scholarly journals Time to Develop and Predictors for Incidence of Tuberculosis among Children Receiving Antiretroviral Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Fassikaw Kebede ◽  
Tsehay Kebede ◽  
Birhanu Kebede ◽  
Abebe Abate ◽  
Dube Jara ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cox Regression ◽  
Survival Curve ◽  
Final Analysis ◽  
Preventive Therapy ◽  
Public Hospitals ◽  
People Living With Hiv ◽  
Human Immune Deficiency Virus ◽  
North West ◽  
Living With Hiv

Infection by the human immune deficiency virus (HIV) is the strongest risk factor for latent or new infection of tuberculosis (TB) through reduction of CD4 T-lymphocytes and cellular immune function. Almost one-third of deaths among people living with HIV are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence of tuberculosis for children living with HIV. Thus, this study assessed time to develop and predictors for incidence of tuberculosis in children attending HIV/AIDS care in public hospitals: North West Ethiopia 2021. Methods. A facility-based retrospective cohort study was conducted among 421 seropositive children on antiretroviral therapy in two hospitals between January 1, 2011 and December 31, 2020. EPI-DATA version 3.2 and STATA/14 software were used for data entry and analysis, respectively. Tuberculosis-free survival time was estimated using the Kaplan-Meier survival curve. Bivariate and multivariable Cox regression model was fitted to identify predictors at a P value <0.05 within 95% CI. Results. In the final analysis, a total of 421 seropositive children were included, of whom, 64 (15.2%) developed tuberculosis at the time of follow-up. The mean (±SD) age of the children was 10.62 ± 3.32 years, with a median (IQR) time to develop TB that was 23.5 ( IQR = ± 19 ) months. This study found that the incidence of tuberculosis was 5.9 (95% CI: 4.7; 7.6) per 100 person-years (PY) risk of observation. Cases at baseline not taking cotrimoxazol preventive therapy (CPT) ( AHR = 2.5 ; 95% CI, 1.4-4.7, P < 0.021 ), being severely stunted ( AHR = 2.9 : 95% CI, 1.2-7.8, P < 0.03 ), and having low hemoglobin level ( AHR = 4.0 ; 95% CI, 2.1-8.1, P < 0.001 ) were found to be predictors of tuberculosis. Conclusion. A higher rate of tuberculosis incidence was reported in our study as compared with previous studies in Ethiopia. Cases at baseline not taking cotrimoxazol preventive therapy (CPT), being severely stunted, and having low hemoglobin (≤10 mg/dl) levels were found to be at higher risk to developed TB incidence.

scholarly journals Impact of Isoniazid Preventive Therapy on Tuberculosis incidence among people living with HIV: A secondary data analysis using Inverse Probability Weighting of individuals attending HIV care and treatment clinics in Tanzania

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254082
Author(s):  
Werner M. Maokola ◽  
Bernard J. Ngowi ◽  
Michael J. Mahande ◽  
Jim Todd ◽  
Masanja Robert ◽  
...  
Keyword(s):  
Observational Studies ◽  
Cox Regression ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Clinical Settings ◽  
Inverse Probability ◽  
Care And Treatment ◽  
Living With Hiv

Background Information on how well Isoniazid Preventive Therapy (IPT) works on reducing TB incidence among people living with HIV (PLHIV) in routine settings using robust statistical methods to establish causality in observational studies is scarce. Objectives To evaluate the effectiveness of IPT in routine clinical settings by comparing TB incidence between IPT and non-IPT groups. Methods We used data from PLHIV enrolled in 315 HIV care and treatment clinic from January 2012 to December 2016. We used Inverse Probability of Treatment Weighting to adjust for the probability of receiving IPT; balancing the baseline covariates between IPT and non-IPT groups. The effectiveness of IPT on TB incidence was estimated using Cox regression using the weighted sample. Results Of 171,743 PLHIV enrolled in the clinics over the five years, 10,326 (6.01%) were excluded leaving 161,417 available for the analysis. Of the 24,800 who received IPT, 1.00% developed TB disease whereas of the 136,617 who never received IPT 6,085 (4.98%) developed TB disease. In 278,545.90 person-years of follow up, a total 7,052 new TB cases were diagnosed. Using the weighted sample, the overall TB incidence was 11.57 (95% CI: 11.09–12.07) per 1,000 person-years. The TB incidence among PLHIV who received IPT was 10.49 (95% CI: 9.11–12.15) per 1,000 person-years and 12.00 (95% CI: 11.69–12.33) per 1,000 person-years in those who never received IPT. After adjusting for other covariates there was 52% lower risk of developing TB disease among those who received IPT compared to those who never received IPT: aHR = 0.48 (95% CI: 0.40–0.58, P<0.001). Conclusion IPT reduced TB incidence by 52% in PLHIV attending routine CTC in Tanzania. IPTW adjusted the groups for imbalances in the covariates associated with receiving IPT to achieve comparable groups of IPT and non-IPT. This study has added evidence on the effectiveness of IPT in routine clinical settings and on the use of IPTW to determine impact of interventions in observational studies.

