scholarly journals Depressive symptoms and their determinants in patients who are on antiretroviral therapy in the case of a low-income country, Ethiopia: a systematic review and meta-analysis

Author(s):  
Mogesie Necho ◽  
Asmare Belete ◽  
Mekonnen Tsehay

Abstract Background The presence of depression in people living with HIV/AIDS could lead to non-adherence to antiretroviral medications. It also leads to further comorbid and opportunistic illness and then lowering the patient's quality of life. The objective of this study was therefore to determine the pooled prevalence of depression and its related factors in HIV patients. Methods Relevant articles in PubMed, Scopus, and EMBASE were investigated. The Meta-XL version 5.3 was used to extract data and STATA-11 Meta-prop packages with the Random effect model was used to quantify depression and its related factors. Sensitivity and subgroup analysis were performed to explore sources of heterogeneity. The Cochran’s Q-statistic and the Higgs I2 test were also done. Besides, the Eggers test and symmetry in the funnel plot were used to detect the presence/absence of publication bias. Result In this meta-analysis, we included 21 articles that assessed 10,090 participants. The average prevalence of depression among people with HIV/AIDS was 35.8% (95% CI 28.29, 43.25). The average estimated prevalence of depressive symptoms was 59.4% in the Oromia region and 29.25% in southern Ethiopia. Besides, the average prevalence of depression was 45.6% and 26.2% as measured with Beck’s depression inventory and Hospital anxiety and depression scale respectively. Moreover, the prevalence of depression was 47.7% in studies that used a sample size ≤ of 400 participants and 28.5% in studies that used a sample size of > 400 participants. The pooled adjusted odds ratio (AOR) of perceived HIV stigma was 3.75 (95% CI 2.34, 5.16) and that of poor social support was 6.22 (95% CI 2.96, 9.47). Moreover, the average odds ratio of poor medication adherence, opportunistic infection, and advanced stages of AIDS were 3.03 (95% CI 1.00, 5.05), 5.5 (95% CI 1.97, 10.03), and 5.43 (95% CI 1.60, 9.28) respectively. Conclusion The pooled prevalence of depression among individuals living with HIV/AIDS was high. Factors such as perceived HIV stigma, poor social support, opportunistic infection, advanced AIDS stage, and poor medication adherence were related to it. Routine screening and management of depression and its related factors should be given due consideration.

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Tadele Amare ◽  
Wondale Getinet ◽  
Shegaye Shumet ◽  
Biksegn Asrat

Background. Depression is a substantial contributor to the global burden of disease and affects people in all communities across the globe. Depression is the most common psychiatric problem associated with HIV/AIDS and half of all PLWHIV with depression go underdiagnosed and untreated. Psychiatric complications of HIVAIDS delay mental health services in less affluent countries. However, there is lack of study with regard to the pooled estimation prevalence of depression in PLWHIV in Ethiopia. Objectives. The aim of this systematic review and meta-analysis is to summarize the most current available evidence from 2010 to March 2017 among adult PLWHIV in Ethiopia. Methods. The team explored multiple databases searching methods including MEDLINE/PubMed, PsycINFO, Google Advance Scholar, and Google Scholar to find studies published with the data on the prevalence of depression among PLWHIV. We searched 150 research articles; of these 143 articles were excluded. Subsequently, thirteen articles were used for synthesis prevalence and four studies were included in the synthesis effect of sex on depression among PLWHIV. Results. The total of pooled estimated prevalence of depression in PLWHIV was 36.65. Estimated prevalence of depression in three studies by using CES-D was 31.19% and in six studies by using PHQ-9 was 37.91%. The remaining four studies used a single tool: Kessler-6 Scale (15.5%), HADS (41.2%), HDSQ (43.9%), and BDI (55.8%). Factors such as age, marital status, living alone, poor medication adherence, poor social support, clinical stages II and III of HIV, stigma, income, and occupation were significantly associated with depression. Conclusions and Recommendation. The pooled estimate prevalence of depression among PLWHIV was higher than that in the general population. It is better to offer special attention to these populations.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Adisu Birhanu Weldesenbet ◽  
Sewnet Adem Kebede ◽  
Biruk Shalmeno Tusa

