1. Regional Hospital, Tanzania. Authors: 1.Kigumi HO- NM- AIST, LGTI
EAST AFRICAN COMMUNITY EAST AFRICAN HEALTH RESEARCH COMMISSION   7th East African Health and Scientific Conference
Effectiveness of Digital Technologies (DATs) in Enhancing ART Adherence among HIV/AIDS Patients in Dodoma
Regional Hospital, Tanzania.
Authors:
1.Kigumi HO- NM- AIST, LGTI
2.Msuya SE- KCMUCo

2. Introduction
Poor Adherence of ART treatment is Public health problem among the PLHIV
The problem results to diseases relapsing and drug resistant even the death
Digital adherence technologies (DATs)is the new approach which include computer application and phone based to facilitate ARV adherence and CTC clinic attendance
DATs approach reminded PLHIV on time for taking their medications and date for CTC attendance
Also DATs facilitate digital observation, compile patient histories and triage patients based on their level of adherence.

3. Component of DATs Computer Data Base
Compiling the information participants
Create link between the data base and patients mobile phone
Sent alert Message or voice note to patient
Mobile Phone
Give an alert to patient for medication time and Clinic date
Sending feedback at the database

4. How DATs Function
Functions that DATs can play to reinforce patient medication adherence and facilitate monitoring and triage of patients by health systems. ‘Differentiated care’ refers to providing different intensities and types of care based on a patient’s levGOel of medication adherence as measured by the DAT.

5. Objective of the study Broad Objective: Specific Objectives
To determine the effectiveness of the DATs on enhancing ART adherence and lost to follow among the HIV patient
Specific Objectives
To strengthen the management of HIV treatment
To asses acceptability of DATs on HIV treatment management

6. Materials and Methods
Prospective cohort study was done between June 2017 to July 2018
800 patients randomly selected from medical record at CTC
400 were the intervention group
4000 were control group
Interventional participants were given the mobile connect to computer data base for medication time
alert and Date for clinic
Both intervention and control were anonymously visited to their home to approval for ART use
Digital feedback from interventional group were automatically recorded and approved during the
home visit

7. Data collection and Data analysis
Data from interventional group collected from the data base, interview during the home visit and CTC clinic date
Data from Control group collected through interview during home visit and CTC clinic
All data entered in SPSS 23.0 for cleaning and analysis
Frequencies is used for categorical data and standard deviations for continuous variables.
Chi square, Fisher’s exact tests, and t-tests were used to compare the frequencies for categorical variables and the means of continuous variables from two groups
Logistic regression models were used to predict factors associated with LTF and ART intake

8. Table 1: Social Demographic Characteristic for participants receiving ART treatment at Dodoma Regional Referral Hospital
Characteristics
Comparison Group
Intervention Group
P-value
N= 400
n(%) Mean, SD
Sex
Male
192(48.0)
116(29.0)
Female
208(52.0)
284(71.0)
0.030²
Mean age
37(9.10)
46(9.7)
< ²
Age Group
<30
130(32.50)
128(32.0)
≥ 30
270(67.50)
272(68.0)
<0.0001
Marital Status
Single/divorced
202(50.50)
205(51.30)
Married/cohabiting
198(49.50)
195(48.70)

9. Table 2: ART and LTFU Characteristic for participants receiving ART treatment at Dodoma Regional Referral Hospital
Characteristics
Comparison Group
Intervention Group
P-value
N= 400
n(%) Mean, SD
Adherence to ART medication and CTC attendance
112(28.0)
288(67.0)
<
Lost To Follow Up
80 (20.0)
Transfers to another ART clinic
20(5.0)
32(8.0)

10. Table 3: Univariate analysis of Intervention vs. Comparison Group
Covariate of Interest
Univariate
P-value
Effects Estimate
Intervention VS Comparison
Time for ART intake
0.9 ( , 8.71)
0.8270
Intervention group
0.14 (-0.073, 0.35)
0.200
Comparison group
0.15 (-0.003, 0.31)
Lost To Follow Up
0.9 (0.51,0.76)
<0.0001
LTFU change over time
Intervention
0.92 (0.91,0,93)
Comparison group
0,93(0.51,076)

11. Discussion of findings
The study examining DATs effectiveness on ART treatments and LTFU
The participants exposed to Intervention show significance improvements on ART treatment
DATs lower the rate of LTFU and participants were more likely remain on treatment
Age and gender reported to be associated with ART treatment and LTFU
The risks factors for were all independently significance associated to ART treatment and LTFU
The results for study is similar to what was observed in in Zimbabwe and Zambia where known as “mothers2mothers” (m2m) was found to improve retention and adherence to the Option
B+ antiretroviral regimens among HIV infected women

12. Conclusion and Recommendation
The findings suggest that providing additional information on DATs application
More Research is needed to understand the acceptability DATs on ART management and LTFU for PLHIV
Needs for supports from implementers and policy makers should support formalize the Use of DATS on HIV treatments managements

13. References
Haberer JE, Musiimenta A, Atukunda EC, et al. Short message service (SMS) reminders and real-time adherence monitoring improve antiretroviral therapy adherence in rural Uganda. AIDS 2016;30:1295–9.
Haberer JE, Musinguzi N, Tsai AC, et al. Real-time electronic adherence monitoring plus follow-up improves adherencecompared with standard electronic adherence monitoring. AIDS 2017;31:169–71.
Liu X, Blaschke T, Thomas B, et al. Usability of a Medication Event Reminder Monitor System (MERM) by providers and patients to improve adherence in the management of tuberculosis. Int J Environ Res Public Health 2017;14:1115.
Karfakis EKaJ. Current practices to increase uptake, retention and adherence for option B+ in Malawi. Mothers to mothers Malawi 2014 (cited 2016 August 26). m2m_Malawi-PMTCT-Report.pdf
Shroufi A, Mafara E, Saint-Sauveur JF, Taziwa F, Vinoles MC. Mother to mother (M2M) peer support for women in prevention of mother to child transmission (PMTCT) programmes: a qualitative study. PloS ONE. 2013;8(6):e64717

14. Acknowledgement
Nelson Mandela African Institutive Of Sciences and Technology(NM-AIST), Arusha
Local Government Training Institute (LGTI), Dodoma
Kilimanjaro Christian medical University College, (KCMUco) Moshi , Kilimanjaro.
Dodoma Regional Referral Hospital (DRRH),Dodoma
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