scholarly journals Barriers in providing tuberculosis services for people living with HIV and their overcoming

2019 ◽  
Vol 100 (3) ◽  
pp. 482-487
Author(s):  
Z M Zagdyn
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Drug Users ◽  
Government Support ◽  
People Living With Hiv ◽  
Regional Government ◽  
Adequate Treatment ◽  
North West ◽  
The North ◽  
Living With Hiv

Aim. To study the opinions of specialists in tuberculosis institutions on barriers and ways to improve the system fighting the spread of human immunodeficiency virus (HIV) and tuberculosis. Methods. In the study questionnaires with open and closed questions were used among employees of tuberculosis facilities in four territories of the North-West Region of Russia (Saint-Petersburg, Leningrad, Arkhangelsk, and Kaliningrad oblasts) during six months in 2018. Total of 284 subjects were included. The questionnaire consisted of 19 structured questions. The respondents’ answers were compared interregionally and were analyzed integrally inside the blocks with the calculation of their ratios. Results. According to the specialists’ opinion working in tuberculosis facilities, the main barriers to providing tuberculosis services for people living with HIV are low level of intersectoral interaction, migration, increase in the number of injecting drug users, lack of regional government support, inconsistency of regulation documents with the requirements of currant reality. As the main conditions for improvement of epidemic situation with association of HIV/tuberculosis, the respondents consider increasing administration of antiretroviral therapy to the patients with HIV, adequate treatment of tuberculosis in HIV-infection and raising awareness of HIV-infection and tuberculosis by the population. Conclusion. To improve the existing system of fighting HIV/tuberculosis, strengthening the connection among the stakeholders may be possible, especially between tuberculosis facilities and detention centers giving the valuable access to antiretroviral therapy, chemoprophylaxis and tuberculosis treatment, including establishment of low-threshold centers, improved population awareness of tuberculosis and HIV-infection.

scholarly journals Does antiretroviral therapy packaging matter? Perceptions and preferences of antiretroviral therapy packaging for people living with HIV in Northern Tanzania.

2019 ◽  
Author(s):  
Charles Muiruri ◽  
Shelley A. Jazowski ◽  
Seleman K. Semvua ◽  
Francis P. Karia ◽  
Brandon A. Knettel ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Final Analysis ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
Visual Identification ◽  
Northern Tanzania ◽  
Referral Hospitals ◽  
The Cost ◽  
Living With Hiv

Abstract Background: Despite improvements in treatment (e.g., reduction in pill intake), antiretroviral therapy (ART) is dispensed in socially inefficient and uneconomical packaging. To make pills less conspicuous and decrease the risk of being stigmatized, people living with HIV (PLWH) often engage in self-repackaging – the practice of transferring ART from original packaging to alternative containers. This behavior has been associated with ART nonadherence and failure to achieve viral load suppression. While much of the literature on ART packaging has centered around medication adherence, patients stated preferences for ART packaging and packaging attributes that influence the observed ART nonadherence are understudied. Methods: We conducted a qualitative study to elucidate perceptions of ART packaging among PLWH at two large referral hospitals in Northern Tanzania. Interviews were conducted until thematic saturation was reached. Interviews were audio recorded, transcribed and coded. Results: Of the sixteen participants whose data were used in the final analysis, a majority were between 36 and 55 years of age (Mean 45.5 years SD: 11.14), had primary-level education (n=11, 68.75%), were self-employed (n=9, 56.25%), and were taking ART for more than 6 years (n=11, 68.75%). Participants identified three attributes of ART packaging that increased anticipated HIV stigma and prompted self-repackaging, including visual identification, bulkiness, and the rattling noise produced by ART pill bottles. Conclusions: Given the drastic reduction in the number of pills required for HIV treatment, there is opportunity to not only assess the cost-effectiveness of innovative ART packaging, but also evaluate the acceptability of such packaging among PLWH in order to address stigma and improve ART adherence.

