Study the Prevalence of Depression in Patients Attending Comprehensive Care Centre, Islamabad, Pakistan

2021 ◽  
Vol 4 (9) ◽  
pp. 1-6
Author(s):  
Mehak Nimra ◽  
Sobia Yousaf ◽  
Huma Naz ◽  
Hira Nain ◽  
Tahreem Shahid ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Clinical Care ◽  
Comprehensive Care ◽  
P Value ◽  
People Living With Hiv ◽  
Care Centre ◽  
Neuropsychiatric Complications ◽  
Significant Difference ◽  
Prevalence Of Depression ◽  
Age Category

Abstract: Depression is one of the most common neuropsychiatric complications of HIV disease, and this leads to worse HIV-related health outcomes. With 350 million people affected worldwide, rates of depression are roughly two times greater in people living with HIV than in the general population. Objective: Determine prevalence of depression in patients attending Comprehensive Care Centre Shifa international Hospital, Islamabad Design: Descriptive cross-sectional quantitative study.  Settings: Shifa international Hospital, Islamabad Comprehensive Care Centre, Methods: This data is from a bigger study ‘prevalence of alcohol use disorders and depression in patients attending Comprehensive Care Centre (CCC). The study population consisted of PLWHA attending the CCC. Two hundred and seventy-two (N=272) participants from CCC attendants were recruited. All consenting male and female aged 18-65 years were interviewed using the researcher’s designed questioner to collect their socio-demographic characteristics. Fully completed questionnaires were entered into excel sheets and analyzed using the Statistical Package for Social Sciences (SPSS) Version 20.  Results: The overall prevalence of depression was 23.8%, with mild depression at 9.7%, moderate depression at 10.4% and severe depression accounting for 3.7%, respectively. Depression was associated with alcohol use (p=0.024). A significant difference between depression and age where depression levels worsens as age advances; respondents in age category of 18-21 years had less or no depression compared to those in the age category of 33 years and above. We found an association between depression and employment. Those laid-off work (1/3), and the retired (15%) had more depression compared to the employed (11%) or self-employed 6%, with a P value of 0.55 (borderline). On multivariate analysis severity of depression (OR=5.5, 95% CI of OR [2.1 –14.3], p<0.0001) was associated with male gender (OR=10, 95% CI of OR [3.6 –28.3], p<0.0001). Conclusion: The study findings indicate a high prevalence of depressive symptoms in patients attending the CCC. There is need to set-up appropriate interventions and strategies to reduce the prevalence of mental health disorders into routine HIV clinical care and support.

PERAN WARGA PEDULI AIDS CAHAYA CARE TUREN DALAM MENINGKATKAN KUALITAS HIDUP ODHA

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Tri Nurhudi Sasono
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Drugs ◽  
P Value ◽  
People Living With Hiv ◽  
Purposive Sampling ◽  
Significant Difference ◽  
Development Goals ◽  
Living With Hiv ◽  
Hiv Aids