Background. Low- and middle-income countries of which Ethiopia is one bears the high burden of depression among human immune deficiency virus and acquired immune deficiency syndrome (HIV/AIDS) patients. Several factors have been identified as being associated with increased depression among HIV/AIDS patients including poor social support. However, studies examining the effect of poor social support on depression among HIV/AIDS patients in Ethiopia have had inconsistent findings. This systematic review and meta-analysis is therefore aimed at estimating the pooled effect of poor social support on depression among HIV/AIDS patients in Ethiopia. Methods. All relevant articles published prior to July 1, 2020, were retrieved from scientific databases: PubMed, Scopus, and Google Scholar systematically. The identified studies reporting the association of depression and poor social support among HIV patients in Ethiopia were included. I 2 tests were used to assess the heterogeneity of the studies. Subgroup analysis was done based on tools to determine how pooled estimates of depression vary across tools. The pooled estimate of association between poor social support and depression was reported. Results. The aggregated meta-analysis revealed a higher odds of depression among patients with poor social support than those who had strong social support (OR: 2.31, 95% CI: 1.69, 2.93). The pooled prevalence of depression among HIV/AIDS patients in Ethiopia was 38.93% (95%: CI: 32.01, 45.84); ( I 2 = 94.44 %, p ≤ 0.001 ). The subgroup analysis was performed based on tools, and the result showed that the highest pooled prevalence (44.42%) was among primary studies that used the Hospital Anxiety and Depression Scale (HADS) tool. Conclusions. Human immune deficiency virus and acquired immune deficiency syndrome (HIV/AIDS) patients with poor social support were more likely to develop depression. The pooled prevalence of depression among HIV/AIDS patient was high in Ethiopia. The highest prevalence of depression was observed among studies that used HADS to screen depression. Therefore, we recommend integration of mental health and psychosocial support services into the HIV/AIDS care. Prevention of HIV/AIDS-related stigma for people with HIV/AIDS is also needed to reduce the impact of poor social support.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257630
Author(s):  
Habtye Bisetegn ◽  
Hussien Ebrahim

Introduction Thrombocytopenia and leucopenia are frequently encountered hematological disorders among people living with HIV/AIDS. This systematic review and meta-analysis were aimed to indicate the national prevalence of thrombocytopenia and leucopenia among HIV/AIDS patients. Methods This systematic review and meta-analysis was conducted following the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. A systematic search was conducted from February 01, 2021 to April 02, 2021 using electronic databases Google Scholar, PubMed, Web of Sciences, Google, EMBASE, SCOPUS and ResearchGate. The quality of the included studies was assessed using Newcastle—Ottawa Quality Assessment Scale (NOS) adapted for cross-sectional studies. Data analysis was done using STATA version 14 using metan commands. Random effect meta-analysis was used to estimate the pooled prevalence of thrombocytopenia and leucopenia among people living with HIV/AIDS in Ethiopia. Result Of the 349 initially searched articles, 90 were assessed for eligibility and only 13 articles published from 2014 to 2020 were included in the final meta-analysis. A total of 3854 participants were involved in the included studies. The pooled prevalence of thrombocytopenia was 9.69% (95%CI; 7.40–11.97%). Significant heterogeneity was observed with I2 value of 84.7%. Thrombocytopenia was 11.91% and 5.95% prevalent among HAART naive and HAART exposed HIV/AIDS patients, respectively. The pooled prevalence of leucopenia among HIV/AIDS patients was 17.31% (95%CI: 12.37–22.25%). Conclusion This study showed a high prevalence of thrombocytopenia and leucopenia among people living with HIV/AIDS, indicating the necessity of regular screening of HIV seropositive patients for different hematological parameters and providing treatment.


2020 ◽  
Author(s):  
Yuanyuan Qin ◽  
Xiaojie Huang ◽  
Hui Chen ◽  
Xinchao Liu ◽  
Yao Li ◽  
...  

