Prospective assessment of loss to follow‐up: incidence and associated factors in a cohort of HIV‐positive adults in rural Tanzania

By the end of March 1990 470 HIV positive patients, 77% injection drug use (IDU) related, had attended the outpatient department of the Regional Infectious Disease Unit with a cumulative loss to follow-up of only 20%. Coincident with the prescribing of oral methadone and a specific all-day IDU-related HIV medical clinic the total number of appointments increased from 28/month in May 1986 to 300/month in May 1989 ( P< 0.001) and the number of defaulted appointments decreased from a maximum of 60% (17/28) to 16% (48/294, P<0.001) in these months. There was a significant initial increase in the number of defaulted appointments for the infectious disease (ID) clinics from 11% (77/726) to 16% (124/797, P<0.01) which returned to previous levels once a specific IDU-related HIV clinic was established. There was also a significant decline in the number of new patients referred which was greater for the urinary tract infection clinics (108 to 56 per 6 months, P<0.0001) than for the ID clinics (119 to 88 per 6 months, P<0.05).

Download Full-text

Comorbidity of HIV, hypertension, and diabetes and associated factors among people receiving antiretroviral therapy in Bahir Dar city, Ethiopia

Journal of Comorbidity ◽

10.1177/2235042x19899319 ◽

2020 ◽

Vol 10 ◽

pp. 2235042X1989931

Author(s):

Zenebework Getahun ◽

Muluken Azage ◽

Taye Abuhay ◽

Fantu Abebe

Keyword(s):

Antiretroviral Therapy ◽

Associated Factors ◽

Cross Sectional Study ◽

Noncommunicable Diseases ◽

Hiv Positive ◽

Bahir Dar ◽

Second Line ◽

Double Burden ◽

Cross Sectional ◽

Hiv Positive Adults

Background: People living with human immunodeficiency virus (HIV) are facing an increased burden of noncommunicable diseases (NCDs) comorbidity. There is, however, paucity of information on the magnitude of HIV-NCDs comorbidity, its associated factors, and how the health system is responding to the double burden in Ethiopia. Objective: To determine the magnitude of comorbidity between HIV and hypertension or diabetes and associated factors among HIV-positive adults receiving antiretroviral therapy (ART) in Bahir Dar city, Ethiopia. Methods: A facility-based cross-sectional study was conducted among 560 randomly selected HIV-positive adults taking ART. Data were collected using a structured questionnaire and analyzed using SPSS version 23. Descriptive statistics were used to describe the data. A logistic regression model was fit to identify associated factors with comorbidity of HIV and NCDs. Results: The magnitude of comorbidity was 19.6% (95% confidence interval (CI): 16.0–23.0). Being older (55 and above years) adjusted odds ratio (AOR: 8.5; 95% CI: 3.2–15.1), taking second-line ART regimen containing tenofovir (AOR: 2.7; 95% CI: 1.3–5.6), and increased body mass index (BMI) ≥25 (AOR: 2.7; 95% CI: 1.2–6.5) were the factors associated with comorbidity. Participants reported that they were not managed in an integrated and coordinated manner. Conclusions: The magnitude of comorbidity among adults was high in the study area. Being older, second-line ART regimen and high BMI ≥25 increased the odds of having NCDs among HIV-positive adults. Targeted screening for the incidences of NCDs, addressing modifiable risk factors, and providing integrated care would help to improve the quality of life comorbid patients.

Download Full-text

Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: a retrospective record review

BMC Public Health ◽

10.1186/s12889-019-7912-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Belisty Temesgen ◽

Getiye Dejenu Kibret ◽

Nakachew Mekonnen Alamirew ◽

Mamaru Wubale Melkamu ◽

Yitbarek Tenaw Hibstie ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Opportunistic Infections ◽

