pregnancies since HIV was diagnosed in participants ranged from 1 to 6 with a mean of 2. The total number of children born by 78 out of 100 HIV positive women were determined to be 120 (22 participants have no child but were pregnant at the time of study), out of which 16 of them were HIV positive. Of these HIV positive children, 13 (11%) were delivered without PMTCT intervention while the remaining 3 (2.5%) were delivered with PMTCT intervention. The above results indicated a statistically significant reduction in vertical transmission of HIV/AIDS as shown by chi-square analysis at P<0.05, 95% confidence interval using SPSS version 16. The pharmacological interventions adopted by the clinic has reduced vertical transmission from 11% to 2.5%. The attitude and practice of the Pharmacists in NTCC centre ABUTH Zaria, was not satisfactory as vii reported by the participants, though issues like job satisfaction and security need to be addressed by the management of the clinic. The Pharmacists need to improve their ability in the language commonly understood by majority of the clients (Hausa) to bridge communication gap. The quality of service delivery to participants was satisfactory but long waiting time (4 hours) was the major complain which also need to be addressed by the management of the clinic. The pharmacological interventions adopted by Nasara Treatment and Care Centre ABUTH, Zaria were found to be effective in reducing vertical transmission of HIV with a statistically significant difference in the serostatus of the participants’ children. With this, the null hypothesis that the pharmacological interventions in Nasara Treatment and Care Centre ABUTH, Zaria is inadequate was rejected.

ASSESSMENT OF THE PHARMACOLOGICAL INTERVENTIONS IN PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) OF HIV/AIDS IN NASARA TREATMENT AND CARE CENTRE, AHMADU BELLO UNIVERSITY TEACHING HOSPITAL, ZARIA-NIGERIA