Abstract Background: Talaromyces marneffei (TM) is a dimorphic fungus mainly prevalent in Southeast Asian countries, which often causes disseminated life-threatening infection. TM infection often occurs in HIV/AIDS patients even in the antiretroviral therapy (ART) era. However, there has as yet, not been a systematic analysis of the prevalence of TM infection in HIV-infected populations in AsiaMethods:In this study, we searched Pubmed, Embase, Web of Science, CNKI, and WanFang from inception to 21 November 2018 for studies reporting TM infection in people living with HIV/AIDS (PLWHA). Our meta-analysis included studies investigating the prevalence of TM infection in PLWHA. Reviews, duplicate studies, and animal studies were excluded. A random effects model was used to estimate pooled prevalence, and meta-regression analysis was conducted to explore potential factors for heterogeneity.Results: 159,064 patients with HIV infection in 33 eligible studies were included in our meta-analysis. The pooled prevalence of TM infection in PLWHA was 3.6%. Vietnam had the highest prevalence (6.4%), followed by Thailand (3.9%), China (3.3%), India (3.2%) and Malaysia (2.1%). In China, TM infection was most prevalent in South China (15.0%), while the burden in Southwest China was not very heavy (0.3%). CD4+ T-cell counts below 200cells/mm3 contributed to the increased risk of TM infection in PLWHA (OR 12.68, 95%CI: 9.58-16.77). However, access to ART did not significantly decrease the risk of TM infection in PLWHA.Conclusions: The burden of TM infection in Asia is heavy, and varies from region to region. PLWHA in lower latitude areas are more likely to suffer from TM infection. Optimization of diagnostic tools and universal screening for TM in vulnerable people to ensure early case detection and prompt antifungal treatment should be considered.


2019 ◽  
Author(s):  
Yuanyuan Qin ◽  
Xiaojie Huang ◽  
Hui Chen ◽  
Xinchao Liu ◽  
Yao Li ◽  
...  

Abstract Background: Talaromyces marneffei (TM) is a dimorphic fungus mainly prevalent in Southeast Asian countries, which often causes disseminated life-threatening infection. TM infection often occurs in HIV/AIDS patients even in the antiretroviral therapy (ART) era. However, there has not been a systematic analysis of the prevalence of TM infection in HIV-infected populations in Asia.Methods:In this study, we searched Pubmed, Embase, Web of Science, CNKI, and WanFang from inception to 21 November 2018 for studies reporting TM infection in people living with HIV/AIDS (PLWHA). Our meta-analysis included studies investigating the prevalence of TM infection in PLWHA. Reviews, duplicate studies, and animal studies were excluded. Random effects model was used to estimate the pooled prevalence and meta-regression analysis was conducted to explore potential factors for heterogeneity.Results: 159,064 patients with HIV infection in 33 eligible studies were included in our meta-analysis. The pooled prevalence of TM infection in PLWHA was 4.0%. Vietnam had the highest prevalence (6.4%), followed by Thailand (3.9%), China (3.3%), India (3.2%) and Malaysia (2.1%). In China, TM infection was most prevalent in South China (15.0%), while the burden in Southwest China was not very heavy (0.3%). TM infection in PLWHA in lower latitude area was significantly more prevalent than that in higher latitude area (OR 2.838, 95%CI: 2.376-3.390, P<0.001). CD4 counts below 200 cells/mm3 increased the risk of TM infection in PLWHA (OR 12.68, 95%CI: 9.58-16.77). However, accessing ART did not significantly decrease the risk of TM infection in PLWHA. Conclusions: The burden of TM infection is heavy in Asia and varies from region to region. PLWHA in lower latitude areas are more likely to suffer from TM infection. Optimization of diagnostic tools and universal screening of TM in vulnerable people for early case detection and for prompt antifungal treatment should be considered.


