COVID-19 Vaccination Uptake and Hesitancy Among Current Tobacco Users

Novel mRNA vaccines have been developed and were first distributed to high-risk individuals (including smokers) in the United States starting in December 2020 to combat the coronavirus (COVID-19) pandemic. Over one-half of the U.S. adult population has received at least 1 dose of a COVID-19 vaccine, but many others have reported hesitation about becoming vaccinated. We examined COVID-19 vaccine uptake and hesitancy from a convenience sample of Pennsylvanian adult smokers in April 2021, approximately 3 months after tobacco users were eligible to receive vaccination in the state. Participants (n = 231) were 23.4% male, 90.5% white, and had a mean age of 48.1 (SD = 11.9) years. All participants were current tobacco users, with the majority reporting current cigarette smoking (90.9%) with an average of 16 (SD = 8.1) cigarettes smoked per day. Nearly 60% (n = 137) reported receiving at least 1 dose of the vaccine and of those who did not (n = 94), 84% (n = 79) said they were somewhat or very unlikely to get a vaccine. Those who were unvaccinated were more likely to not consume news about COVID-19 (chi-square P-value < .01) and less likely to believe government news sources as reliable information for COVID-19 (chi-square P-value < .01). Qualitative responses among those who were vaccine hesitant expressed concerns about the lack of research on the vaccine, distrust of the safety of the vaccine, and fears about side effects. Understanding vaccine hesitancy among tobacco users can help develop targeted communication strategies and directly address concerns to promote vaccination among this population who may be at an increased risk of severe complications from COVID-19.

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Socioeconomic privilege and political ideology are associated with racial disparity in COVID-19 vaccination

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2107873118 ◽

2021 ◽

Vol 118 (33) ◽

pp. e2107873118

Author(s):

Ritu Agarwal ◽

Michelle Dugas ◽

Jui Ramaprasad ◽

Junjie Luo ◽

Gujie Li ◽

...

Keyword(s):

Racial Disparities ◽

Republican Party ◽

Political Ideology ◽

Adult Population ◽

The United States ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Median Income ◽

Structural Inequities ◽

The Impact

Vaccine uptake is critical for mitigating the impact of COVID-19 in the United States, but structural inequities pose a serious threat to progress. Racial disparities in vaccination persist despite the increased availability of vaccines. We ask what factors are associated with such disparities. We combine data from state, federal, and other sources to estimate the relationship between social determinants of health and racial disparities in COVID-19 vaccinations at the county level. Analyzing vaccination data from 19 April 2021, when nearly half of the US adult population was at least partially vaccinated, we find associations between racial disparities in COVID-19 vaccination and median income (negative), disparity in high school education (positive), and vote share for the Republican party in the 2020 presidential election (negative), while vaccine hesitancy is not related to disparities. We examine differences in associations for COVID-19 vaccine uptake as compared with influenza vaccine. Key differences include an amplified role for socioeconomic privilege factors and political ideology, reflective of the unique societal context in which the pandemic has unfolded.

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SARS-CoV-2 Vaccine Acceptability in Patients on Hemodialysis: A Nationwide Survey

Journal of the American Society of Nephrology ◽

10.1681/asn.2021010104 ◽

2021 ◽

pp. ASN.2021010104

Author(s):

Pablo Garcia ◽

Maria E. Montez-Rath ◽

Heather Moore ◽

Johnie Flotte ◽

Chris Fults ◽

...

Keyword(s):

United States ◽

Native American ◽

Side Effects ◽

The United States ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Vaccine Acceptability ◽

Increased Risk ◽

Hispanic White ◽

White Patients

BackgroundPatients on dialysis are at increased risk for COVID-19–related complications. However, a substantial fraction of patients on dialysis belong to groups more likely to be hesitant about vaccination.MethodsWith the goal of identifying strategies to increase COVID-19 vaccine uptake among patients on hemodialysis, we conducted a nationwide vaccine acceptability survey, partnering with a dialysis network to distribute an anonymized English and Spanish language online survey in 150 randomly selected facilities in the United States. We used logistic regression to evaluate characteristics of vaccine-hesitant persons.ResultsA total of 1515 (14% of eligible) patients responded; 20% of all responders, 29% of patients aged 18–44 years, and 29% of Black responders reported being hesitant to seek the COVID-19 vaccine, even if the vaccine was considered safe for the general population. Odds of vaccine hesitancy were higher among patients aged 18–44 years versus those 45–64 years (odds ratio [OR], 1.5; 95% confidence interval [95% CI], 1.0 to 2.3), Black patients versus non-Hispanic White patients (OR, 1.9; 95% CI, 1.3 to 2.7), Native Americans or Pacific Islanders versus non-Hispanic White patients (OR, 2.0; 95% CI, 1.1 to 3.7), and women versus men (OR, 1.6; 95% CI, 1.2 to 2.0). About half (53%) of patients who were vaccine hesitant expressed concerns about side effects. Responders’ main information sources about COVID-19 vaccines were television news and dialysis staff (68% and 38%, respectively).ConclusionsA substantial proportion of patients receiving in-center hemodialysis in the United States are hesitant about seeking COVID-19 vaccination. Facilitating uptake requires outreach to younger patients, women, and Black, Native American, or Pacific Islander patients, and addressing concerns about side effects.

