scholarly journals Depression among Adult HIV/AIDS Patients Attending ART Clinics at Aksum Town, Aksum, Ethiopia: A Cross-Sectional Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Berhe Beyene Gebrezgiabher ◽  
Teklehaymanot Huluf Abraha ◽  
Etsay Hailu ◽  
Hailay Siyum ◽  
Getachew Mebrahtu ◽  
...  

Background. Depression is consistently associated with increased risk of Human Immunodeficiency Virus infection and poor antiretroviral treatment adherence. Though many factors have been reported as determinant factors of depression, site-specific evidence is needed to identify factors associated with depression among adults on antiretroviral treatment. Methods. An institution based cross-sectional study was carried out from March to May 2015 among 411 adults HIV/AIDS patients on ART clinic follow-up. Participants were selected using systematic random sampling techniques. Data were collected using chart review and interviewer- administered techniques. Both bivariable and multivariable logistic regressions were used to compute the statistical test associations by SPSS version-20. Variables with p value < 0.05 were considered as statistically significant. Results. Four hundred eleven patients with a mean age ± Standard Deviation of 36.1±9.2 years and with a total response rate of 97.6% were enrolled in the study. The prevalence of depression was 14.6% (95% CI, 10.90-18.2). Factors independently associated with depression were nonadherence to ART, eating two meals per day or less, having side effect of ART medication, being in the WHO Stage II or above of HIV/AIDS, and living alone with AOR (95% CI) of 3.3 (1.436, 7.759), 2.8 (1.382, 5.794), 4.7 (1.317, 16.514), 2.8 (0.142, 0.786), and 2.4 (1.097, 5.429), respectively. Conclusion. Though the magnitude of depression was found relatively low, it was commonly observed as a mental health problem among adult patients with HIV/AIDS on ART. Programs on counseling and close follow-up of adherence to ART, drug side effects, and nutrition should be strengthened. Health facilities should link adult patients with HIV/AIDS who live alone to governmental and nongovernmental social supporter organizations.

2019 ◽  
Author(s):  
Demelash Wachamo ◽  
Fisseha Bonja

Abstract Background Opportunistic infections are late complications of HIV infection is the depletion of the immune system. It is a major public health problem and high morbidity AIDS patients die of AIDS-related infections in developing countries like Ethiopia. Identification of opportunistic infections (OIs) is important to develop a specific intervention. Therefore, this study aimed to assess the burden and associated factors of opportunistic infections.Method A facility-based cross-sectional study was conducted on 420 randomly selected HIV/AIDS patients taking anti-retroviral therapy. Data was collected from selected hospitals in Sidama Zone based on population proportion to size. Data was collected by a pre-tested questionnaire and a pre-tested checklist from the medical records of patients. Data entry and analyzed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05.Result The magnitude of opportunistic infections was 39.6%. Major identified OIs was oral candidacies 23.2%, recurrent bacterial pneumonia 21.5%, Herpes zoster 6.3%, and Pulmonary Tuberculosis 6.0%.The magnitude of opportunistic associated with; older age [AOR=2.69, 95% CI: 1.33-5.43], No formal education [AOR=3.12, 95% CI: 1.06-9.25], Low monthly income [AOR=2.27, 95%CI:1.35-3.83], initial CD4 count less than 200 cells/mm3 [AOR=1.91, 95% CI:1.05-3.46), WHO clinical stage II [AOR=2.43, 95% CI:1.34-4.42] and stage III and IV [AOR=4.27, 95% CI: 2.12-8.59], had no extra medicine additional to ART (prophylaxis) had [AOR= 5.91, 95% CI: 3.31-10.56], who interrupt ART medicines [AOR=2.03, 95% CI: 1.09- 3.80] and Khat chewing [AOR=5.48, 95% CI: 2.32-12.96] when compared to their counterparts.Conclusions The overall magnitude of opportunistic infections was high when compared with other studies. Health officials and clinicians need to give attention on the strengthening of the provision if ART with prophylaxis on early-stage and adhrerence, implementation of the TB/HIV collaboration activity, and early initiation of ART to reduce opportunistic infections.


2019 ◽  
Vol 8 (1) ◽  
pp. 22-26
Author(s):  
Dilli Ram Kafle ◽  
Surendra Sah ◽  
Miluna Bhusal

Background: About 5-10% of the population get at least one seizure in their lifetime. Treatment is started in patients with first unprovoked seizure if the risk of seizure recurrence is predicted to be high. If patients with first seizure are not treated 40-50% of patients develop recurrence within 2 years of the initial seizure. Starting treatment may cause reduction in the risk of recurrence by almost one half. The aim of the study was to identify the factors causing recurrence in patients with first unprovoked seizure. Materials and Methods: It is a prospective cross-sectional study conducted at Nobel Medical College from March 2015 to March 2019. Patients who presented to Nobel Medical College with first unprovoked seizure were enrolled in the study with follow up during the hospital visit. Results: Eighty six patients participated in our study. Recurrence of seizure occurred in 21(24.4%) patients within the study period of 4 years. Abnormal Electroencephalography was significantly associated with recurrence of seizure in patients with first seizure. (P value<0.001) Neuro imaging abnormality was also associated with increased risk of seizure recurrence (Pvalue<0.001) .Starting an antiepileptic after first seizure reduced the risk of further seizure. Conclusion: Recurrence of seizure was observed in almost a quarter of patients within the study period of four years. Recurrence risk was higher in those patients with abnormal Electro encephalography and in those patients with identified cause than those patients whose seizure was assumed to be idiopathic.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Thomas Kiggundu ◽  
Robert Kalyesubula ◽  
Irene Andia-Biraro ◽  
Gyaviira Makanga ◽  
Pauline Byakika-Kibwika

