Abstract:
Background: Sub-Saharan Africa has been severely affected by the HIV and AIDS pandemic. Global efforts at
improving care and treatment has included scaling up use of antiretroviral therapy (ART). In Tanzania, HIV care and
treatment program, including the provision of free ART started in 2004 with a pilot program at Muhimbili National
Hospital in Dar es Salaam. This study describes the socio-demographic and clinical features of patients enrolled at the
care and treatment clinic at MNH, Dar es Salaam, Tanzania.
Methods: A cross-sectional study looking at baseline characteristics of patients enrolled at the HIV clinic at MNH
between June 2004 - Dec 2005 compared to those enrolled between 2006 and September 2008.
Results: Of all enrolled patients, 2408 (58.5%) were used for analysis. More females than males were attending the
clinic. Their baseline median CD4 cell count was low (136 cells/μl) with 65.7% having below 200 cells/μl. Females had
higher CD4 cell counts (150 cells/μl) than males (109 cells/μl) p < 0.001). The most common presenting features were
skin rash and/or itching (51.6%); progressive weight loss (32.7%) and fever (23.4). Patients enrolled earlier at the clinic
(2004-5) were significantly more symptomatic and had significantly lower CD4 cell count (127 cells/μl) compared to
CD4 of 167 cells/μl in those seen later (2006-8) (p < 0.001).
Conclusion: Patients enrolled to the MNH HIV clinic were predominantly females, and presented with advanced
immune-deficiency. Improved access to HIV care and treatment services seems to be associated with patients' early
presentation to the clinics in the course of HIV disease.
