PRESENTATION SCHEME

1. Syndromic approaches for common outpatient conditions in adults: a priority revitalising primary care Bawoh. M PhD.

10. Disease episodes in Kenyan cohort of HIV-infected people

11. Diagram demonstrating CD4 count for different diagnoses Asympto Feb Illness Upper RTI Pneumo Vag cand UTI STI Folliculitis Oral cand Chronic diarh Diagnoses associated with immunosuppression 0 500 1000 1500 CD4 Count

12. Excess mortality in the era of HIV Age specific mortality rates for diarrhea in 1983 and 1995 Age groups 1983 1995 Deaths per 1000 population

13. Existing evidence that treatment is important Pelvic inflammatory disease Cohen, et al. 1997 & Bukusi et al. 1998 Bacterial pneumonia Gilks, et al. 1996 Tuberculosis Ackah, et al. 1995 Strengthen Health Care System Mwanza STI study: reduced HIV incidence Grosskurth, et al. 1995 Reduced mortality in hospitalized HIV patients Arthur, et al. 2000 40% HIV presumably died of 1 st OI Sewankambo, et al. 2000 Evidence Response to treatment in HIV infected persons

14. Survival of cohort in Nairobi who received primary health care, compared by initial CD4 count Gap: No comparison group with “usual” access to care

17. Gaps in knowledge of treatment efficacy Pneumonia Acute bronchitis Sinusitis Dermatoses Folliculitis Chronic diarrhea

18. Research & development of evaluation indicators and process Clinical outcome Referral pattern & rate of hospitalization Incidence of OIs Survival Validation indicators Cost of care Quality of life