Abstract Background HIV infection affects multiple organs and the kidney is a common target making renal disease, one of the recognized complications. Microalbuminuria represents an early, important marker of kidney damage in several populations including HIV-infected antiretroviral therapy (ART) naïve patients. Early detection of microalbuminuria is critical to slowing down progression to chronic kidney disease (CKD) in HIV-infected patients, however, the burden of microalbuminuria in HIV-infected antiretroviral therapy (ART) naïve patients in Uganda is unclear. Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic among adult HIV − infected ART naïve outpatients. Data on patient demographics, medical history was collected. Physical examination was performed to assess body mass index (BMI) and hypertension. A single spot morning urine sample from each participant was analysed for microalbuminuria using spectrophotometry and colorimetry. Microalbuminuria was defined by a urine albumin creatinine ratio (UACR) 30-299 mg/g and macroalbuminuria by a UACR > 300 mg/g. To assess the factors associated with microalbuminuria, chi-square, Fisher’s exact test, quantile regression and logistic regression were used. Results A total of 185 adult participants were consecutively enrolled with median age and CD4+ counts of 33(IQR = 28–40) years and 428 (IQR = 145–689) cells/μL respectively. The prevalence of microalbuminuria was 18.9% (95% CI, 14–25%). None of the participants had macroalbuminuria. CD4+ count <350cells/μL was associated with increased risk of microalbuminuria (OR: 0.27, 95% CI: 0.12–0.59), P value = 0.001). Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria. Conclusion Microalbuminuria was highly prevalent in adult HIV − infected ART naive patients especially those with low CD4+ count. There is need to study the effect of ART on microalbuminuria in adult HIV − infected patients.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A477-A478
Author(s):  
Yamit Basson-Shleymovich ◽  
Tali Cukierman-Yaffe ◽  
Tal Yahalom-Peri ◽  
Michal Azmon

Abstract Diabetes is a major public health burden associated with high mortality, morbidity, hospitalization and health care services utilization rates. People with diabetes have an increased risk for mobility disability compared to those without diabetes, after controlling for age. People with diabetes also have a higher risk for falls and fractures. Data from the last several years suggests that this increased risk is not only due to diabetes co-morbidities but also due to an accelerated decline in physical capacity due to lower muscle quality and a more rapid decline in muscle mass (sarcopenia) and lower extremity strength over time. HBA1C is a measure of average glucose levels; however, it does not provide information about glycemic variability, or daily patterns of glycemia. In the last several years, several organizations have published consensus statements on the role of continuous glucose monitoring (CGM) in glucose control. The use of CGM has brought about the development of many glucose indices, amongst them is: Time In Range% (TIR) of 70–180 mg/dL (3.9–10 mmol/L). Less is known regarding the association between TIR and sarcopenia, muscle mass loss that leads to deterioration in mobility, disabilities and decline in physical indices in older people with diabetes. Aims: To assess among older people with diabetes type 2, the cross sectional association between: TIR and aerobic capacity, gait speed, strength, balance and frailty indices. Methods: A cross sectional study, conducted amongst people with diabetes over the age of 60. Participants were provided with a blinded CGM system- (I Pro2 carelink, Medtronic) for 1 week and underwent elaborate physical-functional assessment in the beginning and at the end of that week. The association between the % of time in range (Time in Range-TIR) and several physical indices was determined using linear regression. Results: This analysis pertains to 55 men and women who completed the evaluation. After adjustment for age and gender, we found that 1% increase in TIR was associated with a 0.341 higher score on the 30 second Sit to Stand score (a measure of lower extremity strength) (P-value=0.02), a 0.351 higher score on the BERG scale (a measure of balance) (P-value=0.01), a 0.271 lower score on the timed up and go score (a measure of fall risk and balance) (P-value=0.008), a 0.289 higher score on the 6-minute walk score (a measure of aerobic capacity and endurance) (P-value=0.02) and a 0.261 lower score on the 360 turn test (a measure of dynamic balance) (P-value=0.0004). The same was not observed for the relationship between HGA1C & physical indices.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e056009
Author(s):  
Shimeles Biru Zewude ◽  
Tewodros Magegnet Ajebe

ObjectivesThis study aims to identify levels of adherence to antiretroviral therapy (ART) drugs and factors associated with them in Northwest Ethiopia. We hypothesise that in the era of COVID-19, there would be suboptimal adherence to ART drugs.DesignAn observational cross-sectional study was conducted. Factors associated with the level of adherence were selected for multiple logistic regressions at a p value of less than 0.2 in the analysis. Statistically significant associated factors were identified at a p value less than 0.05 and adjusted OR with a 95% CI.SettingThe study was conducted in one specialised hospital and three district hospitals found in the South Gondar zone, Northwest Ethiopia.ParticipantsAbout 432 people living with HIV/AIDS receiving highly active ART in South Gondar zone public hospitals and who have been on treatment for more than a 3-month period participated in the study.Primary and secondary outcome measuresLevels of adherence to ART drugs and their associated factors.ResultsAmong 432 study participants, 81.5% (95% CI: 78% to 85.2%) of participants were optimally adherent to ART drugs. Determinants of a low level of adherence: stigma or discrimination (OR=0.4, p=0.016), missed scheduled clinical visit (OR=0.45, p=0.034), being on tuberculosis treatment (OR=0.45, p=0.01), recent CD4 cell count less than 500 cells/mm3 (OR=0.3, p=0.023) and patients who had been on WHO clinical stage III at the time of ART initiation (OR=0.24, p=0.027) were factors significantly associated with adherence to ART drugs.ConclusionsLevel of adherence was relatively low compared with some local studies. The intervention targeted to reduce discrimination, counselling before initiation of treatment and awareness regarding compliance is advised to improve adherence to antiretroviral regimens.


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