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Factors Influencing SARS-CoV-2 Vaccine Acceptance and Hesitancy in a Population-Based Sample in Italy

Vaccines ◽

10.3390/vaccines9060633 ◽

2021 ◽

Vol 9 (6) ◽

pp. 633

Author(s):

Marco Del Riccio ◽

Sara Boccalini ◽

Lisa Rigon ◽

Massimiliano Alberto Biamonte ◽

Giuseppe Albora ◽

...

Keyword(s):

Online Survey ◽

Adult Population ◽

Herd Immunity ◽

Population Based ◽

Vaccine Hesitancy ◽

Convenience Sample ◽

Major Barrier ◽

Trust In Institutions ◽

General Adult Population ◽

High Level

Vaccination against SARS-CoV-2 represents an effective and safe tool to protect the population against the disease; however, COVID-19 vaccine hesitancy could be a major barrier to achieving herd immunity. Despite the severity of the current pandemic, the population’s intention to get vaccinated against COVID-19 is still not clear. The aim of this study was to evaluate the intention to get vaccinated against COVID-19 among a convenience sample of the general population resident in Italy and the factors associated with hesitancy and acceptance of the vaccine in the context of the current pandemic before the rolling out of COVID-19 vaccines. An anonymous online survey was diffused among a general adult population living in Italy. Participants aged 18 or older and living in Italy were considered eligible. Incomplete questionnaires were excluded. Overall, 7605 valid questionnaires were collected. Most of the participants (81.9%) were inclined to get vaccinated; male sex (OR 1.38, 95% CI 1.12–1.71), a high level of trust in institutions (OR 3.93, 95% CI 2.04–7.83), and personal beliefs about high safety of COVID-19 vaccines (OR 56.33, 95% CI 31.57–105.87) were found to be among the significant predictors of COVID-19 acceptance. These data could help design larger studies to address the problem of COVID-19 vaccine hesitancy in the current pandemic.

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Pendidikan Kesehatan dengan Pendekatan Model Information Motivation Behavior Skill (IMB) terhadap Peningkatan Pengetahuan dan Pola Konsumsi Sayur dan Buah pada Ibu Hamil

Jurnal Kesehatan ◽

10.26630/jk.v10i3.1433 ◽

2019 ◽

Vol 10 (3) ◽

pp. 320

Author(s):

Farhati Farhati ◽

Riska Resmana ◽

Dian Nurhadianti

Keyword(s):

Health Education ◽

Pregnant Women ◽

Consumption Patterns ◽

P Value ◽

Chi Square ◽

Increased Risk ◽

Post Test ◽

Quasi Experimental ◽

Chi Square Test ◽

Vegetables And Fruits

<p>Low consumption of vegetables and fruit causes an increased risk of chronic diseases such as cancer, heart disease, and diabetes. The results showed that the majority of pregnant women (52.9%) rarely consume vegetables and fruit in sufficient quantities as recommended. Therefore, it is necessary to provide education about the importance of vegetables and fruits consumption, one of which is through the Information Motivation Behavioral Skill (IMB) approach. This study aims to determine the effect of health education with the Information Motivation Behavior Skill (IMB) approach to increasing knowledge and consumption patterns of vegetables and fruits in pregnant women. This research is a quasi-experimental study with pre-post test design with control groups conducted in pregnant women in the city of Bandung with 60 samples using the observation sheet and questionnaire instruments. Data analysis used the chi-square test. The result of this study indicates that there are significant differences in knowledge and patterns of consumption of vegetables and fruit in pregnant women between the control and treatment groups with a p-value<0.05. Information Motivation Behavior Skill (IMB) Health Education Model approach has a role in increasing the knowledge and consumption patterns of vegetables and fruits in pregnant women.</p>

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A Community-Based Management of COVID-19 in a Mobile Container Unit

Vaccines ◽

10.3390/vaccines9111362 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1362

Author(s):

Elena Petrova ◽

Timothy Farinholt ◽

Tejas P. Joshi ◽

Hannah Moreno ◽

Mayar Al Mohajer ◽

...

