Cameroon: Mobile Phone SMS Fortifies ARV Fidelity - Research

Cameroon: Mobile Phone SMS Fortifies ARV Fidelity - Research

Ntaryike Divine Jr

Douala, Cameroon

29 August 2011

A caucus of researchers in Cameroon has concluded that regularly reminding HIV/AIDS patients of the need to be punctual and meticulous in taking medication can substantially ramp up their adherence to antiretroviral therapy.

The conclusion is based on a study dubbed “Cameroon Mobile Phone SMS [CAMPS] Trial.”  It was conducted over a period of six months, beginning January 2011 at the Day Care Center of Central Hospital in the capital Yaoundé.  The dozen-man research team from the Center for the Development of Best Practices in Health, CDBPH, was led by Lawrence Mbuagbaw.

“We thought it could be a good idea to see whether mobile phones can be used to improve adherence to HIV medication.  Similar studies are ongoing in Kenya, India and other countries and they show that text messages can be effective in improving adherence,” he said during a public presentation of the findings in late August.

Some 200 patients undertaking antiretroviral treatment were enrolled and randomly assigned to a control group.  Trial subjects in one cluster received 101 weekly reminder and motivational Short Message Service [SMS] texts while the other continued with usual care.

According to the research results, participants who received the SMS showed adherence rates surpassing 90 percent.  Their average weight increase stood at 3kg, compared to 1.7kg in the group that did not receive the SMS reminders. Elsewhere, the researchers noted an 8 percent progress in medication fidelity for the SMS recipients compared to 2.3 percent in the control group.

“Their adherence improved; which means they take their medication better and they’ll be healthier and there’ll be a reduction in the development of resistance strains to the virus,” Mbuagbaw explained.

He added that the lifelong antiretroviral therapy frustrates rapid replication and mutation rates of the human immune-deficiency virus, thus delaying death by lowering viral loads in patients.  He said the benefits of antiretroviral therapy are maximized when adherence rates attain or exceed 95 percent and anything less culminates in early treatment failure.

Getting any of the trial subjects to comment proved impossible.  Based on agreements reached between the researchers and trial subjects, none of them accepted to comment, not even anonymously, an attitude that exemplifies lingering stigma around HIV/AIDS in Cameroon.

Cameroon is home to over 20 million inhabitants and has an HIV/AIDS prevalence rate of 5.3 percent, according to the Ministry of Health.  In recent years, the government has considerably scaled up access to treatment by multiplying treatment centers and slashing costs.  In May 2007, ARV treatment at public hospitals was rendered gratis from a widely unaffordable US$1,200 six years before.

These measures have contributed to slight drops in AIDS-related mortality and the CDBPH researchers are confident that addressing treatment interruptions could significantly improve the situation. They have blamed existing non-adherence among some patients on persisting stigma, as many shy away from taking pills in public. Elsewhere, frequent stockouts and difficult access to prescribed nutrition are also responsible.

Based on the findings, the CDBPH is lobbying for government support to extend the research nationwide and eventually set up SMS reminder outfits.  Statistics show that 40  percent of all Cameroonians currently use mobile telephones and the Telecommunications Regulatory Agency says the figure is set to hop with dropping access rates and increasing availability of low-priced and affordable handsets.