scholarly journals Beneficial Effect of Isoniazid Preventive Therapy and Antiretroviral Therapy on the Incidence of Tuberculosis in People Living with HIV in Ethiopia

PLoS ONE ◽  
2014 ◽  
Vol 9 (8) ◽  
pp. e104557 ◽  
Author(s):  
Kesetebirhan Delele Yirdaw ◽  
Degu Jerene ◽  
Zewdu Gashu ◽  
M. E. Edginton ◽  
Ajay M. V. Kumar ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Beneficial Effect ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Behavioral and Psychosocial Factors of Quality of Life Among Adult People Living With HIV on Highly Active Antiretroviral Therapy, in Public Hospitals of South West Ethiopia, 2018: a Case Control Study

2020 ◽  
Author(s):  
Abreha Addis Gesese ◽  
Yitages Getachew Desta ◽  
Endale zenebe Behire
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Poor Quality ◽  
Public Hospitals ◽  
People Living With Hiv ◽  
Khat Chewing ◽  
Highly Active ◽  
Living With Hiv

Abstract Background: Despite of the availability of Highly Active Antiretroviral Therapy, people living with HIV/AIDS suffer from socioeconomic, behavioral and psychosocial related factors affecting their quality of life. Previous studies assessed the magnitude of quality of life but the present one will identify behavioral and psychosocial factors associated with poor quality of live among adult PLWHIV on Antiretroviral therapy in the study setting.Objective: To identify behavioral and psychosocial determinants of Quality of life among Adult PLWHIV on HARRT, in Public Hospitals of Jimma Zone, South West, Ethiopia 2018.Method: Institution based unmatched case control study was employed. Simple random sampling technique was used to select cases and controls using screening criteria. Interviewer administered data collection method was used. Data were entered into Epi-Data and analyzed using SPSS version 20. Bivariate and multivariate logistic regressions were performed. The study was conducted from March 10-April 10- 2018.Results: A total of 75(25%) cases and 225(75%) of controls included in the study. Finally, the odds of poor quality of life among underweight (BMI kg/m2) 2.7 times [AOR 2.7 95%CI (1.0, 7.1)] more likely than normal /obese respondents, khat chewing 1-4 times/weak/month about 4.5 times [AOR 4.5 95%CI (1.85, 10.9)] and at daily intervals 4.7 times more [AOR 4.7 95% CI (1.18, 18.8)] likely than who never chew respectively. Being dissatisfied from support AOR 9.8 95% CI (1.9, 50), Stigmatized patients 8 times more likely than non-stigmatized AOR 8.0 95%CI (3.6, 18.1). Moreover, the odds of poor quality of life among severely depressed patients were 4 times AOR 4.0 95% CI (1.67, 9.83) more likely than mild depressed patients.Conclusion: Being underweight (BMI kg/m2), khat chewing 1-4 times/weak/month, khat chewing at daily interval, being dissatisfied from support, stigma and depression were independently associated. This may inform possible interventions to reduce comorbidities and disease exacerbation by improving on dietary and nutritional programs and support, reducing behavioral factors, improving social support, reducing stigma and depression by appropriate counseling and strengthening currently existing Information Education Communication to help develop life skills.

