scholarly journals Prevalence and Risk Factors of Mortality among Adult HIV Patients Initiating ART in Rural Setting of HIV Care and Treatment Services in North Western Tanzania: A Retrospective Cohort Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Daniel Wilfred Gunda ◽  
Igembe Nkandala ◽  
Semvua Bukheti Kilonzo ◽  
Boniface Bartholomew Kilangi ◽  
Bonaventura Cornel Mpondo
Keyword(s):  
Risk Factors ◽  
Opportunistic Infections ◽  
Rural Setting ◽  
Hiv Care ◽  
First Year ◽  
Hiv Diagnosis ◽  
Hiv Patients ◽  
Treatment Services ◽  
Rural Tanzania ◽  
Risk Patients

Introduction. HIV still causes high mortality despite use of ART. This study was designed to determine the prevalence and risk factors of mortality among HIV patients receiving ART in northwestern rural Tanzania. Methods. A retrospective study of HIV patients on ART was done at Sengerema in Mwanza, Tanzania. The data on demography, date of HIV diagnosis, WHO stage, opportunistic infections, CD4, hemoglobin, ART regimen, and time and outcome on treatment as dead or alive were collected and analyzed using STATA version 11. Results. In total, 740 patients were studied. The median age was 35 (27–42) years with female predominance of 465 (62.8%). Of the participants, 261 (35.3%) had WHO stages 3 and 4 diseases. Most participants, 258 (34.9%), had baseline CD4 counts <200 cells/μl. Deaths occurred in 86 (11.6%) patients which were independently associated with male gender (16.0% versus 9.0%, p=0.015), being divorced (OR = 2.7, p<0.001), WHO stages 3 and 4 (OR = 2.3, p=0.05), CD4 <200 cells/μl (OR = 3.4, p<0.001), and severe anemia (OR = 6.6, p<0.001). Conclusions. The mortality is high among HIV patients receiving ART in northwestern rural Tanzania. Universal testing could increase early diagnosis and treatment. A close follow-up of at-risk patients within the first year of ART could reduce the mortality of this subgroup of patients.

scholarly journals Incidence and risk factors for hypertension among HIV patients in rural Tanzania – A prospective cohort study

PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0172089 ◽  
Author(s):  
Eduardo Rodríguez-Arbolí ◽  
Kim Mwamelo ◽  
Aneth Vedastus Kalinjuma ◽  
Hansjakob Furrer ◽  
Christoph Hatz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Hiv Patients ◽  
Rural Tanzania

scholarly journals The Prevalence and Associated Factors of Hypertension among HIV Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Grace Wambura Mbuthia ◽  
Karani Magutah ◽  
Stephen T. McGarvey
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Associated Factors ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Health Concern ◽  
Cvd Risk ◽  
Hiv Patients ◽  
Care Clinic ◽  
Persons Living With Hiv

Background. The dual burden of cardiovascular diseases and Human Immunodeficiency Virus (HIV) in sub-Saharan Africa is of public health concern. Persons living with HIV are 1.5–2 times more likely to develop CVD risk factors compared to the noninfected individuals. Hypertension is a major risk factor leading to the rising CVD epidemic in SSA. However, the burden of hypertension among HIV patients in Kenya is not well documented. Objective. This study determined the prevalence and the associated factors of hypertension among HIV patients receiving regular care at Thika Level 5 Hospital Comprehensive Care Clinic (CCC), within metropolitan Nairobi, Kenya. Methods. The current cross-sectional study involved review of patients’ records/charts. Charts for adult patients seen in the last 6 months at Thika Level 5 Hospital CCC were included in the study. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg on two different readings one month apart, while overweight/obesity was defined as body mass index (BMI) ≥ 25 kg/m2. Results. In a sample of 939 HIV patients, the majority, 68.8% (646), were female. The patients’ ages ranged from 18 to 84 years with a median age of 44 (IQR 37–51) years. The mean BMI was higher for females (25.8 kg/m2) compared to that of males (23.1 kg/m2). However, the prevalence of hypertension was higher among males (25.3%) compared to females (16.9%). Age >40 years (AOR = 2.80, p ≤ 0.001 ), male sex (AOR = 2.10; p = 0.04 ), history of alcohol consumption (AOR = 2.56, p ≤ 0.001 ), and being overweight/obese (AOR = 2.77 p ≤ 0.001 ) were significantly associated with hypertension. The antiretroviral (ARV) regimen and, additionally, the duration of antiretroviral therapy had no association with being hypertensive. Conclusion. The prevalence of hypertension is high among HIV patients. Traditional cardiovascular risk factors were associated with hypertension, but no association was observed with ART regime or duration of ARV use. There is a need to integrate hypertension management into regular HIV care.

scholarly journals Cascade of care among HIV patients diagnosed in 2013 in Georgia: Risk factors for late diagnosis and attrition from HIV care

2017 ◽  
Vol 5 ◽  
pp. 205031211773197 ◽  
Author(s):  
Ekaterine Ruadze ◽  
Nikoloz Chkhartishvili ◽  
Otar Chokoshvili ◽  
Tengiz Tsertsvadze
Keyword(s):  
Risk Factors ◽  
Late Diagnosis ◽  
Hiv Care ◽  
Hiv Patients ◽  
Cascade Of Care

scholarly journals Analysis of the Consequences of the COVID-19 Pandemic on the Continuum of the Care in a Cohort of HIV-Positive Patients Followed in a Single Center of Northern Italy.