Keyword(s):

Healthcare Workers ◽

Vaccine Coverage ◽

The United States ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Air Filtration ◽

Clinical Environment ◽

Mobile Clinic ◽

Community Based ◽

Community Healthcare

Vaccine uptake is a multifactor measure of successful immunization outcomes that includes access to healthcare and vaccine hesitancy for both healthcare workers and communities. The present coronavirus disease (COVID-19) pandemic has highlighted the need for novel strategies to expand vaccine coverage in underserved regions. Mobile clinics hold the promise of ameliorating such inequities, although there is a paucity of studies that validate environmental infection in such facilities. Here, we describe community-based management of COVID-19 through a Smart Pod mobile clinic deployed in an underserved community area in the United States (Aldine, Harris County, TX, USA). In particular, we validate infection control and biological decontamination of the Smart Pod by testing surfaces and the air-filtration system for the COVID-19 virus and bacterial pathogens. We show the Smart Pod to be efficacious in providing a safe clinical environment for vaccine delivery. Moreover, in the Smart Pod, up-to-date education of community healthcare workers was provided to reduce vaccine hesitancy and improve COVID-19 vaccine uptake. The proposed solution has the potential to augment existing hospital capacity and combat the COVID-19 pandemic locally and globally.

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A double-blind randomized placebo-controlled study of low dose mirtazapine once daily in patients of major depressive disorders on escitalopram

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191602 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1067

Author(s):

Mallikarjuna Rao I. ◽

Usha Kiran Prayaga ◽

Dharma Rao Uppada ◽

Ramachandra Rao E. ◽

B. L. Kudagi

Keyword(s):

Depressive Disorders ◽

Low Dose ◽

Rating Scale ◽

Controlled Study ◽

P Value ◽

Chi Square ◽

Double Blind ◽

Increased Risk ◽

Significant Difference ◽

Chi Square Test

Background: The SSRIs being used as 1st line therapy in treatment of depression have delayed therapeutic effect which makes the patient vulnerable to an increased risk of suicide and decreased adherence to the treatment and will prematurely discontinue the therapy. The present study was conducted to evaluate if low dose mirtazapine-escitalopram combination therapy has any add on benefit over monotherapy with escitalopram.Methods: In a single-centered, comparative study involving patients with depression attending the out-patient after screening and exclusion, 60 eligible patients were randomly assigned to receive tablet mirtazapine 7.5 mg plus tablet escitalopram 10 mg intervention or tablet escitalopram 10 mg plus placebo intervention in a double-blind 6-week treatment phase. The primary outcome measure was the change in the 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) score from baseline. Participants were evaluated at baseline, 1st, 2nd,4th and 6th week. Results were analyzed using Chi-Square test for adverse effects and independent t-test analysis for efficacy parameter.Results: In the analysis of results at 6th week the numbers of patients achieved remission in mirtazapine group are more with a p-value of 0.018 which is significant and the numbers of responders in mirtazapine group are also more which is statistically significant on chi-square test. There is no significant difference was observed between the two groups with reference to occurrence of adverse effect.Conclusions: Adding low dose mirtazapine has an added benefit in terms of efficacy and getting remission early with more number of responders in the treatment of major depression.

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Hubungan usia dan hipertensi terhadap kejadian BPH di RSUD. Dr. H. Abdul Moeloek tahun 2020

MAHESA : Malahayati Health Student Journal ◽

10.33024/mahesa.v1i3.3923 ◽

2021 ◽

Vol 1 (3) ◽

pp. 247-251

Author(s):

Elsa Rizki Lilian ◽

Andi Siswandi ◽

Anggunan Anggunan

Keyword(s):

Significant Relationship ◽

Bivariate Analysis ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Prostate Hyperplasia ◽