Abstract : Indicator of the health welfare through Sustanable Development Goals (SDGs) is to reduce the incidence of HIV-AIDS, decrease the rate of the epidemic and maintain the quality of life of people living with HIV-AIDS (PLWHA). Trend cases of HIV-AIDS is the most recent spread among people, especially housewives. In Malang until 2015 found 278 Housewife of 409 cases of AIDS. The prevalence of HIV-AIDS in Malang Regency is ranked second after Surabaya city in East Java. For the importance of public participation and citizen care AIDS Cahaya Care Turen take responsibility for the condition. Determination Rule Goverment number 2 2015 year on the Participation of the community response to HIV-AIDS in Malang as a legal rule. Concerned Citizens activities AIDS (WPA). WPA Cahaya Care Turen is increases HIV risk and quality of life PLWHA. The purpose of this study was to determine the role of Citizens AIDS Cahaya Care Quality of Care Turen against people living with HIV in Puskesmas Turen Malang. The study design using a quasi-experimental, with purposive sampling using a sampling technique. Total number of research subjects 23. Based on test results obtained with the Wilcoxon p value <0.005, which means that there is a significant difference before and after PLWHA joining participated in the WPA Cahaya Care Turen. The conclusion of this study is WPA activities involving people living with HIV and at risk groups can optimize compliance with antiretroviral drugs that have an impact on improving the quality of life of PLHIV. Suggestions in this research is done WPA Program activities are structured and ongoing cross-sector in order to improve the quality of life and empower PLWHA.Keywords : WPA Cahaya Care Turen, Quality of life, PLWHA Abstrak : Salah satu indikator kesejahteraan kesehatan melalui Sustanable Development Goals (SDGs) adalah menekan angka kejadian HIV-AIDS, menurunkan laju epidemik dan mempertahankan kualitas hidup Orang dengan HIV-AIDS (ODHA). Trend kasus HIV-AIDS terkini terbanyak adalah menjangkit dikalangan masyarakat khususnya pada ibu rumah tangga. Kabupaten Malang sampai dengan tahun 2015 ditemukan 278 Ibu Rumah Tangga dari 409 kasus AIDS. Prevalensi HIV-AIDS di Kabupaten Malang ini merupakan peringkat kedua di Jawa Timur setelah Kota Surabaya. Untuk itu pentingnya peran serta masyarakat dan warga peduli AIDS Cahaya Care Turen ikut bertanggung jawab terhadap kondisi tersebut. Penetapan Peraturan Bupati Malang no.2 th.2015 tentang Peran serta masyarakat penanggulangan HIV-AIDS di Kabupaten Malang diharapkan dapat mengurangi risiko penularan HIV dan meningkatkan kualitas hidup ODHA. Tujuan dari penelitian ini adalah untuk mengetahui Peran Warga Peduli AIDS Cahaya Care Turen terhadap Kualitas ODHA Di Wilayah Kerja Puskesmas Turen Kabupaten Malang. Desain penelitian menggunakan quasi eksperimen, dengan teknik sampling menggunakan purposive sampling. Jumlah subyek penelitian sejumlah 23. Berdasarkan hasil uji dengan Wilcoxon didapatkan nilai p value < 0.005 yang berarti bahwa terdapat perbedaan bermakna sebelum dan sesudah ODHA bergabung mengikuti kegiatan WPA Cahaya Care Turen. Kesimpulan dalam penelitian ini adalah kegiatan WPA dengan melibatkan ODHA dan kelompok beresiko dapat mengoptimalkan kepatuhan obat ART sehingga berdampak terhadap peningkatan kualitas hidup ODHA. Saran dalam penelitian ini adalah dilakukannya Program kegiatan WPA yang terstruktur dan berkesinambungan lintas sektor guna meningkatkan kualitas hidup dan memberdayakan ODHA.     Kata kunci : WPA Cahaya Care Turen, kualitas hidup, ODHA

scholarly journals Assessment of Markers of Depression and CD4 Cell Count among Adult HIV-Positive Patients on Anti-Retroviral at a Nigerian University Teaching Hospital

2020 ◽  
Vol 8 (4) ◽  
pp. 283-290
Author(s):  
A. Amoko ◽  
P.O. Ajiboye ◽  
F.A. Olagunju ◽  
R.O. Shittu
Keyword(s):  
Family Medicine ◽  
Cell Count ◽  
Teaching Hospital ◽  
Cd4 Count ◽  
Hiv Positive ◽  
P Value ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Prevalence Of Depression ◽  
Cd4 Cell

Objective: Depression is a common mental health problem among people living with HIV/AIDS (PLWHA); because low count of lymphocytes with  cluster of differentiation 4 (CD4 cell count) is associated with severe symptoms of HIV infection, there are thoughts that low CD4 cells count can provoke depressive illness. This study was conducted to determine the relationship between CD4 count and depression among adult HIV positivepatients attending Family Medicine clinics at University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.Method: A hospital based descriptive cross-sectional study was done over a period of 6 months among 350 systematically randomly selected adult HIV-positive patients. PHQ-9 was used to obtain information on depression and the CD4 count was determined using a flow-cytometric method. Data were obtained and analyzed using SPSS-17. Chi-square was used to determine degree of association between the depression and the level of CD4 count. P-value of < 0.05 was considered statistically significant.Results: The prevalence of depression among the respondents was 33.4%. The prevalence of depression was highest among respondents with low CD4 count (≤349cells/ul), 37.0%, and least among those with high CD4 count (≥500cells/ul), 28.3%. This relationship was however not statistically significant.Conclusion: The overall prevalence of depression was high among the respondents (33.4%) suggesting the need for routine depression screening among HIV positive patients. There was no statistically significant association between presence of depression and level of CD4 count (p-value=0.302). Keywords: Depression, CD4count, PLWHA, Family Medicine, UITH.

