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Previous Volume 355:2276-2277 November 30, 2006 Number 22 Next

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View larger version (91K): [in this window] [in a new window]   Ligula Hospital, a regional hospital in Mtwara, Tanzania, has enrolled more than 700 patients as part of a national rollout of antiretroviral treatment and AIDS care sponsored by the Tanzanian government in collaboration with the Clinton Foundation HIV–AIDS Initiative and other partners. The plan is to have 400,000 HIV-infected Tanzanians receiving antiretroviral drugs by 2008 and another 1.2 million enrolled in care. Many will travel long distances to get to an HIV clinic. Ligula Hospital has radiography and ultrasonography but lacks specialists, oxygen therapy, an ICU, and CT scanners.

 

View larger version (58K): [in this window] [in a new window]   Dr. Delilah Kimambo examines a chest radiograph of a patient with HIV and severe pneumonia. She has worked at Ligula Hospital since she finished her training 3 years ago — 5 years of postsecondary school medical training and a 1-year internship in medicine, pediatrics, obstetrics, gynecology, radiology, and basic surgery.

 

View larger version (71K): [in this window] [in a new window]   Dr. Kimambo visits the bedside of a patient with a 1-week history of fever, meningismus, and an abscess that extended from his neck to his shoulder. After incision and drainage, he remained febrile. Kimambo is one of three doctors and two nurses who staff the HIV–AIDS Care and Treatment Center, sharing primary care duties for the 700 patients with HIV–AIDS.

 

View larger version (86K): [in this window] [in a new window]   Dr. Aloyce Mshana examines a child with oral candidiasis and impetigo. The decision to test for HIV is complicated, because the social stigma attached to a positive test may result in the mother's being shunned by her family and community. The availability of antiretroviral medications and the visible improvement in patients receiving treatment have increased the acceptance of testing.

 

View larger version (80K): [in this window] [in a new window]   Mohamed Mkwavila, a nurse on the inpatient men's ward, cares for a man who was hospitalized because weight loss and severe cellulitis in his legs made him unable to walk. The patient's condition slowly improved once antiretroviral therapy was begun.

 

View larger version (89K): [in this window] [in a new window]   Nurses Clara Mbatiya and Perpetua Bernard staff the HIV–AIDS Care and Treatment Center.

 

Source Information

Dr. Zeeman is an assistant professor of medicine and staff physician at the Center for Infectious Disease at Boston Medical Center, Boston, and an emergency physician at MetroWest Medical Center, Natick and Framingham, MA.

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