Managing patient infected with hiv in a government health clinic six years experience
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Managing patient infected with HIV in a Government health Clinic – Six years experience. Dr. Norsiah Ali PMC MD(USM),MMed (UM) Family Medicine Specialist, Tampin Health Clinic, Tampin, N. Sembilan,Malaysia @ Fellowship Community Addiction Medicine Department of General Practice

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Managing patient infected with HIV in a Government health Clinic – Six years experience

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Managing patient infected with hiv in a government health clinic six years experience

Managing patient infected with HIV in a Government health Clinic – Six years experience

Dr. Norsiah Ali PMC

MD(USM),MMed (UM)

Family Medicine Specialist,

Tampin Health Clinic, Tampin, N. Sembilan,Malaysia

@ Fellowship Community Addiction Medicine

Department of General Practice

Monash University, Victoria


Managing patient infected with hiv in a government health clinic six years experience

TAMPIN HEALTH CLINIC

Location, Population coverage, Daily attendances, Staff, Activities…


Introduction

Introduction

  • HIV infection has caused a lot of sufferings and thousands has died.

  • In Malaysia, it has spread tremendously to both urban and rural populations since it was first identified and mainly related to drug addiction.

  • The pool for drug addiction in Malaysia is mainly in some pockets in urban areas and villages particularly FELDA areas.

  • Currently the majority of clinics providing treatment to HIV infected patients are located in urban area. Therefore there is a need to provide care accessible to patient.


Felda federal land development authority

308 areas

500 families per area

Settlers are mainly from poor socioeconomic and low education status

FELDA (Federal Land Development Authority)


History of hiv service in tampin health clinic

History of HIV servicein Tampin Health Clinic

  • First started in 2001 after FMS attended a course conducted by the AIDS Division Ministry of Health.

  • Integrate with other illnesses

  • 1st case: 52 yrs old man

  • Initial years: Counseling sessions, Symptomatic Rx, prophylaxis against PCP….many died.

  • 2004: 6 patients referred for HAART ( 3 KL Hosp, 3 Seremban Hosp)

  • April 2005 : FMS attached to ID Clinic GHKL for 2 weeks

  • July 2005 : HAART initiated in Tampin Health Clinic


Clinic session

Clinic session


Registed patients

Registed patients


How patients are captured n 118

How patients are captured ( N=118 )


Health forum in felda area

Health Forum in FELDA area


Managing patient infected with hiv in a government health clinic six years experience

Collaboration with other agencies….National Drug Agency, Police Dept, Drug Rehab Centre, Community Leaders etc.


Sociodemography

Gender:

Male – 109 (92.4%)

Female – 9 (7.6%)

b. Ethnic group

Malay- 98 ( 83 %)

Chinese – 6 ( 5 %)

Indian – 14 (12%)

Sociodemography


Age distribution

Age distribution


Risk factors stage when first came to clinic

Risk factors & Stage when first came to clinic


Co infections adi n 118

Co-infections & ADI (N=118)


Outcome after 6 12 on arv n 32

Outcome after 6/12 on ARV (N=32)


An interactive session with infected patients

an interactive session with infected patients


Difficulties

Difficulties

  • To ensure patient comply to treatment and f/up.

  • Need to regularly keep track with patient’s attendance and serial counseling.

  • Lack of manpower

  • Delay in getting lab result (Hep C, CD 4 )

  • Not many can afford Hep C treatment

  • Relapse to drug addiction – Methadone

  • Involve with police case


Conclusion

Conclusion

  • HIV Clinic can be conducted in a primary care clinic

  • Need to have good liaison with ID physician

  • Collaboration with other agencies and community

  • Dedicated and motivated staff

  • Good support services ( laboratory, counseling sessions etc )

  • Careful selection of patients for HAART


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