scholarly journals Time to viral load suppression and its associated factors in cohort of patients taking antiretroviral treatment in East Shewa Zone, Oromiya, Ethiopia, 2018

2019 ◽  
Author(s):  
Jemal H Ali
Keyword(s):  
Viral Load ◽  
Marital Status ◽  
Associated Factors ◽  
Plasma Viral Load ◽  
Baseline Viral Load ◽  
Rank Test ◽  
P Value ◽  
People Living With Hiv ◽  
Age Group ◽  
Significant Difference

Abstract Background: Human immuno-deficiency virus is a virus that causes Acquired Immuno- Deficiency Syndrome. The key goal of ART is to achieve and maintain durable viral suppression. Thus, the most important use of the viral load is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East shewa zone, Oromiya, Ethiopia. Methods: The study was conducted in East Shewa zone, Oromiya, Ethiopia from August 2017 to January 2018. Patients diagnosed with human immunodeficiency virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurement were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of SPSS, IBM Inc. Significance group comparison was done by Kaplan Meier log rank test. Cox proportional hazard model was used to select significant factors to the variability between groups. Data was collected by using structured questionnaires and interview. A total of ETB 81,120.00 was utilized to carry out the study. Result: plasma viral load was suppressed below detection level in 72% of individuals taking different regimen of ART. The median HIV-1 plasma viral load in the cohort was log 5.3111 copies/ml. Survival curve difference were observed in category of marital status (p-value 0.023) and baseline CD4 values (p-value 0.023) whereas no significant difference were observed in Educational status (p-value 0.404), MUAC (p- value 0.407) BMI(p-value 0.335) and BTB(p-value 0.257). Estimated median time to PVL suppression was 181days (CI: 140.5-221.4) with the age group of 30-39years having minimum time to achieve suppression with 92 days (CI: 60.1-123.8) and the maximum time required to reach the level was age group between 50-59 years. Conclusion: Estimated time to achieve PVL after taking ART was found to be 181 days. Factors affecting time to suppression level was marital status and baseline CD4.

scholarly journals Patterns and patient factors associated with loss to follow-up in the Muhimbili Sickle Cell Cohort, Tanzania

2020 ◽  
Author(s):  
Upendo Masamu ◽  
Raphael Zozimus Sangeda ◽  
Daniel Kandoga ◽  
Jesca Ondego ◽  
Florah Ndobho ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Sickle Cell ◽  
Retention Rate ◽  
Clinical Care ◽  
Comprehensive Care ◽  
Rank Test ◽  
P Value ◽  
Mean Cell Volume ◽  
Loss To Follow Up

Abstract Background: Monitoring patient's clinical attendance is a crucial means of improving retention in care and treatment programmes. Sickle cell patients' outcomes are improved by participation in comprehensive care programmes, but these benefits cannot be achieved when patients are lost from clinical care. In this study, patients are defined as loss to follow-up when they did not attend clinic for more than nine months. Precise information on the retention rate and characteristics of those who are not following their clinic appointments is needed to enable the implementation of interventions that will be effective in increasing the retention to care. Method: This was a retrospective study involving sickle cell patients registered in the Muhimbili Sickle Cohort in Tanzania. Descriptive and survival analysis techniques both non-parametric methods (Kaplan-Meier estimator and Log-rank test) and semi-parametric method (Cox’s proportional hazard model), were used. A p-value of 0.05 was considered significant to make an inference from the analysis.Results: A total of 5476 patients were registered in the cohort from 2004 to 2016. Of these, 3350 (58.13%) were actively participating in clinics, while 2126 (41.87%) were inactive, of which 1927 (35.19%) were loss to follow-up. We used data from 2004-2014 because between 2015-2016, patients were referred to other government hospitals. From the survival analysis results, pediatric (HR: 14.29,95% CI: 11.0071-18.5768, p <0.001) and children between 5-17 years [HR:2.61,95% CI:2.2324 - 3.0705, p< 0.001] patients were more likely to be loss to follow-up than the adult (18 and above years) patients. It was found that patients with above averages for hematocrit (HR: 2.38, 95% CI: 1.0076 - 1.0404, p=0.0039) or mean cell volume (HR: 4.28, (95% CI: 1.0260 - 1.0598, p<0.001) were more likely to be loss to follow-up than their counterparts. Conclusion: Loss to follow-up is evident in the cohort of patients in long term comprehensive care. It is, therefore, necessary to design interventions that improve patients’ retention. Suggested solutions include refresher training for health care workers and those responsible for patient follow-up on techniques for retaining patients and comprehensive transition programs to prepare patients who are moving from pediatric to adult clinics

scholarly journals Mental health disorders and alcohol use are associated with increased likelihood of smoking relapse among people living with HIV attending routine clinical care