2020 ◽  
Author(s):  
Eugenia Quiros-Roldan ◽  
Paola Magro ◽  
Canio Carriero ◽  
Annacarla Chiesa ◽  
Issa El Hamad ◽  
...  
Keyword(s):  
Antiretroviral Drugs ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hiv Diagnosis ◽  
Hiv Patients ◽  
Medical Visits ◽  
Missed Visits ◽  
Hiv Continuum Of Care ◽  
New Strategies ◽  
The Continuum

Abstract Background: During the COVID-19 pandemic, hospitals faced increasing pressure, where HIV patients risked to either acquire SARS-Cov-2 and to interrupt the HIV continuum of care.Methods: retrospective, observational study. We compared the numbers of medical visits performed, antiretroviral drugs dispensed and the number of new HIV diagnosis and of hospitalizations in a cohort of HIV patients followed by the Spedali Civili of Brescia, between the bimester of the COVID-19 pandemic peak and the bimester of October-November 2019.Results: We observed a reduction in the number of new HIV diagnosis from 6.4 in 2019 to 2.5 per month in 2020, a raise of missed visits from 5% to 8%, a drop in ART dispensation especially for not-protease inhibitors and an increase of hospitalized HIV patients due to COVID-19.Conclusions: Our experience highlights the importance of a resilient healthcare system and the need to implement new strategies in order to guarantee the continuum of HIV care even in the context of emergency.

scholarly journals Prevalence and Risk Factors of Active TB among Adult HIV Patients Receiving ART in Northwestern Tanzania: A Retrospective Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Daniel W. Gunda ◽  
Simon C. Maganga ◽  
Igembe Nkandala ◽  
Semvua B. Kilonzo ◽  
Bonaventura C. Mpondo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Stage ◽  
Male Gender ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Hiv Patients ◽  
Northwestern Tanzania

Introduction. Although ART has improved the outcome of people living with HIV/AIDS, still some patients develop TB while receiving ART. The literature on the magnitude of this problem is still scarce in our setting especially northwestern Tanzania. This study was designed to determine the prevalence of active TB among HIV patients on ART and assess its potential risk factors.Methods. A retrospective cohort study was done among adult HIV-positive patients initiated on ART at Bugando Medical Centre. Patients who were TB positive before ART initiation were excluded. Data regarding demographic, clinical, and laboratory information, TB status on receipt of ART, and time on ART were collected and analyzed using STATA 11 to determine the prevalence of TB and its associated factors.Results. In total, 391 patients were enrolled in this study. The median age was 39 (32–46) years, and a total of 129 (32.99%) participants had CD4 counts <200 cells/µl and 179 (45.78%) had WHO stage 3 and 4 illnesses. A total of 43 (11.0%) participants developed TB while receiving ART which was independently associated with male gender (OR = 2.9;p=0.007), WHO clinical stage 3 and 4 (OR = 1.4;p=0.029), baseline CD4 count <200 cells/µl (OR = 9.1;p<0.001), and having not used IPT (OR = 3.1;p=0.05).Conclusions. Active TB is prevalent among HIV patients while receiving ART in northwestern Tanzania which is independently associated with male gender, advanced HIV disease, and nonuse of IPT. Universal HIV testing could reduce late HIV diagnosis and hence reduce the risk of developing TB while receiving ART in our setting. Also IPT should be widely used for those who are negative for TB on screening.

scholarly journals What drives mortality among HIV patients in a conflict setting? A prospective cohort study in the Central African Republic

2018 ◽  
Author(s):  
Thomas Crellen ◽  
Charles Ssonko ◽  
Turid Piening ◽  
Marcel Mbeko Simaleko ◽  
Diemer Henri St. Calvaire ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central African Republic ◽  
Linear Models ◽  
Opportunistic Infections ◽  
Patient Specific ◽  
People Living With Hiv ◽  
Armed Groups ◽  
Conflict Setting ◽  
Hiv Patients ◽  
The Impact

