Research paperImprovements in health-related quality of life among methadone maintenance clients in Dar es Salaam, Tanzania
Section snippets
Background
During the mid-1980s, East Africa became an important drug transit stop, introducing heroin in the region. As a consequence, the region also became a point of consumption, with an estimated 533,000 opiate users in East Africa (UNODC, 2011). Since the late 1990s, the injection of heroin has become widespread in Dar es Salaam, Tanzania and is spreading throughout the country (McCurdy et al., 2005, Ross et al., 2008, UNODC, 2011). The injection of heroin and other illicit substances contributes to
Study setting
In February 2011, the Tanzania AIDS Prevention Project launched the first MMT clinic in Tanzania, offering methadone, at Muhimbili National Hospital in Dar es Salaam. The establishment of methadone services was supported by the Tanzanian government – namely, the Ministry of Health and Social Welfare and Drug Control Commission – as well as the U.S. Centers for Disease Control and Prevention (CDC), Muhimbili University of Health and Allied Sciences, and Pangaea Global AIDS (Pangaea). The
Ethical considerations
Ethical clearance was granted by Muhimbili University of Health and Allied Sciences (MUHAS) Research and Publication Committee in Dar es Salaam, Tanzania. The use and analysis of de-identified, programmatic data was also approved by the U.S. Centers for Disease Control and Prevention, E&I Review Services in the United States as program evaluation and non-human subjects research.
MMT clients
A total of 288 MMT clients were included in this study. Baseline characteristics of enrolled patients are presented in Table 1. Overall, 260 (90%) were male; 162 (56%) had primary education or lower; 93 (32%) had children; 36 (13%) were married, and 238 (83%) were unemployed. Median length of heroin use was 10 years (IQR: 6, 15) and 5 (2%), 65 (22%) and 39 (14%) reported poly-substance use with cocaine, alcohol, benzodiazepine, respectively.
Improvements in HRQOL
At baseline, mean overall Physical and Mental Health
Discussion
Utilizing data from the first publicly funded methadone clinic on the mainland of Sub-Saharan Africa, this study compared HRQOL among PWID prior to and three to six months after MMT initiation and examined factors associated with changes in HRQOL. Consistent with research documenting the impact of MMT on quality of life (Feelemyer et al., 2013), we observed significant short-term improvements in HRQOL, on average, in the first cohort of opioid addicts receiving MMT in Tanzania. Longer duration
Funding
This work was supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through Centers for Disease Control and Prevention under the terms of [Grant number 5U2GPS000951], the National Institutes of Health, National Institute on Drug Abuse (Grant No. 1R34DA037787), and in part from research supported by the Baylor-UT Health Center for AIDS Research (CFAR), an NIH funded program [AI036211].
Acknowledgements
We would like to thank the clients, providers and program managers of the methadone clinic at Muhimbili National Hospital.
Conflict of interest: We declare that we have no conflicts of interest.
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