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cosmas M. Zyambo ◽  
Greer A. Burkholder ◽  
Karen L. Cropsey ◽  
James H. Willig ◽  
Craig M. Wilson ◽  
...  
Keyword(s):  
Mental Health ◽  
Alcohol Use ◽  
Underserved Populations ◽  
Clinical Care ◽  
Multivariable Analysis ◽  
People Living With Hiv ◽  
Smoking Relapse ◽  
Routine Clinical Care ◽  
Quit Smoking ◽  
Living With Hiv

Abstract Background People living with HIV (PLWH) have a high level of interest in quitting smoking, but only a small proportion have sustainable abstinence 6 months after cessation. Few investigations have focused on relapse to smoking among PLWH. In this investigation, we evaluated the prevalence of relapse after smoking cessation and the characteristics associated with smoking relapse using a retrospective, longitudinal cohort of PLWH during an eight-year observation. Methods All patients aged ≥19 years that reported current smoking during the study period and then reported not smoking on a subsequent tobacco use questionnaire (quitters) were eligible for the study. In addition, patients required at least one subsequent follow-up visit after quitting where smoking status was again reported to allow for assessment of relapse. A Cox proportional hazard model was fit to evaluate factors associated with smoking relapse in PLWH attending routine clinical care. Results Of the 473 patients who quit smoking in the study, 51% relapsed. In multivariable analysis, factors significantly associated with a higher likelihood of relapse were anxiety symptoms (HR = 1.55, 95% CI [1.11, 2.17]) and at-risk alcohol use (HR = 1.74, 95% CI [1.06, 2.85]), whereas antiretroviral therapy (ART) adherence (HR = 0.65, 95% CI [0.49, 0.99]) and longer time in care (HR = 0.94, 95% CI [0.91, 0.98]) were associated with a reduced likelihood of relapse after cessation. Conclusion Our study underscores the high prevalence of smoking relapse that exists among PLWH after they quit smoking. Successful engagement in mental health care may enhance efforts to reduce relapse in the underserved populations of PLWH.

scholarly journals Diagnostic Features and 2-Hydroxyglutarate (2-HG) Levels Among Acute Myeloid Leukemia (AML) Patients with and without Isocitrate Dehydrogenase (IDH) Mutations

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1045-1045
Author(s):  
Andrew M. Brunner ◽  
Seth A. Wander ◽  
Donna Neuberg ◽  
Hossein Sadrzadeh ◽  
Karen K. Ballen ◽  
...  
Keyword(s):  
Isocitrate Dehydrogenase ◽  
Research Funding ◽  
De Novo ◽  
Clinical Care ◽  
Advisory Board ◽  
P Value ◽  
Idh Mutation ◽  
Mutational Status ◽  
Idh Mutations ◽  
Significant Difference