Increased Risk ◽

Surgical Ward ◽

The Relationship ◽

Lower Urinary

ABSTRACT: THE CORRELATIONS OF AGE AND HYPERTENSION WITH THE OCCURRENCE OF BPH IN THE SURGICAL WARD AT RSUD DR.H.ABDUL MOELOEK IN 2020Introduction: Lower Urinary Tractus Symptoms (LUTS) is a problem that is experienced by men around the world and one that often occurs is Benign prostate hyperplasia (BPH). BPH is a histological disorder characterized by the proliferation of prostate cells. It is estimated that 50% of men show BPH histopathology at the age of 60 years old and an increase of 90% at the age of 80 years old. Hypertension is also known to have a role in increasing prostate volume, in a cohort study it was found that hypertension resulted in an increased risk of 1.5 times to cause LUTS/BPH.Objective: To determine the relationship between age and hypertension on the incidence of BPH in Dr. H. Abdul Moeloek in 2020.Methods: This study is quantitative research, an observative analytic study design with a cross-sectional approach was carried out at RSUD Dr. H. Abdul Moeloek which was taken on October 16, 2020. The population was all patients in the Surgical Ward with total sampling. Data collection was obtained from secondary data from medical records. Data analysis was performed Univariate analysis (frequency distribution) and bivariate analysis with chi-square.Results: Respondents with BPH aged >50 years old were 32 respondents (97%) and respondents with BPH and hypertension were 20 respondents (60.6%). The results of the bivariate analysis using chi-square showed a significant relationship between BPH and age p value=0.000 (P<0.05) and the relationship between BPH and hypertension with p value=0.000 (p<0.05).Conclusion: There is a significant relationship between BPH with age and hypertension with the occurrence of BPH in the Surgical polyclinic at RSUD Dr.H.Abdul Moeloek in 2020. Keywords: BPH, Age, Hypertension INTISARI: HUBUNGAN USIA DAN HIPERTENSI TERHADAP KEJADIAN BPH DI RSUD Dr.H.ABDUL MOELOEK Pendahuluan: Lower Urinary Tractus Symptoms (LUTS) adalah masalah yang banyak dialami oleh laki-laki di seluruh dunia dan salah satu yang sering terjadi adalah Benigna Prostat Hyperplasia (BPH). BPH adalah kelainan histologis yang khas di tandai dengan proliferasi sel-sel prostat. Diperkirakan 50% laki-laki menunjukan histopatologi BPH pada umur 60 tahun dan meningkat 90% pada umur 80 tahun Hipertensi juga diketahui memiliki peranan dalam peningkatan volume prostat yakni pada suatu penelitian cohort diketahui adanya hipertensi mengakibatkan peningkatan resiko sebanyak 1,5 kali untuk menimbulkan gejala LUTS/BPH.Tujuan: Untuk mengetahui adanya hubungan usia dan hipertensi terhadap kejadian BPH di RSUD Dr. H. Abdul Moeloek Tahun 2020Metode: Jenis penelitian kuantitatif, rancangan penelitian analitik observatif dengan pendekatan cross sectional telah dilakukan di RSUD Dr.H.Abdul Moeloek Provinsi Lampung yang berlangsung pada 16 Oktober 2020. Populasi adalah seluruh pasien di Poli Bedah dengan pengambilan sampel secara total sampling. Pengumpulan data diperoleh dari data sekunder yang diperoleh dari rekam medis. Analisis data secara univariat (distribusi frekuensi) dan uji bivariat mengunakan chi squareHasil: Responden dengan BPH yang berusia >50 tahun sebanyak 32 responden (97%) dan responden dengan BPH dengan hipertensi sebanyak 20 responden (60,6%). Hasil Uji bivariat menggunakan chi square menunjukkan adanya hubungan signifikan antara BPH dengan usia diperoleh nilai p=0,000 (P<0,05) dan hubungan BPH dengan hipertensi nilai p=0,000 (p<0,05).Kesimpulan: Terdapat hubungan signifikan antara BPH dengan usia dan terdapat hubungan sgnifikan antara BPH dengan hipertensi di poli klinik bedah RSUD Dr.H.Abdul Moeloek tahun 2020.Kata kunci: BPH, Usia, Hipertensi

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Patient Preferences for Physician Attire in Ophthalmology Practices

Journal of Academic Ophthalmology ◽

10.1055/s-0039-1688913 ◽

2019 ◽

Vol 11 (01) ◽

pp. e36-e42 ◽

Cited By ~ 1

Author(s):

Lindsey B. De Lott ◽

Joseph F. Panarelli ◽

David Samimi ◽

Christopher Petrilli ◽

Ashley Snyder ◽

...