Preventive Therapy ◽

Hemoglobin Level ◽

Disease Stage ◽

Hiv Positive ◽

Immunodeficiency Virus ◽

Hiv Positive Adults ◽

Record Review

Abstract Background Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence and predictors of tuberculosis among people living with HIV. Thus, this study assessed the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy. Methods This study was a retrospective record review including 544 HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital between January 1, 2012 and December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from antiretroviral intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of tuberculosis. Results In the final analysis, a total of 492 HIV-positive adults were included, of whom, 83 (16.9%) developed tuberculosis at the time of follow-up. This study found that the incidence of tuberculosis was 6.5 (95% CI: 5.2, 8.0) per 100-person-years (PY) of observation. Advanced World Health Organization clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking Isonized Preventive Therapy (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of tuberculosis. Conclusion The study found that there was a high rate of tuberculosis occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking Isonized Preventive Therapy were found to be the predictors of tuberculosis. Therefore, early detection and treatment of opportunistic infections like tuberculosis should get a special attention.

Download Full-text

Retaining HIV-positive patients in HIV care: a personalised approach for those at risk of loss to follow-up at an inner city sexual health service

Sexual Health ◽

10.1071/sh17036 ◽

2018 ◽

Vol 15 (1) ◽

pp. 91

Author(s):

Loretta Healey ◽

Catherine C. O'Connor

Keyword(s):

Health Service ◽

Sexual Health ◽

Text Messages ◽

Hiv Care ◽

Hiv Positive ◽

Hiv Patients ◽

Loss To Follow Up ◽

Sexual Health Service ◽

Lost To Follow Up

In 2013 a personalised approach to follow-up of HIV patients who had withdrawn from HIV care was taken at RPA Sexual Health, a Sydney metropolitan sexual health service. HIV patients were telephoned, sent text messages, emailed and sent letters multiple times where applicable. With this intervention 20 of 23 people who had withdrawn from HIV care re-engaged. Since that time, active follow-up of all people diagnosed with HIV has resulted in only 2% of HIV patients at RPA Sexual Health being lost to follow-up.

Download Full-text

Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review

10.21203/rs.2.11527/v4 ◽

2019 ◽

Author(s):

Belisty Temesgen ◽

Getiye Dejenu Kibret ◽

Nakachew Mekonnen Alamirew ◽

Animut Alebel

Keyword(s):

Opportunistic Infections ◽

Hemoglobin Level ◽

Disease Stage ◽

Hiv Positive ◽

Retrospective Record Review ◽

Immunodeficiency Virus ◽

Hiv Positive Adults ◽

Debre Markos ◽

Record Review

Abstract Background: Tuberculosis (TB) is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus (PLHIV) are attributed to tuberculosis. Despite this fact, in Ethiopia, particularly in our study area there is a scarcity of information regarding the incidence and predictors of TB among people living with HIV. Thus, this study aimed to assess the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy (ART). Methods: A retrospective record review was conducted among 544 HIV-positive adults on ART at Debre Markos Referral Hospital from January 1, 2012 to December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from ART intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Model with the least value of Akaike’s information criteria was selected as the best model. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of TB. Results: Among 492 HIV-positive adults included in the final analysis, 16.9% developed TB at the time of follow-up. The incidence rate of TB was found to be 6.5 (95%CI: 5.2, 8.0) per 100-person-years of observation. Advanced WHO clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking IPT (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of TB. Conclusion: The study found that there was a high rate of TB occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking IPT were found to be the predictors of TB. Therefore, early detection and treatment of opportunistic infections like TB should get a special attention. Keywords: Debre Markos, HIV, Incidence, Predictors, TB

Download Full-text

ADHERENCE TO ANTIRETROVIRAL THERAPY AND ASSOCIATED FACTORS AMONG HIV POSITIVE ADULTS ATTENDING TREATMENT AT NEKEMTE REFERRAL HOSPITAL, WEST ETHIOPIA, 2019

10.21203/rs.2.12737/v2 ◽

2019 ◽

Author(s):

Muktar Abadiga

Keyword(s):

Antiretroviral Therapy ◽

Associated Factors ◽

Referral Hospital ◽

Hiv Positive ◽

Hiv Positive Adults

Abstract The authors have withdrawn this preprint from Research Square

Download Full-text