scholarly journals Decrease in late presentation for HIV care in Kinshasa, DRC, 2006–2020

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Nadine Mayasi Ngongo ◽  
Hippolyte Situakibanza Nani-Tuma ◽  
Marcel Mbula Mambimbi ◽  
Murielle Longokolo Mashi ◽  
Ben Bepouka Izizag ◽  
...  
Keyword(s):  
Cell Count ◽  
Clinical Stage ◽  
Late Presentation ◽  
Hiv Care ◽  
Older Individuals ◽  
Cd4 Cell Count ◽  
Information Strategies ◽  
Hiv Positive Adults ◽  
Advanced Hiv Disease ◽  
Cd4 Cell

Abstract Introduction Late presentation for HIV care is a well-described issue for the success of ART outcomes and the cause of higher morbidity, mortality and further transmission. Monitoring the level of late presentation and understanding the factors associated with it would help to tailor screening and information strategies for better efficiency. We performed a retrospective cohort study in Kinshasa, the capital of the DRC. The studied population included HIV-positive adults newly enrolled in HIV care between January 2006 and June 2020 at 25 HIV urban care facilities. Patient information collected at presentation for HIV care included age, sex, WHO clinical stage and screening context. We used 2 definitions of late presentation: the WHO definition of advanced HIV disease (WHO stage 3/4 or CD4 cell count < 200 cells/mm3) and a more inclusive definition (WHO stage 3/4 or CD4 cell count < 350 cells/mm3). Results A total of 10,137 HIV-infected individuals were included in the analysis. The median age was 40 years; 68% were female. A total of 45.9% or 47.5% of the patients were late presenters, depending on the definition used. The percentage of patients with late presentation (defined as WHO stage 3/4 or CD4 cell count < 350 cells/mm3) decreased during recent years, from 70.7% in 2013 to 46.5% in 2017 and 23.4% in 2020. Age was associated with a significantly higher risk of LP (p < 0.0001). We did not observe any impact of sex. Conclusions The frequency of late presentation for care is decreasing in Kinshasa, DRC. Efforts have to be continued. In particular, the issue of late diagnosis in older individuals should be addressed.

A Systematic Review and Meta-regression of Temporal Trends in Adult CD4+ Cell Count at Presentation to HIV Care, 1992-2011

2013 ◽  
Vol 57 (7) ◽  
pp. 1027-1037 ◽  
Author(s):  
C. R. Lesko ◽  
S. R. Cole ◽  
A. Zinski ◽  
C. Poole ◽  
M. J. Mugavero
Keyword(s):  
Systematic Review ◽  
Cell Count ◽  
Temporal Trends ◽  
Hiv Care ◽  
Cd4 Cell Count ◽  
Meta Regression ◽  
Cd4 Cell

scholarly journals Using record linkage to assess the impact of late presentation for care and treatment on short-term mortality among HIV-infected adults in rural South Africa.

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Chodziwadziwa Whiteson Kabudula ◽  
Georges Reniers ◽  
Francesc Xavier Gómez-Olivé ◽  
Kathleen Kahn ◽  
Stephen Tollman
Keyword(s):  
South Africa ◽  
Cell Count ◽  
Late Presentation ◽  
Short Term ◽  
Cd4 Cell Count ◽  
Short Term Mortality ◽  
Care And Treatment ◽  
Cd4 Cell ◽  
The Impact ◽  
Rural South Africa

