preprint · medRxiv
An analysis of national antiretroviral therapy dispensing data in Tanzania examined treatment consumption from 2017 to 2021 using the World Health Organisation Defined Daily Dose methodology. Over this period, national consumption increased from 12.2 to 27.1 defined daily doses per 1,000 inhabitants per day, representing a compound annual growth rate of 22.4 percent across more than 2.1 million patients. Clinic visits per patient fell from 6.78 to 5.24 per year as multi-month dispensing expanded. Concurrently, regimen composition underwent a major transition, with integrase strand transfer inhibitors growing tenfold after 2019. By 2021, dolutegravir-based combinations accounted for approximately 70 percent of all dispensed doses. Although regional differences narrowed over time, consumption remained concentrated in Dar es Salaam, Mwanza, and Dodoma, with forecasts projecting continued moderate growth through 2025.
Tracking medicine consumption through standardised metrics helps health systems evaluate treatment access, policy shifts, and supply chain demands. This analysis demonstrates how adopting the Defined Daily Dose framework enables health authorities to accurately monitor drug utilisation and observe the real-world uptake of preferred, modern therapeutic regimens across different regions.
This applied analysis provides an evidence-based method and forecasting model for national health programmes, procurement agencies, and supply chain planners. It is directly relevant to pharmaceutical distributors and public health logistics managers seeking to align procurement volumes with evolving clinical guidelines and regional demand patterns. The methodology is tested on real programmatic data and ready for operational use in public health logistics.
AI-generated from the published abstract. Always read the original work before citing.
Abstract Objectives To quantify national and regional trends in antiretroviral therapy (ART) consumption in Tanzania from 2017 to 2021 using the World Health Organisation (WHO) Defined Daily Dose (DDD) methodology and to describe shifts in regimen composition during the transition to dolutegravir-based therapy. Methods A retrospective descriptive analysis was conducted using programmatic dispensing data from the National AIDS and Sexually Transmitted Infections Control Programme (NASHCoP). ART dispensing records from all reporting HIV Care and Treatment Clinics were harmonised with WHO ATC/DDD codes and linked to annual population estimates. Consumption was expressed as DDDs per 1,000 inhabitants per day. Temporal trends, therapeutic class distributions, and regional variations were analysed using Power BI and R. Short-term national forecasts until 2025 were modelled using quadratic regression. Results Between 2017 and 2021, ART consumption increased from 12.2 to 27.1 DDD/1,000/day (compound annual growth rate, 22.4%), with a five-year mean of 19.7 DDD/1,000/day. A total of 2,108,707 unique patients accounted for 39.7 million clinic visits in the study. The average number of visits per patient per year declined from 6.78 to 5.24, consistent with the expansion of the multi-month dispensing program (MM). Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) remained the core therapeutic class, whereas the use of integrase strand transfer inhibitors (INSTIs) has increased by more than tenfold since 2019. Dolutegravir (DTG) - based combinations (TDF/3TC/DTG) have become the predominant regimen, accounting for approximately 70% of dispensed DDDs by 2021. Regional variation narrowed over time, although the highest consumption persisted in Dar es Salaam, Mwanza, and Dodoma. Forecast modelling indicated continued moderate growth through 2025. Conclusions The national ART consumption in Tanzania more than doubled between 2017 and 2021, reflecting the expansion of treatment coverage, evolution of differentiated service delivery, and the transition to DTG-based regimens. The routine computation of DDD per 1,000 inhabitants per day provides a standardised and feasible metric for monitoring ART utilisation within national HIV programs.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.64898/2025.12.06.25341745
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
