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


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


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


RESULTS
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.


CONCLUSIONS
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.
Médecins Sans Frontières, Phnom Penh, Cambodia. b.janssens@bigfoot.com
B
B
Janssens
W
W
Van Damme
B
B
Raleigh
J
J
Gupta
S
S
Khem
K
K
Soy Ty
Mc
M
Vun
N
N
Ford
R
R
Zachariah
D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D002160:Cambodia / Q000453:epidemiology; D002908:Chronic Disease / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D015658:HIV Infections / Q000401:mortality / Q000628:therapy*; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D016896:Treatment Outcome