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Eyob Gebretsadik

Ethiopian Ministry of Health /Health service Quality directorate, Ethiopia

Title: Evidence basred care on monitoring of toxicity of TDF among HIV positive Pregnant and Lactating mother who are on haart in Ethiopia

Biography

Eyob Gebretsadik has completed his MD at the age of 25 years from Jimma University medical college in 2004 and earned his postgraduate studies in masters of public health from Wollo University School of health science, Ethiopia. He has been served in the different position as mentor, and a regional director on HIV/AIDS care, treatment and support programs with several international partners for more than ten years. He has led several Quality improvement projects in hospital setting across the country worth mentioning of early detection of first-line HAART treatment failure and switching in resource-limited settings among others. He is currently working in the Ethiopian federal ministry of health as a national consultant and resource person for the national Quality of care for Maternal and neonatal health, and consultant for World Health Organization of Ethiopian country office. He has published more than 5 papers in reputed national and internal journals and has been leading a national technical working group for quality of care in the ministry of health. 

Abstract

Increasing incidence of Fanconi, proximal kidney tubular damage and declining GFR are becoming more common in HIV positive pregnant women. Recently stronger evidence from the practice has drawn clinicians’ attention to monitor the toxicity of TDF before initiation and during follow up. The objective of the study to generate evidence-based laboratory monitoring of GFR using simple android based calculation of GFR to early identify and manage Chronic renal disease (CRD) among TDF based HAART users of pregnant and lactating women.. HIV+ pregnant and lactating women on TDF based HAART(n=111) enrolled from three general hospitals to be closely followed for incidence of CKD based on NKF K/DOQI .24.3% of subjects had a gfr of  90-131 ml/min, 16.2 % mild decline of GFR 60-89 ml/min while 3.6% (n=4) had stage-5 (< 15ml/min/m2) kidney failure that required dialysis. HIV+ lactating women had stronger association with RR of 0.918 and 95% CI of 0.845-0.998. Stage 5 CKD had been observed among WHO clinical stage-1 (P=0.014) with odds ratio of 5.4 and 95% CI (1.24-24.42), baseline CD4 > 500 with cohort risk estimate of 4.103 with 95 % CI (1.02, 16.54) (P=0.02). The prevalence of stage-2 kidney diseases is significantly associated lower BMI of below18.5, clinical stage-1, and CD4 > 500. Thus a close laboratory monitoring schedule for pregnant women and GFR calculation using simple android application, and early diagnosis of toxicity and management as to the WHO guide  is mandatory.