| dc.description.abstract | Background: Access to ARVs has increased over time as a result of emerging policies such as; the Uganda adapted WHO 2015 ART guidelines which state that all people testing positive for HIV should be enrolled on ART regardless of their level of HIV-related immunologic detoriarion (CD4+ cell count). Increased access to ARVs has been associated with their increased off-label use. In Uganda, pigs’ feeds are being adulterated with the life prolonging drugs (ARVs) for people living with HIV/AIDS. This practice could breed antimicrobial-resistant HIV virus which could be harmful to pork consumers, since there is prior exposure to subtherapeutic levels of ARVs. Main Objective: To determine the prevalence of detectable drug residuals for TDF, EFV and NVP in blood samples of pigs from selected abattoirs in Uganda.
Methods: This was a cross sectional study that involved two sub-studies. In sub-study one, the pigs were the study units from Teso abattoirs in Lira district and Wambazzi abattoir in Kampala district. The study aimed at determining the prevalence of detectable drug residuals for EFV, NVP and TDF from blood samples of pigs. A portion of venous blood sample (5ml) was collected from the pig’s jugular vein as the pigs were being slaughtered into an EDTA purple top blood vacutainer collecting tube. A total of 361 pigs were sampled. Sample processing involved protein precipitation from plasma, followed by high performance liquid chromatography with EFV, NVP and TDF columns and detection at 210, 280 and 260nm respectively. Sub-study two was a qualitative study with humans as study units, the study aimed at assessing the knowledge and practices of stake holders (farmers and agricultural officers) related to the use of ARVs in pigs. Focus group discussions (FGD) were conducted after consent using Krueger method.
Results: A total of 361 samples were tested for presence of ARV drug residues The overall
prevalence for samples with detectable ARV drug residuals was 27.42% (95% CI:22.89 to 32.34). Of the 361 samples, 256 samples collected from Kampala (Wambizzi abattoir) 19.14% (95% CI:14.51 to 24.50) had detectable ARV drug residues. Of the 105 samples collected from Lira (Teso abattoirs), 47.62% (CI:37.78 to 57.60) had detectable ARV drug levels. The median (IQR) detectable ARV drug residual concentration was; EFV 0.26 0.23-0.31) mg/L and NVP 0.08(0.06-0.11) mg/L. In the FGD interviews, all farmers (32) accepted that indeed ARVs are being used by farmers to feed the pigs.
Conclusion: The study confirms the use of ARVs (EFV and NVP) as detected in pigs by farmers in Uganda. | en_US |