AbstractBackgroundProvision of antiretroviral therapy (ART) during conflict settings is rarely attempted and little is known about the expected patterns of mortality. The Central African Republic (CAR) continues to have a low coverage of ART despite an estimated 120,000 people living with HIV and 11,000 AIDS-related deaths in 2013. We present results from a cohort in Zemio, Haut-Mboumou prefecture. This region had the highest prevalence of HIV nationally (14.8% in 2010) and was subject to repeated attacks by armed groups on civilians during the observed period.MethodsConflict from armed groups can impact cohort mortality rates i) directly if HIV patients are victims of armed conflict, or ii) indirectly if population displacement or fear of movement reduces access to ART. Using monthly counts of civilian deaths, injuries and abductions, we estimated the impact of the conflict on patient mortality. We also determine patient-level risk factors for mortality and how this varies with time spent in the cohort. Model-fitting was performed in a Bayesian framework, using generalised-linear models with terms accounting for temporal autocorrelation.ResultsPatients were recruited and observed from October 2011 to May 2017. Overall 1631 patients were enrolled, giving 4107 person-years and 148 deaths. Our first model shows that patient mortality did not increase during periods of heightened conflict. The monthly risk (probability) of mortality was markedly higher at the beginning of the program (0.047 in November 2011 [95% credible interval; CrI 0.0078, 0.21]) and had declined greater than ten-fold by the end of the observed period (0.0016 in June 2017 [95% CrI 0.00042, 0.0036]). Our second model shows the risk of mortality for individual patients was highest in the first five months spent in the cohort. Male sex was associated with a higher mortality (odds ratio; OR 1.7 [95% CrI 1.2, 2.8]) along with the severity of opportunistic infections at baseline.ConclusionsOur results show that chronic conflict did not appear to adversely affect rates of mortality in this cohort, and that mortality was driven predominantly by patient specific risk factors. In areas initiating ART for the first time, particular attention should be focussed on stabilising patients with advanced symptoms.FundingMédecins Sans Frontières

scholarly journals Missed opportunities for tuberculosis prevention among patients accessing a UK HIV service

2018 ◽  
Vol 29 (12) ◽  
pp. 1234-1237 ◽  
Author(s):  
Hannah M Rickman ◽  
Robert F Miller ◽  
Stephen Morris-Jones ◽  
Lusha Kellgren ◽  
Simon G Edwards ◽  
...  
Keyword(s):  
Risk Factors ◽  
Outpatient Service ◽  
Latent Tuberculosis ◽  
Hiv Care ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Missed Opportunities ◽  
Ltbi Screening ◽  
Living With Hiv

United Kingdom guidelines recommend screening for and treatment of latent tuberculosis infection (LTBI) in HIV-positive patients at high risk of active tuberculosis (TB) disease, but implementation is suboptimal. We investigated potential missed opportunities to identify and treat LTBI among HIV-positive patients accessing a large HIV outpatient service in London. Case records of all adult patients attending our service for HIV care diagnosed with active TB between 2011 and 2015 were reviewed to determine whether they met criteria for LTBI screening and whether screening was undertaken. Twenty-five patients were treated for TB. Of 15 (60%) patients who started TB treatment ≥6 months after HIV diagnosis, 14 (93%) met UK guideline-recommended criteria for LTBI screening and treatment; only one (7%) had been screened for LTBI. Eight of these 15 (53%) patients had additional risk factors for TB which are not reflected in current UK guidelines. Of 15 patients treated for TB ≥6 months after diagnosis of HIV, 14 (93%) had not been screened for LTBI, suggesting missed opportunities for TB prevention. People living with HIV may benefit from a broader approach to LTBI screening which takes into account additional recognised TB risk factors and ongoing TB exposure.

scholarly journals Prevalence, risk factors and clinical correlates of COPD in a rural setting in Tanzania

2018 ◽  
Vol 51 (2) ◽  
pp. 1700182 ◽  
Author(s):  
Ng'weina Francis Magitta ◽  
Richard William Walker ◽  
Komalkirti Keshavkiran Apte ◽  
Meshack Denson Shimwela ◽  
Julius David Mwaiselage ◽  
...  
Keyword(s):  
Risk Factors ◽  
Indoor Air Pollution ◽  
Developed Countries ◽  
Forced Expiratory Volume ◽  
Rural Setting ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Rural Tanzania ◽  
History Of

Chronic obstructive pulmonary disease (COPD) causes substantial burden of disease in developed countries, but there are limited data from Africa. We aimed to estimate the prevalence of COPD in Tanzania and identify the risk factors associated with it.This was a cross-sectional descriptive survey involving adults aged ≥35 years. We collected data on symptoms and risk factors using the Burden of Obstructive Lung Diseases questionnaire. Spirometry was performed and COPD diagnosed based on post-bronchodilator forced expiratory volume in 1 s/forced vital capacity <70%. We also measured indoor and outdoor carbon monoxide (CO) levels.A total of 869 participants (49.1% females) completed the questionnaires. Of these, 57.1% completed post-bronchodilator spirometry. Of the 25.2% ever-smokers, only 5.4% were current smokers. COPD prevalence was estimated at 17.5% (21.7% in males and 12.9% in females). COPD was associated with a history of cough, phlegm production and wheezing. 51.7% of COPD patients reported cough and 85% had mild to moderate airway limitation. Females had a higher rate of exacerbation. Pulmonary tuberculosis (TB) was reported in 10% of patients. Only 1.7% of patients who were diagnosed as COPD had ever received any medication, with only one female COPD patient having received an inhaler. 99.5% of the population used biomass fuels for cooking. The majority of households had CO levels up to 20 ppm.The prevalence of COPD in Tanzania is high, with a peak at a relatively young age and a preponderance in males. A history of TB, cigarette smoking and male sex are important risk factors. Indoor air pollution coupled with use of biomass fuel for cooking and heating may be an important risk factor for developing COPD in rural Tanzania. However, these factors need to be studied further.

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