Author(s):  
Bereket Duko ◽  
Mohammed Ayalew ◽  
Getinet Ayano

Abstract Background Alcohol use disorder (AUD) is common among people living with HIV/AIDS (PLWHA) and associated with a greater risk of poor medication adherence, unsafe sexual behaviors as well as poor quality of life. To our knowledge, there is no previous systematic review and meta-analysis that reported the pooled prevalence estimate of AUD among PLWHA. Therefore, this review aimed to systematically review the available studies on the prevalence of AUD among PLWHA and forward possible recommendations for future clinical practice and research. Methods PubMed, EMBASE, Psych INFO and SCOPUS databases were searched to identify the relevant studies. We have also scanned the reference lists of the eligible studies to supplement our electronic search. We used the Comprehensive Meta-Analysis software versions 3.0 to conduct a meta-analysis. Subgroup and sensitivity analysis were performed and Cochran’s Q- and the I2- test were employed to see the heterogeneity. The presence of publication bias was explored by utilizing Egger’s test and visual inspection of the symmetry in funnel plots. Results A total of 25 studies with 25,154 participants across developed and developing countries were included in the final analysis. Our meta-analysis revealed that the pooled prevalence estimate of AUD among PLWHA was found to be 29.80% (95% CI; 24.10–35.76). The prevalence of AUD was higher in males (26.90%) than female (13.37%) HIV patients. In this study, the pooled prevalence of AUD was considerably higher (31.52%) when measured by Alcohol Use Disorders Identification Test (AUDIT) as compared to Composite International Diagnostic Interview (CIDI) (13.51%). In addition, the pooled prevalence of AUD was higher in the developed countries (42.09%) while lower for developing countries (24.52%). Conclusion In the current study, the pooled prevalence estimates of AUD among PLWHA was considerably high (29.80%). Screening and appropriate management of AUD among PLWHA are recommended.


2020 ◽  
Author(s):  
Tadesse Yirga Akalu ◽  
Yared Asmare Aynalem ◽  
Wondimeneh Shibabaw Shiferaw ◽  
Yoseph Merkeb Alamneh ◽  
Asmamaw Getnet ◽  
...  

Abstract Background: Intestinal parasites are a group of opportunistic gastrointestinal diseases commonly encountered among people living with human immunodeficiency virus (HIV). Intestinal parasites increased the risk of morbidity and mortality among these vulnerable populations. Therefore, to design appropriate prevention strategies, up-to-date information concerning prevalence of intestinal parasite is crucial. However, studies assessing the prevalence and associated factors of intestinal parasite in Ethiopia are inconsistent and widely varied. Therefore, this systematic review and meta-analysis is designed to assess the pooled prevalence and determine risk factors.Methods: International databases; PubMed, Web of Science,Cochrane Library, Scopus, PsycINFO, African Journals Online, and Google Scholar were systematically searched. A funnel plot and Egger’s regression test were used to determine publication bias. The I2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. Subgroup and meta-regression analyses were conducted. Sensitivity analysis was done to see the effect of a single study on the overall estimation. STATA version 14 statistical software was used for meta-analysis.Results: A total of 27 studies with 8,946 individuals were used to estimate the pooled prevalence of intestinal parasitosis among people living with HIV.The estimated pooled prevalence of intestinal parasitosis was 40.24% (95% CI: 33.8–46.6). Subgroup analysis of this study revealed that the highest prevalence was observed in Tigray region 45.7% (95% CI: 7.9­-83.5), followed by Oromia region 42.2% (95% CI: 28.8–55.6). Availability of latrine (OR: 26.6, 95%CI: 2.8-15.8), presence of animal (OR: 2.7, 95% CI: 1.2-5.8) and source of drinking water (OR: 3.2, 95% CI: 1.3-7.5) were significantly associated with intestinal parasitosis.Conclusion: The prevalence of intestinal parasite was high in Ethiopia. There should be a need to work for improving the hygienic standard on quality of drinking water and regular utilization of latrine among people living with HIV/AIDS.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244887
Author(s):  
Adam Wondmieneh ◽  
Getnet Gedefaw ◽  
Birhan Alemnew ◽  
Addisu Getie ◽  
Melaku Bimerew ◽  
...  