Provision of Isoniazid Preventive Therapy: The Experiences of People Living with HIV

2020 ◽  
Vol 21 (2) ◽  
Author(s):  
Keamogetse Selehelo ◽  
Lufuno Makhado ◽  
Karabo Angel Madiba
Keyword(s):  
South Africa ◽  
Health Centre ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
World Health ◽  
Hiv Care ◽  
People Living With Hiv ◽  
North West ◽  
Retention In Hiv Care ◽  
Living With Hiv

Isoniazid preventive therapy (IPT) is a strategy that has been proposed by the National Department of Health of South Africa and the World Health Organization for people living with HIV (PLWH) to prevent latent tuberculosis (TB) progressing to active TB. This research focused on exploring and describing experiences of PLWH regarding IPT provision in the Ngaka Modiri Molema district in the North West province of South Africa. A qualitative, exploratory, contextual and descriptive research design was used for this study. Semi-structured individual interviews were conducted to collect data from PLWH. The sample size consisted of 14 participants and data saturation was reached at participant 11. A thematic data analysis was employed in this study. The study consisted of 10 female participants and 4 male participants. Three main themes emerged during interviews, namely factors that facilitate IPT provision and uptake, factors that inhibit the adherence of patients to IPT, and strategies to improve provision or adherence. The provision of IPT at a community health centre in Ngaka Modiri Molema district municipality was reported to be satisfactorily although challenges were also marked. IPT must be available at all times to ensure the promotion of PLWH adherence, continuity of care and retention in HIV care. In addition, screening of PLWH for active TB disease before they can be initiated should be a priority. PLWH should be supported and followed up through the directly observed treatment, short-course strategy to promote adherence and this can also be facilitated through adherence social clubs.

scholarly journals Behavioral and Psychosocial Factors of Quality of Life Among Adult People Living With HIV on Highly Active Antiretroviral Therapy, in Public Hospitals of South West Ethiopia, 2018: a Case Control Study

2020 ◽  
Author(s):  
Abreha Addis Gesese ◽  
Yitages Getachew Desta ◽  
Endale zenebe Behire
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Poor Quality ◽  
Public Hospitals ◽  
People Living With Hiv ◽  
Khat Chewing ◽  
Highly Active ◽  
Living With Hiv

Abstract Background: Despite of the availability of Highly Active Antiretroviral Therapy, people living with HIV/AIDS suffer from socioeconomic, behavioral and psychosocial related factors affecting their quality of life. Previous studies assessed the magnitude of quality of life but the present one will identify behavioral and psychosocial factors associated with poor quality of live among adult PLWHIV on Antiretroviral therapy in the study setting.Objective: To identify behavioral and psychosocial determinants of Quality of life among Adult PLWHIV on HARRT, in Public Hospitals of Jimma Zone, South West, Ethiopia 2018.Method: Institution based unmatched case control study was employed. Simple random sampling technique was used to select cases and controls using screening criteria. Interviewer administered data collection method was used. Data were entered into Epi-Data and analyzed using SPSS version 20. Bivariate and multivariate logistic regressions were performed. The study was conducted from March 10-April 10- 2018.Results: A total of 75(25%) cases and 225(75%) of controls included in the study. Finally, the odds of poor quality of life among underweight (BMI kg/m2) 2.7 times [AOR 2.7 95%CI (1.0, 7.1)] more likely than normal /obese respondents, khat chewing 1-4 times/weak/month about 4.5 times [AOR 4.5 95%CI (1.85, 10.9)] and at daily intervals 4.7 times more [AOR 4.7 95% CI (1.18, 18.8)] likely than who never chew respectively. Being dissatisfied from support AOR 9.8 95% CI (1.9, 50), Stigmatized patients 8 times more likely than non-stigmatized AOR 8.0 95%CI (3.6, 18.1). Moreover, the odds of poor quality of life among severely depressed patients were 4 times AOR 4.0 95% CI (1.67, 9.83) more likely than mild depressed patients.Conclusion: Being underweight (BMI kg/m2), khat chewing 1-4 times/weak/month, khat chewing at daily interval, being dissatisfied from support, stigma and depression were independently associated. This may inform possible interventions to reduce comorbidities and disease exacerbation by improving on dietary and nutritional programs and support, reducing behavioral factors, improving social support, reducing stigma and depression by appropriate counseling and strengthening currently existing Information Education Communication to help develop life skills.

Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
History Of ◽  
Family History Of Hypertension ◽  
Living With Hiv

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

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