Abstract Mutations in genes encoding isocitrate dehydrogenase 1/2 (IDH 1/2) enzymes result in increased 2-hydroxyguterate (2-HG) levels, which may provide a non-invasive marker of disease in IDH-mutant AML. The purpose of this study was to characterize patients with IDH-mutant AML by assessing presenting features, concurrent mutations, and 2-HG levels. From 7-2011 through 6-2014, we identified 170 consecutive patients with newly diagnosed AML and measured 2-HG by liquid chromatography-tandem mass spectrometry in serum, urine, marrow aspirate, and marrow pellet samples. All patients had IDH1 R132, IDH2 R140 and R172 testing; 169/170 had hotspot mutational profiling for AKT1, APC, BRAF, CTNNB1, EGFR, ERBB2, KIT, KRAS, MAP2K1,NOTCH1, NRAS, PIK3CA, P53, and PTEN. We assessed FLT3 (168/170), NPM1 (168/170), CEBPA (100/170) mutational status as routine clinical care; 2 patients had BCR/ABL alterations, and 6 were JAK2 positive (of 36 tested). IDH1/2-mutant were compared to wildtype (WT) patients using a Wilcoxon rank sum test, Fisher's exact test, or Kruskal Wallis test, as appropriate. The group was 54% male; 83% white, 2.4% black, 2.4% Asian, and 6.5% Hispanic. 12 patients had APL. IDH mutations included IDH1 R132C (n=10), IDH2 R172 (n=7), and IDH2 140Q (n=22). Other mutations included NPM1 (20.8%), FLT3-ITD (17.3%), FLT3-TKD (6.6%), NRAS (18.4%), TP53 (3%), KRAS (6.5%), and KIT (1.2%). CEBPA mutations occurred in 13 of 100 patients. IDH mutations (n=39) more frequently co-occurred with normal cytogenetics and NPM1 mutations, vs IDH-WT, consistent with prior reports (Table 1). No patients with favorable cytogenetics harbored an IDH1/2 mutation. Significantly higher 2-HG levels were detected among those with IDH1/2 mutations compared to IDH WT, in the serum (p<0.0001), urine (p<0.0001), marrow aspirate (p<0.0001) and marrow pellet (p<0.0001). Overall, elevated 2-HG levels were present regardless of type of IDH mutation. Serum and marrow pellet 2-HG levels were elevated (> 1000 ng/mL in serum and > 1000ng/2x10^6 cells in marrow pellet) in 30/38 and 24/29 IDH-mutant patients, respectively, compared to 1/129 and 5/117 IDH WT patients. All but 2 IDH-mutant patients displayed either or both an elevated marrow pellet or serum 2-HG. Patients with IDH2 R172 mutations had lower marrow 2HG levels compared to those with R140Q mutations (Figure 1, p=0.0434). The WBC and blast count was lower among IDH2 R172-mutant compared to R140Q- or IDH1 R132C-mutant patients (p= 0.0134 and p=0.0039, respectively); there was no significant difference in serum 2HG levels. All three canonical IDH1/2 mutations have higher 2HG levels compared to IDH WT. IDH2 R172 mutated AML may present with lower WBC counts and peripheral blast percentage compared to IDH1 R132C and IDH2 R140Q mutant AML. Urine and serum 2HG levels effectively identify patients with mutant IDH1/2, of particular relevance given targeted therapies for these mutations. Table 1. Characteristics of IDH1/2-mutant and WT AML patients. IDH1/2 Mutated IDH1/2 WT p-value Age, y (median, range) 67 (41-86) 65 (20-87) 0.4718 AML History (n, %) De Novo 28 (72%) 82 (63%) 0.6336 Therapy-related 4 (10%) 15 (11%) MDS 2 (5%) 17 (13%) Cytogenetic Risk (n, %) Favorable 0 23 (18%) 0.0006 Intermediate 30 (81%) 71 (55%) Normal 25 (68%) 44 (34%) Poor 7 (19%) 34 (27%) Concurrent Mutations (n, %) NPM1 15 (38%) 20 (16%) 0.0033 FLT3-ITD 3 (8%) 26 (20%) 0.0907 FLT3-TKD 2 (5%) 9 (7%) 1.000 CEBPA Heterozygous Homozygous 3 (14%) 0 8 (10%) 2 (3%) 0.8118 NRAS 9 (23%) 22 (17%) 0.4788 KRAS 0 11 (8%) 0.0700 KIT 1 (3%) 1 (1%) 0.4093 P53 1 (3%) 4 (3%) 1.000 Table 2. WBC and 2-HG levels by IDH mutation (median, range). BQL, below quantitative limit. IDH1 R132C N= 10 IDH2 R172 N=7 IDH2 R140Q N=22 IDH WT N=131 WBC count 10.1 [1.8-333.2] 1.6 [0.7-3.2] 5.9 [0.9-122.8] 6.3 [0.4-315.4] Peripheral blast % 33.0 [0-98] 1.0 [0-9.8] 18.2 [2-91] 15 [0-94] Marrow aspirate 2-HG (ng/mL) 20,900 [1330-93500] (n=7) 4300 [2230-26000] (n=6) 30800 [BQL-311000] (n=19) BQL [BQL-22000] (n=116) Serum 2-HG (ng/mL) 1807 [101-66207] (n=9) 1102 [287-2908] (n=7) 1464 [365.1-11696] (n=22) 86.9 [BQL-1224] (n=128) Urine 2-HG (ng/mL) 33850 [7260-282000] (n=10) 7430 [2460-63700] (n=7) 11300 [2070-177000] (n=20) 3140 [BQL-53200] (n=125) Marrow pellet 2-HG (ng/2*10^6 cells) 13680 [193-172,800] (n=7) 7480 [1056-79600] (n=5) 5560 [564-96400] (n=17) 65 [BQL-4040] (n=116) Figure 1 Figure 1. Disclosures Brunner: NIH T32 CA 71345-18: Research Funding. Attar:Agios: Employment. Yen:Agios: Employment. Yang:Agios Pharmaceuticals: Employment, Stockholder Other. Straley:Agios: Employment. Agresta:Agios Pharmaceuticals: Employment, Stockholder Other. Stone:Agios: Consultancy. Fathi:Millennium: Research Funding; Seattle Genetics: Advisory Board, Advisory Board Other; Agios: Advisory Board, Advisory Board Other.

