scholarly journals Prevalence of Cryptococcal Antigenemia and Associated Factors among HIV/AIDS Patients at Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Mohabaw Jemal ◽  
Teshiwal Deress ◽  
Teshome Belachew ◽  
Yesuf Adem

Background. Cryptococcosis is the most common opportunistic fungal infection. High morbidity and mortality are frequently observed among hospitalized HIV/AIDS patients, particularly having CD4 count ≤100 cells/μl. Therefore, this study aimed to determine the prevalence of cryptococcal antigenemia and associated factors among HIV/AIDS patients. Methods. A hospital-based cross-sectional study was conducted among 140 HIV/AIDS patients. A cryptococcal antigen test was performed for all patients along with medical chart and laboratory registration book review. Cryptococcal antigen was detected from serum by using Remel Cryptococcal Antigen Test Kit. Data related to possible associated factors were extracted from patients’ charts and laboratory registration book. Data were coded, entered, and analyzed using SPSS version 20. Logistic regression analysis was done to see the association between dependent and independent variables. A P value <0.05 was considered statistically significant. Finally, data were presented in the form of texts, figures, and tables. Result. Among 140 serum cryptococcal antigenemia-tested study subjects, 16 (11.43%) were positive for serum cryptococcal antigen. Of them, 43.8% (7/16) were pulmonary tuberculosis coinfected, 31.2% (5/16) were extrapulmonary tuberculosis positive, and 25% (4/16) had bacterial bloodstream infections. In addition, 68.7% (11/16) had CD4 count less than 100 cells/μl, 18.7% (3/16) had CD4 count 100–150 cells/μl, 50% (8/16) were antiretroviral therapy defaulters, and 31.3% (5/16) were naïve. In this study, the majority, 75% (12/16), of the serum cryptococcal antigen-positive subjects were clinical stage IV. Of the assessed associated factors, tuberculosis coinfection (AOR: 0.04; 95% CI [0.005–0.25]) and antiretroviral therapy status (AOR: 0.02; 95% CI [0.001–0.5]) were significantly associated factors enhancing serum cryptococcal antigenemia. Conclusion. In this study, the high rate of cryptococcal antigenemia was observed among hospitalized HIV/AIDS patients, and it is alarming and highlights the need for improving CD4 status, expanding serum cryptococcal antigen screening, and strengthening regular cryptococcal antigenemia surveillance systems.

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Tsegu Hailu Gebru ◽  
Haftea Hagos Mekonen ◽  
Kbrom Gemechu Kiros

Abstract Background Undernutrition and HIV/AIDS are highly prevalent in sub-Saharan Africa, Ethiopia inclusive as linked in a vicious cycle. Thus, several studies have documented that undernutrition among HIV/AIDS patients increases the risk of mortality, decrease survival rates, affect the overall clinical outcome and quality of life. Despite this fact, information about the burden of undernutrition and associated factors among adults receiving antiretroviral therapy is lacking in the particular study area. Hence, this study aimed to examine the prevalence of undernutrition and associated factors among adult HIV/AIADS patients receiving antiretroviral therapy patients in Eastern Zone of Tigray, Northern Ethiopia. Methods A cross-sectional research design was adopted in data collection while systematic sampling technique was employed to sample and select the study subjects. A structured questionnaire was used to collect information from 394 study subjects through face to face method. Also, data on demographics, laboratory and anthropometric variables were collected from each selected patients sampled. The data collected were entered and analyzed using SPSS version 22.. Bivariate and multivariable logistic regression analysis with 95% confidence interval were used to find factors associated with undernutrition. The adjusted odds ratio was calculated to show the strength of the association. Variables with p-value of < 0.05 were considered statically significant. Results The mean age of the respondents was 41 (± 10). Out of 394 study respondents, about 42.9% of them were undernourished (95% CI: 37.8–47.7). Respondents who had CD4+ count less than 200 cells/μl (AOR = 1.84; 95% CI: 1–3.36), being advanced clinical staging (AOR = 3.6; 95% CI: 2.11–6.18), and not taking co-trimoxazole preventive therapy (AOR = 2.38; 95% CI: 1.21–4.6) were independently associated with undernutrition. Conclusion The result of this study indicated that the prevalence of undernutrition was high. Respondents with advanced clinical stage of CD4+ count less than 200 cells/ul and those that were not taking co-trimoxazole preventive therapy was found to be positively associated with undernutrition. Therefore, the implementation of nutritional programs is very crucial to improve the nutritional status of HIV/AIDS patients in the particular study.


Author(s):  
Mirna Widiyanti ◽  
Moch Irfan Hadi ◽  
Mei Lina Fitri Kumalasari ◽  
Evi Iriani Natalia ◽  
Dedi Ananta Purba ◽  
...  

