Bulletin of the World Health Organization

Offering integrated care for HIV/AIDS, diabetes and hypertension within chronic disease clinics in Cambodia

B Janssens, W Van Damme, B Raleigh, J Gupta, S Khem, K Soy Ty, MC Vun, N Ford, R Zachariah

Problem

In Cambodia, care for people with HIV/AIDS (prevalence 1.9%) is expanding, but care for people with type II diabetes (prevalence 5–10%), arterial hypertension and other treatable chronic diseases remains very limited.

Approach

We describe the experience and outcomes of offering integrated care for HIV/AIDS, diabetes and hypertension within the setting of chronic disease clinics.

Local setting

Chronic disease clinics were set up in the provincial referral hospitals of Siem Reap and Takeo, 2 provincial capitals in Cambodia.

Relevant changes

At 24 months of care, 87.7% of all HIV/AIDS patients were alive and in active follow–up. For diabetes patients, this proportion was 71%. Of the HIV/AIDS patients, 9.3% had died and 3% were lost to follow-up, while for diabetes this included 3 (0.1%) deaths and 28.9% lost to follow-up. Of all diabetes patients who stayed more than 3 months in the cohort, 90% were still in follow-up at 24 months.

Lessons learned

Over the first three years, the chronic disease clinics have demonstrated the feasibility of integrating care for HIV/AIDS with non-communicable chronic diseases in Cambodia. Adherence support strategies proved to be complementary, resulting in good outcomes. Services were well accepted by patients, and this has had a positive effect on HIV/AIDS-related stigma. This experience shows how care for HIV/AIDS patients can act as an impetus to tackle other common chronic diseases.

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