ABSTRACT ObjectivesTo assess the impact of late presentation (CD4 cell count <200 cells/μl at presentation) for care and treatment on short-term mortality (death within a year of presentation) among HIV-infected adults in rural South Africa. ApproachWe applied deterministic and probabilistic record linkage approaches to link adult patients seeking care and treatment for HIV from a health facility between 2007 and 2013 to population under continuous surveillance by the Agincourt Health and Demographic Surveillance System (HDSS) in rural northeast South Africa. The resulting record-linked dataset was thereafter analysed to estimate short-term mortality (death within a year of presentation) differences in late presenters (initial presentation at health facility with CD4 cell count less than 200 cells/μl) and early presenters (presentation with CD4 cell count of 200 or more cells/μl). In the linked dataset, CD4 cell count was extracted from the health facility database where as date of death came from the HDSS database. ResultsA total of 3,553 patients who sought care and treatment for HIV at Bhubhezi clinic between 2007 and 2013 were linked to the Agincourt HDSS surveillance population. Proportion of patients classified as late presenters was 60.9%. Short-term mortality was 8.9% (317/3,553): 11.1% among those who presented late and 5.5 % among those who presented early (P<0.001). ConclusionRecord linkage facilitated the assessment of the impact of late presentation for care and treatment on short-term mortality among HIV-infected adults in rural South Africa. In the population studied, late presentation is high and is contributing to high mortality among people living with HIV. Strategies that would facilitate early presentation are needed in order to reduce mortality among people living with HIV.

scholarly journals The Continuing Value of CD4 Cell Count Monitoring for Differential HIV Care and Surveillance

10.2196/11136 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e11136 ◽  
Author(s):  
Brian Rice ◽  
Andrew Boulle ◽  
Sandra Schwarcz ◽  
Amir Shroufi ◽  
George Rutherford ◽  
...  
Keyword(s):  
Cell Count ◽  
Hiv Care ◽  
Cd4 Cell Count ◽  
Cd4 Cell

scholarly journals Anxiety and Depression Among Women Living with HIV: Prevalence and Correlations

2020 ◽  
Vol 16 (1) ◽  
pp. 59-66
Author(s):  
Abdilahi Yousuf ◽  
Ramli Musa ◽  
Muhammad Lokman Md. Isa ◽  
Siti Roshaidai Mohd Arifin
Keyword(s):  
Cell Count ◽  
Clinical Stage ◽  
Public Hospitals ◽  
Anxiety And Depression ◽  
Hiv Positive ◽  
Cd4 Cell Count ◽  
Women Living With Hiv ◽  
Hiv Positive Women ◽  
Living With Hiv ◽  
Cd4 Cell

Introduction: It has been found that HIV positive women are becoming increasingly affected by various illnesses, including Common Mental Disorders (CMDs) such as depression. Such comorbidity escalates the disease progression to the severe stage and commonly hinders treatment adherence. This study determined the prevalence of anxiety and depression amidst women living with HIV. Methods: Based on a cross-sectional and facility-based study, 357 HIV positive women were recruited using the systematic sampling technique from two public hospitals in Jijiga town, Ethiopia. The Hospital Anxiety and Depression Scale (HADS) was administered for screening, and followed by a pre-tested questionnaire that comprised of Perceived Social Support and HIV stigma. Results: The results revealed that the prevalence of both anxiety and depression amidst HIV positive women was 28.9% and 32.5%, respectively. In the multivariate analysis, it was discovered that lack of formal education, being divorced, unemployed, and earning a monthly income less than 1400 ETB (37.5 USD) were significantly associated with depression. Women with symptomatic HIV clinical stage III (AOR =2.06, 95% C.I (0.75-5.61), with CD4 cell count below 250 (AOR = 1.14, 95% C.I (0.57-2.28), and with co-infections (AOR= 1.04, 95% C.I (0.40-2.71) also suffered from depression. Conclusion: The study outcomes show that the prevalence of depression in women with HIV was 32.5%, but they were more likely to be depressed if they were illiterate, divorced, unemployed or had a financial burden. In addition, HIV positive women with less CD4 cell count and in the final clinical stage or suffered from a co-infection were also associated with depressive symptoms. This signifies the public health implications of psychological and cognitive morbidities of the illness among these women with chronic illnesses. Hence, future mental health interventions and HIV care should be integrated with substantial emphasis given to vulnerable groups, including HIV positive women.

scholarly journals Assessment of Casual Relations, Direct and Indirect Effects of Latent Covariates On CD4 Cell Count Change Among HIV Positive Adults

