Comorbid bloodborne diseases among people with opioid use disorders on medication-assisted treatment in Tanzania.

Background 

People who use drugs (PWUDs) are at an increased risk of acquiring and transmitting blood-borne diseases, such as HIV, hepatitis B(HBV), and hepatitis C (HCV) virus. To prevent and manage HIV and other infections among people who use drugs, Tanzania has been providing medication-assisted treatment (MAT). The comprehensive packages of care for opioid use disorders include biological, social, and psychological interventions for PWUDs. These include screening and managing co-morbid physical and mental health disorders (HIV, hepatitis, tuberculosis, mood disorders, psychosis, and other substance use disorders), psychosocial interventions, occupational therapy, and family and community re-integration. 

Method 

This is an observational finding from the medication-assisted treatment clinic at the Muhimbili National Hospital in Tanzania. People with opioid use disorders receive comprehensive care for their opioid use disorders and comorbid physical and mental disorders. These involve medically assisted treatment, screening, and appropriate interventions for HIV, hepatitis B, and C viruses, mental disorders, psychosocial interventions, occupational therapy, and reconnecting with their families. Multidisciplinary teams offering services involve psychiatrists, clinical psychologists, nurses, pharmacists, social workers, and occupational therapists. The majority of Clients received their methadone, through a direct observation at the pharmacy, and some as take-home doses. There are individual and structural assessment factors that guide the model for taking their medication. All data are saved and stored at the MAT clinic.

Findings 

As of January 2024, a total of 972 (939 males and 33 females) PWUDs are receiving MAT services at the Muhimbili National Hospital in Dar es Salaam, Tanzania. As part of their comprehensive care for opioid use disorders, 960 (98.7%) receive direct observation treatment (DOT) for the Methadone syrup at the clinic, and 12 (1.2%) receive a take-home dosage. Currently, there are 82 HIV-positive clients. Of them, 30 receive direct observation treatment of the antiretroviral medication at the MAT clinic nursing station, and 52 receive a monthly dose supply for taking at home. 125(13.0%) clients tested positive for Hepatitis C and B and are on regular clinical assessment and radiological investigations accordingly for follow-up.  

Conclusion 

Bloodborne diseases are common among PWUDs. Integrated comprehensive care to address drug use problems and associated illnesses helps in early identification and management. Therefore, including comprehensive interventions to screen and manage bloodborne diseases associated with drug use problems is important