scholarly journals Analysis of survival for patients in relation to central venous catheter and nosocomial blood stream infections: A case study of Aga Khan University Hospital, Nairobi

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1770
Author(s):  
Francis Maina Kiroro ◽  
Majid Twahir
Keyword(s):  
Clinical Care ◽  
Survival Rates ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
University Hospital ◽  
P Value ◽  
Infection Status ◽  
Central Venous ◽  
Mortality And Morbidity ◽  
Significant Difference

Background: This study was focussed on survival rates of patients admitted to acute care units who utilized medical devices known as central venous catheters (CVC). CVCs are useful devices in clinical care; however some infections such as central line associated bloodstream infections (CLABSI) may occur, which are associated with increased lengths of stay and costs as well as higher morbidity and mortality rates. The overall objective of the present study was to determine survival probabilities and hazard rates for patients who used CVC devices and compare the subgroups by infection status. Methods: The study was focused on all patients who were admitted to Critical Care Units between 8th December 2012 and 31st March 2016 and utilized CVC devices. It was a retrospective study. Survival analysis techniques, test of equality of proportions, Man-Whitney test and Chi–square test of independence were used. Results: A total of 363 out of 1089 patients included in the study died during hospitalization. 47 patients developed nosocomial CLABSI. The average duration was 18.19 days and median of 12 days for hospitalized patients who did not develop a nosocomial CLABSI compared to an average of 56.79 days and a median of 51 days for those who did. There was a significantly higher proportion of mortality of those who developed nosocomial CLABSI compared to those that didn’t (p-value=0.01379). The results indicate that there was a significant association between infection status and discharge status, and significant difference to the survival rates of the patients based on infection status. Conclusions: There is a significant impact on mortality and morbidity of patients who develop nosocomial CLABSI. The duration of hospitalization by patients who developed CLABSI was significantly higher compared to patients who did not. Increased length of stay leads to higher cost of hospitalization.

scholarly journals Characteristics and treatment outcomes of HIV infected elderly patients enrolled in Kisii Teaching and Referral Hospital, Kenya

2020 ◽  
Vol 20 (4) ◽  
pp. 1537-45
Author(s):  
Benuel Nyagaka ◽  
Stanslaus Kiilu Musyoki ◽  
Lucy Karani ◽  
Anthony Kebira Nyamache
Keyword(s):  
Viral Load ◽  
Elderly Patients ◽  
Clinical Care ◽  
Cd4 Count ◽  
Referral Hospital ◽  
People Living With Hiv ◽  
Keywords Hiv ◽  
Significant Difference ◽  
Baseline Characteristics ◽  
Hiv Aids

Background: A better understanding of the baseline characteristics of elderly people living with HIV/AIDS (PLWHA) is relevant because the world’s HIV population is ageing. Objectives: This study aimed to evaluate the baseline characteristics of PLWHA aged ≥ 50years at recruitment to HIV/ AIDS clinic compared against the viral load (VL) and CD4 count among patients attending Kisii Teaching and Referral Hospital (KTRH), Kenya. Methods: We retrospectively evaluated temporal inclinations of CD4 levels, viral load change and baseline demographic characteristics in the electronic records at the hospital using a mixed error-component model for 1329 PLWHA attending clinic between January 2008 and December 2019. Results: Findings showed a significant difference in the comparison between baseline VL and WHO AIDS staging (p=0.026). Overall VL levels decreased over the period significantly by WHO AIDS staging (p<0.0001). Significant difference was ob- served by gender (p<0.0001), across age groups (p<0.0001) and baseline CD4 counts (p=0.003). There were significant differences in WHO staging by CD4 count >200cell/mm3 (p=0.048) and residence (p=0.001). Conclusion: Age, WHO AIDS staging, gender and residence are relevant parameters associated with viral load decline and CD4 count in elderly PLWHA. A noticeable VL suppression was attained confirming possible attainment of VL suppression among PLWHA under clinical care. Keywords: HIV infected elderly patients; Kisii Teaching and Referral Hospital, Kenya.