2021 ◽  
Author(s):  
Awoke Seyoum Tegegne
Keyword(s):  
Cell Count ◽  
Indirect Effect ◽  
Latent Variables ◽  
Hiv Positive ◽  
Health Staff ◽  
Cd4 Cell Count ◽  
Hiv Positive Adults ◽  
Cd4 Cell ◽  
Count Change ◽  
Cd4 Cell Count Change

Abstract Background: The use of structural equation modelling and latent variables remains unusual in epidemiology despite its potential usefulness and assessment of casual relations. Measuring direct and indirect effect of latent variables helps for proper intervention and for the ART program to be effective. The main objective of current investigation was to assess casual relations, direct and indirect effect of latent covariates on CD4 cell count change for HIV positive adults under HAART. Methods: Based on the repeated measures of CD4 cell count change data obtained in ART section at Felege Hiwot Teaching and Specialized hospital, AMOS software was employed parameter estimation. The data was conducted on 792 randomly selected HIV positive adults. The data was collected by the health staff for sake of delivering medication adherence. Results: CD4 cell count change was directly and indirectly affected by the latent variables. The powers of effects of observed variables with and without latent variables were a little bit different from each other. Hence, the power effect of observed variables with latent variables was lower as compared to without latent variables. The direct effect of latent variables on the response variable was a little bit greater than indirect effect. Conclusion: The power of effects of observed variables were stronger than their effects with latent variables. Hence, the latent variables had significant contributions for progress of CD4 cell count change. Health related education about the direct and indirect effect of latent variables should be given for patients under HAART.

scholarly journals Immediate Blood Draw for CD4+ Cell Count Is Associated with Linkage to Care in Durban, South Africa: Findings from Pathways to Engagement in HIV Care

PLoS ONE ◽  
2016 ◽  
Vol 11 (10) ◽  
pp. e0162085 ◽  
Author(s):  
Susie Hoffman ◽  
Theresa M. Exner ◽  
Naomi Lince-Deroche ◽  
Cheng-Shiun Leu ◽  
Jessica L. Phillip ◽  
...  
Keyword(s):  
South Africa ◽  
Cell Count ◽  
Linkage To Care ◽  
Hiv Care ◽  
Blood Draw ◽  
Cd4 Cell Count ◽  
Engagement In Hiv Care ◽  
Cd4 Cell

Late HIV presentation – missed opportunities and factors associated with a changing pattern over time

2016 ◽  
Vol 28 (8) ◽  
pp. 814-821 ◽  
Author(s):  
Sarah O’Connell ◽  
Julia Enkelmann ◽  
Corinna Sadlier ◽  
Colm Bergin
Keyword(s):  
Hiv Testing ◽  
Cell Count ◽  
Demographic Data ◽  
Hiv Care ◽  
Late Presenters ◽  
Cd4 Cell Count ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell ◽  
Over Time

Delayed diagnosis of HIV infection has negative clinical, economic and public health implications. The study primary aim was to identify factors associated with late HIV presentation (Late Presenters [LPS], CD4 cell count < 350 cells/mm3). A secondary aim was to identify changing trends of late HIV presentation from 2002 to 2014 at our centre. A retrospective cohort study was performed. Demographic data and CD4 cell count of new HIV diagnoses presenting to our ambulatory HIV service over four time-periods from 2002 to 2014 were recorded. Proportion of LPS and factors associated with late presentation were compared using Graphpad Instat. In 2014, of 231 new patients attending for HIV care, 75 (32.6%) were late presenters versus 146 (66.4%) in 2002. This indicates a decreasing proportion of LPS from 2002 to 2014. However, the proportion of those with CD4 cell counts <200 on presentation at these two time intervals remain unchanged. The overall proportion of male LPS has increased over time and the proportion of LPS in the men who have sex with men (MSM) cohort has decreased over time, reflecting increased frequency of both HIV testing and diagnoses in MSM in recent years. The proportion of heterosexual LPS has not changed significantly in the same time period and LPS were older in 2014 versus 2002. The proportion of LPS defined by CD4 cell count remains higher than is justifiable in an era of increased HIV testing and awareness. Further targets for HIV testing to decrease rates of LPS include non-traditional risk groups including heterosexual and older patient cohorts. LPS rates are lower than rates found internationally, and it is possible that consensus definition of LPS needs to be revised.