Keyword(s):

Patient Preferences ◽

Primary Outcome ◽

Female Physician ◽

The United States ◽

White Coat ◽

Emergency Rooms ◽

Chi Square ◽

Convenience Sample ◽

Composite Scores ◽

One Way Anova

Importance Interest is growing in targeting physician attire to improve the patient experience. Few studies in ophthalmology have examined patient preferences for physician attire. Objective To understand patient preferences for physician attire in ophthalmology practices in the United States. Design Survey-based, cohort study. Setting Two private and two academic ophthalmology practices. Participants A convenience sample of patients receiving ophthalmic care between June 1, 2015 and October 31, 2016. Methods A questionnaire containing 22 questions and photographs of a male and female physician in seven forms of attire were presented to patients; 14 unique questionnaires were randomly distributed. Patient preference for physician attire was the primary outcome determined by summing ratings of how knowledgeable, trustworthy, caring, approachable, and comfortable the pictured physician made the respondent feel. One-way ANOVA assessed differences in mean composite scores. Comparisons between respondent demographics, practice type, and attire preferences were assessed by chi-square tests. Patient satisfaction was assessed by agreement with questions about importance of physician attire and whether this influences happiness with care. Results In total, 1,297 of 1,826 (71.0%) questionnaires were completed. Physician attire was rated as “important” by 62.9% of participants. A total of 43.6% of participants indicated that physician attire influenced how happy they were with their care. Overall, formal attire with white coat was preferred to casual, formal, and business attire (all comparisons, p < 0.05). No differences in composite scores between formal attire with white coat, scrubs alone, scrubs with white coat, or casual attire with white coat were observed. However, compared with formal attire with white coat, physicians wearing scrubs without white coat appeared less knowledgeable (mean [standard deviation]: 8.2 [1.8] vs. 7.4 [2.1]; p < 0.05) and trustworthy (8.3 [1.8] vs. 7.6 [2.1]; p < 0.05). Additionally, casual attire with white coat was rated as less knowledgeable compared with formal attire with white coat (7.4 [2.0] vs. 8.2 [1.8]; p < 0.05). Preferences for attire varied by clinical setting: patients preferred surgeons (45.2%) and physicians in emergency rooms (41.7%) in scrubs rather than formal attire with white coat. Conclusions Physician attire is important to patients receiving ophthalmic care. Policies aimed at physician attire in ophthalmology practices should be considered.

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Pulse Knowledge, Attitudes, Practices, and Cooking Experience of Midwestern US University Students

Nutrients ◽

10.3390/nu12113499 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3499

Author(s):

Donna M. Winham ◽

Elizabeth D. Davitt ◽

Michelle M. Heer ◽

Mack C. Shelley

Keyword(s):

College Students ◽

Self Efficacy ◽

Online Survey ◽

Daily Intake ◽

The United States ◽

Chi Square ◽

Convenience Sample ◽

Attitudes And Practices ◽

Positive Attitudes ◽

Chi Square Analysis

Many American college students fail to meet dietary guideline recommendations for fruits, vegetables, and fiber. Pulses are a subgroup of legumes, harvested solely for dry grain seeds within a pod. Commonly consumed pulses include dry beans, dry peas, lentils, and chickpeas. Pulses are high in shortfall nutrients and could fill some nutritional gaps of college students. However, little is known about pulse intakes among young adults. The study aims were: (1) to identify knowledge, attitudes, and practices regarding pulse consumption; and (2) to describe experiences of preparing dry pulses among college students. A convenience sample of 1433 students aged 18–30 enrolled at a Midwestern university in the United States completed an online survey in April 2020. Demographic and attitude variables were compared by the monthly count of pulse types eaten using chi-square, analysis of variance, and logistic regression modeling to predict pulse type intakes. Higher numbers of pulse types eaten was associated with being White, vegetarian/vegan, higher cooking self-efficacy, positive attitudes toward pulses, and greater daily intake of fruits, vegetables, and fiber. Knowledge and experience of cooking dry pulses was low, with canned pulses purchased more often. College students may not be consuming pulses due to unfamiliarity with them, low knowledge of nutrition benefits, and a general lack of cooking self-efficacy. Increased familiarization and promotion surrounding pulses may increase their consumption.

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Prevalence of microalbuminuria and associated factors among HIV − infected ART naïve patients at Mulago hospital: a cross-sectional study in Uganda

BMC Nephrology ◽

10.1186/s12882-020-02091-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Thomas Kiggundu ◽

Robert Kalyesubula ◽

Irene Andia-Biraro ◽

Gyaviira Makanga ◽

Pauline Byakika-Kibwika

Keyword(s):

Antiretroviral Therapy ◽

Cross Sectional Study ◽

Cd4 Count ◽

P Value ◽

Mulago Hospital ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Increased Risk

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.

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