The value of the Sit-In Approach (SIA) in the most complicated cases

Fidelis Temba (AGPAHI staff) reviews the case of Stephano Daudi with nurses Josephine Masesa and Rebecca Maasai

 

One morning, Fidelis Temba, a clinical program officer from AGPAHI, examined Stephano Daudi, a four-year-old boy who had been on HIV treatment for two years. Josephine Masesa, an HIV nurse at Ushetu Health Centre, observed closely. Temba questioned Stephano’s mother and discovered that the child is three months late for a blood test to monitor the effectiveness of his treatment. Temba noted the boy’s pale complexion and off-and-on fever. His distended belly suggested a case of parasitic worms, since his quarterly deworming treatment was also three months late. Thus far, it was a run-of-the-mill case.

However, Temba then explored the family’s medical history and grew anxious. Stephano’s father, also living with HIV and on treatment, had been diagnosed and given treatment for TB, and it’s not clear if he had fully recovered. Stephano’s mother, also living with HIV, had not yet started treatment, which could have meant trouble for Stephano should she become ill and unable to care for him.

The exposure to TB, plus the potential for anemia and malnutrition that could result from the case of worms, could be severe. Temba prescribed immediate deworming treatment and an antibiotic to quell Stephano’s fever. He also ordered a test to ensure that Stephano’s treatment was fully suppressing the HIV virus. Temba made an appointment for his mother to start treatment the following week.

The risks in Stephano’s case could have been easily missed, and the lesson was not lost – even on an experienced HIV nurse like Masesa. Sometimes with long queues of patients, she says, nurses forget or don’t take the time to fully complete patient examinations, like reviewing the family’s health history. After the session with Temba, Masesa said, “We will fill [the health history] out, and we will know why.”

What We Do

  • TB in the Mining Sector Programme +

    TB in mining sector (TIMS) project is funded by Global fund through Development Aid from People to People (ADPP - Mozambique). AGPAHI is a sub-recipient of ADPP Mozambique.The project target is to screen TB to approximately 30,000 mine workers and their families.

  • CIFF Reprogramming +

    Project Goal is to improve health services to prevent HIV transmission, increase identification of adolescents with HIV infection, and improve HIV care and treatment and retention for ALHIV in Tanzania.

  • Provision of Comprehensive HIV Care +

    The purpose of** Boresha Project** is to support comprehensive facility-based HIV testing, care, treatment and support service provision in 9 scale-up and 25 sustained districts in the five lake zone regions of Geita, Mara, Mwanza, Simiyu and Shinyanga. .

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