Background<br />The body mass index (BMI) may contribute somewhat to drug metabolism, thus affecting the efficacy of antiretroviral therapy (ART). CD4+ counts   in people infected with HIV are essential in determining the stage of the disease, initiation of antiretroviral therapy, opportunistic infections and evaluating treatment outcomes. The aim of this study was to determine the association of BMI and clinical stage with CD4+ counts in HIV patients seeking treatment using first-line antiretroviral therapy (ART).<br /><br />Methods<br />An analytic study with a cross-sectional approach was conducted involving 251 HIV/AIDS patients who had received first-line antiretrovirals over six months. BMI, clinical staging according to WHO and CD4 + were collected. Multiple linear regression was used to evaluate the relationship between BMI, clinical stage and CD4+.<br /><br />Results<br />Among the enrolled patients, the median age was 36 years, 135 (55%) of the patients was female, 102 (40.6%) was overweight/obese, 161 (64.1%) was in stage 3 of the disease, and the median CD4+ count was 389 cells/mm3. Multiple linear regression test showed two variables with a significant effect on CD4+ count, namely BMI (B=69.247; 95 % CI : 42.886-95.608) and clinical stage (B=61.590; 28.910-94.270). BMI was the most influencing factor for CD4+ count (β=0.307) compared to clinical stage (β=0.216). <br /><br />Conclusions<br />Body mass index was the most influencing factor for CD4 + counts of HIV/AIDS patients. Regular ART can increase CD4+ counts and maintain the health of HIV/AIDS patients.


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 ◽  
Author(s):  
Muktar Abadiga

Abstract BACK GROUND Antiretroviral therapy has a remarkable clinical effect in decreasing the viral replication, reducing the progress of AIDS and deaths related to AIDS. The clinical outcome of ART depends on the strict adherence to antiretroviral medication. However; only a few studies have been done on the adherence status of ART and its determinant factors in Ethiopia and this study could provide an opportunity to identify obstacles to taking medication. Therefore, the purpose of this study was to assess adherence status and associated factors among HIV infected patients on ART attending Nekemte referral hospital, West Ethiopia. METHODS Institutional based cross-sectional study was conducted on 311 HIV/AIDS patients, from March 01 to March 30, 2019. The study participants were selected by simple random sampling method and were interviewed using structured questionnaires. The data were coded, checked, cleaned and entered into Epi data version 3.1 and then exported to SPSS window version 20.0 for analysis. Multivariable logistic regression was used to find the independent variables which best predict adherence. Association and statistical significance were measured using odds ratio at 95% confidence interval and p-value less than 0.05. RESULTS A total of 305 HIV/AIDS patients were included in this study. Out of this,73.1% were adhered to their medication. Respondent’s knowledge about HIV and its treatment (AOR=8.13, 95% CI: 3.06, 21.61), family/social support (AOR=7.36, 95% CI: 2.07, 26.10), adverse effects of ARV medications (AOR=5.62, 95% CI: 2.11, 14.93), co-morbidity of other chronic illness (AOR=5.46, 95% CI: 1.86, 16.02), and family disclosure status (AOR= 5.27, 95% CI: 2.20, 12.62) were significantly associated with adherence to medication among HIV/AIDS patients. CONCLUSION In this study, the level of adherence to antiretroviral therapy was found low compared to the WHO standard. The clinician should emphasize adverse drug reaction, early detect and treat co-morbidities, improve knowledge through health education, and encourage HIV/AIDS patient to disclose their HIV status.


2017 ◽  
Vol 5 (2) ◽  
pp. 147
Author(s):  
Gusti Ayu Eka Utarini ◽  
Anak Agung Sagung Sawitri ◽  
Tuti Parwati Merati

Background and purpose: Antiretroviral therapy (ART) is associated with improved nutritional status among HIV/AIDS patients. This study aims to examine proportion, median time, incidence rate, and predictors of improved nutritional status among HIV/AIDS patients who received ART at Sanglah General Hospital Denpasar.Methods: A restrospective cohort study was conducted in Denpasar City. A total of 207 medical records of HIV/AIDS patients who received ART between 1st of January 2012 and 30th of June 2015 were included in the study. Kaplan Meier analysis was performed to calculate incidence rate and median time of improved nutritional status among HIV/AIDS patients. Sociodemographic characteristics and clinical variables included body mass index (BMI), body weight, haemoglobin level, CD4 count, HIV clinical stadium, ART regiments, and opportunistic infections (OIs). Data were analysed using cox proportional hazard model to identify predictors of improved nutritional status among HIV/AIDS patients.Results: As many as 65.22% of HIV/AIDS patients who received ART experienced an improvement in their nutritional status with the incidence rate of 9.1 per 100 person months and median time of 6.1 months. Multivariate analysis showed that predictors of improved nutritional status were BMI at ART initiation (AHR=1.34; 95%CI: 1.16-1.5), HIV clinical stadium (AHR=1.45; 95%CI: 1.02-2.06), CD4 count at ART initiation (AHR=0.89; 95%CI: 0.81-0.99) and the presence of diarrhoea (AHR=1.83; 95%CI: 1.06-3.14).Conclusions: Predictors of improved nutritional status among HIV/AIDS patients who received ART were BMI, HIV clinical stadium, CD4 count and diarrhoea.


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