scholarly journals Survival Analysis of Time to Death of HIV-Infected Patients under Antiretroviral Therapy in Tepi General Hospital, South West Ethiopia

2021 ◽  
Vol 20 (4) ◽  
Author(s):  
Alemu Bekele Eticha ◽  
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
General Hospital ◽  
Biological Activities ◽  
Clinical Stage ◽  
Cd4 Cell Count ◽  
Time To Death ◽  
Number Of Patients ◽  
Cd4 Cell ◽  
Over 40 Years

Abstract Despite advancements in HIV/AIDS prevention and treatment, HIV continues to be a global problem. Antiretroviral therapy is a critical treatment that has been used to treat HIV-infected patients since 1996. Even though an increase in the number of patients enrolled in ART, the mortality rate for HIV cases in Ethiopia has never been overcome. Thus, this study aimed to identify influential factors of death of HIV-infected individuals received antiretroviral therapy at the Tepi General Hospital. The secondary data was extracted from each selected patient for whom the ART was initiated from September 2011 to June 2018. Then, Cox regression technique provided the essential determinants of time to death of HIV-infected patients. The findings revealed that 35.14 percent of HIV patients died despite being on ART. The identified causes of death were being over 40 years old, being in clinical stage IV, being uneducated, having a low body weight, and having a low CD4 cell count. Gender, tuberculosis status, and functional status, on the other hand, were not supported as factors. Thus, age over 40 years, being underweight, having a low baseline CD4 cell count, being in an advanced WHO clinical stage, and having a low education level were identified as critical risk factors that exposed to early death even while on ART. As a result, the hospital advised prioritizing patients based on the identified factors. Keywords: AIDS; Analysis; Biological modeling; Biological activities

scholarly journals Socio-Demographic and Clinical Predictor Variables on CD4 Cell Count Change among HIV Positive adults; a Structural Equations Modelling

2020 ◽  
Author(s):  
Awoke Seyoum ◽  
Principal Ndlovu Ndlovu ◽  
Temesgen Zewotire Zewotire
Keyword(s):  
Cell Count ◽  
Structural Equation ◽  
Structural Equations ◽  
Equation Modeling ◽  
Hiv Positive ◽  
Cd4 Cell Count ◽  
Hiv Positive Adults ◽  
Cd4 Cell ◽  
Count Change ◽  
Cd4 Cell Count Change

Abstract Background: The prevalence of HIV/AIDS among adult individuals has been increasing in Sub-Sahara African countries over the last decade. In Ethiopia , the prevalence of HIV among adults was 1%. Hence, 23, 000 people were newly infected with HIV and 11,000 people were died because of AIDS related illness in 2018. The purpose of this study was to identify the most significant socio-demographic, economic, individual and clinical determinants of CD4 cell count change in HIV positive adults who initiated HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia. Methods: A secondary and retrospective study design was conducted on 792 HIV positive adults. A structural equation modeling was employed to identify the socio-demographic and clinical covariates that have a statistically significant effect on the status of CD4 cell count change. Results: Literate patients, patients living with partner, patients living in urban area, patients disclosed the disease to family members, high income , ownership of cell, age and sex (male) were statistically significant variables. Conclusion: There was direct relation between socio-demographic variables with retention of HIV positive individuals in HAART program. There was also a direct and significant effect of clinical variables on adherence competence and adherence on CD4 cell change. Retention of patients in the HAART program had direct and significant effect on CD4 cell count change. This finding will be important for policy makers, health officials and for patients to easier access to healthcare service. Keywords: Socio-demographic, clinical factors, individual characteristics, Structural equation, CD4count change

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