Background Intestinal parasitic infections are major public health problems throughout the world, particularly in people living with HIV/AIDS. People living with HIV/AIDS are vulnerable groups for a variety of diseases, hence they are easily affected by opportunistic and non-opportunistic intestinal parasites due to the weakening of their immunity. Therefore, this study aimed to estimate the pooled prevalence and factors associated with intestinal parasitic infections among people living with HIV/AIDS in Ethiopia. Methods Articles were identified through search engines in the online electronic databases PubMed/MEDLINE, EMBASE, HINARI, CINAHL, Cochrane Library, Google Scholar, and reference lists of previous studies following the PRISMA Protocol. Studies conducted between 2003 and 2020 with English language were included in this study. This review included papers with having high-quality NOS scores. Meta-analysis was computed using STATA version 11 software. Heterogeneity was assessed using the Cochrane Q-test and I2 test statistics. Subgroup and sensitivity analysis was employed with evidence of heterogeneity. Publication bias was determined using the funnel plot and Egger’s regression test statistic. Results This study included a total of twenty-two cross-sectional studies with 5,833 study participants. The mean age of the study participants was 35 years old. The pooled prevalence of intestinal parasitic infection among people living with HIV/AIDS in Ethiopia was 39.15% (95%CI: 32.34, 45.95). The pooled prevalence of intestinal parasitic infections among people living with HIV/AIDS who had taking ART and who had not to start ART was found to be 28.27% (95%CI 22.47, 34.06) and 41.63% (95%CI: 28.75, 54.52) respectively. Unavailability of latrine (AOR: 4.87, (95% CI: 2.39, 9.92)), CD4+ T cell count <200cells/μl ((AOR: 3.53, (95%CI: 1.98, 6.27)), and having a history of diarrhea (AOR: 4.79 (95%CI: 1.53, 14.99) were factors significantly associated with intestinal parasitic infections. Conclusion In this study, the overall pooled prevalence of intestinal parasitic infections among HIV/AIDS patients in Ethiopia was relatively high. CD4+ T-cell count <200cells/μl, unavailability of a latrine, and history of diarrhea were significantly associated with intestinal parasitic infections. Therefore, the policymakers and health care professionals could give special attention to the presence of latrines, early detection and treatment of intestinal parasitic infections, and early initiation of ART drugs.


2019 ◽  
Author(s):  
Yuanyuan Qin ◽  
Xiaojie Huang ◽  
Hui Chen ◽  
Xinchao Liu ◽  
Yao Li ◽  
...  

Abstract Background: Talaromyces marneffei (TM) is a dimorphic fungus mainly prevalent in Southeast Asian countries, which often causes disseminated life-threatening infection. TM infection often occurs in HIV/AIDS patients even in the antiretroviral therapy (ART) era. However, there has not been a systematic analysis of the prevalence of TM infection in HIV-infected populations in Asia. Methods:In this study, we searched Pubmed, Embase, Web of Science, CNKI, and WanFang from inception to 21 November 2018 for studies reporting TM infection in people living with HIV/AIDS (PLWHA). Our meta-analysis included studies investigating the prevalence of TM infection in PLWHA. Reviews, duplicate studies, and animal studies were excluded. Random effects model was used to estimate the pooled prevalence and meta-regression analysis was conducted to explore potential factors for heterogeneity. Results: 159,064 patients with HIV infection in 33 eligible studies were included in our meta-analysis. The pooled prevalence of TM infection in PLWHA was 4.0%. Vietnam had the highest prevalence (6.4%), followed by Thailand (3.9%), China (3.3%), India (3.2%) and Malaysia (2.1%). In China, TM infection was most prevalent in South China (15.0%), while the burden in Southwest China was not very heavy (0.3%). TM infection in PLWHA in lower latitude area was significantly more prevalent than that in higher latitude area (OR 2.838, 95%CI: 2.376-3.390, P<0.001). CD4 counts below 200 cells/mm3 increased the risk of TM infection in PLWHA (OR 12.68, 95%CI: 9.58-16.77). However, accessing ART did not significantly decrease the risk of TM infection in PLWHA.Conclusions: The burden of TM infection is heavy in Asia and varies from region to region. PLWHA in lower latitude areas are more likely to suffer from TM infection. Prophylaxis against TM should be given to HIV-infected people with low CD4 counts who is living in or has visited endemic areas.


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