Twelve-month Treatment Retention and Associated Factors: A Comparison of 2 Medically Assisted Therapy Clinics in Dar es Salaam, Tanzania.

Journal: Journal of addiction medicine

Volume: 16

Issue: 6

Year of Publication: 2022

Affiliated Institutions:  From the Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa (DAM); Directorate of Clinical Services, Mirembe Mental Health Hospital, Dodoma, Tanzania (DAM); Department Psychiatry and Mental Health, Muhimbili National Hospital, Dar es Salaam, Tanzania (DAM, JKM, FAM); Department Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (JKM, FAM); Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, (SM); Department of Psychiatry, University of Toronto, Toronto, ON, Canada (PAK); and Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada (PAK).

Abstract summary 

Retention in methadone maintenance treatment is instrumental in achieving better treatment outcomes. In this study, we compared 2 medication-assisted treatment (MAT) clinics in Dar es Salaam, Tanzania with respect to patient characteristics, outcomes, and factors that predict 12-month treatment retention.This retrospective registry-based cohort study utilized data collected for routine clinical and program monitoring at 2 sites, Mwananyamala and Muhimbili MAT clinics. Cumulative retention in treatment was calculated using life tables. The analysis of treatment retention predictor variables used both Kaplan-Meier and Cox proportional hazard analyses.We examined the socio-demographic and program-related characteristics of 362 (181 from each clinic) patients. Twelve-month treatment retention was higher at Mwananyamala (73%) than Muhimbili (64%) MAT clinic, but the difference was not significant. In both clinics, a higher methadone dose (>60mg) significantly predicted treatment retention ( P < 0.05). Being employed and traveling an average short distance (<5 km) from home to clinic significantly increased the likelihood of remaining in treatment in Muhimbili MAT clinic (P< 0.05) only.A methadone dose of 60 mg and above was associated with longer retention in treatment. At 1 clinic in a denser and more central location, employment and a short travel distance from home to clinic were associated with longer tenure in treatment. These findings have potential implications for clinical practice, research, and scaling up MAT services in Tanzania.

Authors & Co-authors:  Mlaki Damas A DA Mbwambo Jessie K JK McCurdy Sheryl S Masao Frank A FA Kaduri Pamela A PA

Study Outcome 

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Statistics
Citations :  United Nations Office on Drugs and Crime. World Drug Report 2021. United Nations Office on Drugs and Crime; 2021. Available at: https://www.unodc.org/res/wdr2021/field/WDR21_Booklet_2.pdf . Accessed July 16, 2021.
Authors :  5
Identifiers
Doi : 10.1097/ADM.0000000000000995
SSN : 1935-3227
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
Tanzania
Publication Country
Netherlands