scholarly journals Anxiety and depression in pregnant women amid COVID-19 pandemic

2021 ◽  
Vol 12 (9) ◽  
pp. 26-30
Author(s):  
Pravin Shrestha ◽  
Vibha Mahato ◽  
Anil Subedi ◽  
Shipra Shrestha
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
P Value ◽  
Second Trimester ◽  
Cross Sectional ◽  
Significant Difference ◽  
Prevalence Of Depression ◽  
Hospital Patients

Background: COVID-19 has become a global pandemic. It has affected the psychological condition of pregnant women. Aims and Objective: This study aims to assess prevalence of depression and anxiety in pregnancy during COVID-19 pandemic. Materials and Methods: The current study was an observational, cross sectional study conducted in the Department of Obstetrics and Gynecology, Manipal Teaching Hospital. Patients were assessed using Nepali version of Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) for anxiety and depression respectively. Result: There were total of 115 patients in this study. The prevalence of anxiety according to BAI was 39.1%. The prevalence of depression according to BDI was 19%. There was a statistically significant difference in rate of anxiety according to maternal age (p value 0.028). Anxiety was higher in women less than 20 years of age. Anxiety symptoms were more prevalent i.e., 44.6% in third trimester followed by 31.4% in second trimester and 29.4% in first trimester. Symptoms of depression was higher in women more than 35 years of age (27.2%) and in second trimester of pregnancy (27.2%). Conclusion: Antenatal anxiety and depression are important issues because it impacts both maternal wellbeing and fetal health. Prevalence of anxiety and depression among pregnant women during COVID 19 pandemic was studied. The prevalence of anxiety and depression was 39.1% and 19% respectively.

scholarly journals Patterns and patient factors associated with loss to follow-up in the Muhimbili Sickle Cell Cohort, Tanzania

2020 ◽  
Author(s):  
Upendo Masamu ◽  
Raphael Zozimus Sangeda ◽  
Daniel Kandoga ◽  
Jesca Ondego ◽  
Florah Ndobho ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Sickle Cell ◽  
Retention Rate ◽  
Clinical Care ◽  
Comprehensive Care ◽  
Rank Test ◽  
P Value ◽  
Mean Cell Volume ◽  
Loss To Follow Up

Abstract Background: Monitoring patient's clinical attendance is a crucial means of improving retention in care and treatment programmes. Sickle cell patients' outcomes are improved by participation in comprehensive care programmes, but these benefits cannot be achieved when patients are lost from clinical care. In this study, patients are defined as loss to follow-up when they did not attend clinic for more than nine months. Precise information on the retention rate and characteristics of those who are not following their clinic appointments is needed to enable the implementation of interventions that will be effective in increasing the retention to care. Method: This was a retrospective study involving sickle cell patients registered in the Muhimbili Sickle Cohort in Tanzania. Descriptive and survival analysis techniques both non-parametric methods (Kaplan-Meier estimator and Log-rank test) and semi-parametric method (Cox’s proportional hazard model), were used. A p-value of 0.05 was considered significant to make an inference from the analysis. Results: A total of 5476 patients were registered in the cohort from 2004 to 2016. Of these, 3350 (58.13%) were actively participating in clinics, while 2126 (41.87%) were inactive, of which 1927 (35.19%) were loss to follow-up. We used data from 2004-2014 because between 2015-2016, patients were referred to other government hospitals. From the survival analysis results, pediatric (HR: 14.29,95% CI: 11.0071-18.5768, p <0.001) and children between 5-17 years [HR:2.61,95% CI:2.2324 - 3.0705, p< 0.001] patients were more likely to be loss to follow-up than the adult (18 and above years) patients. It was found that patients with above averages for hematocrit (HR: 2.38, 95% CI: 1.0076 - 1.0404, p=0.0039) or mean cell volume (HR: 4.28, (95% CI: 1.0260 - 1.0598, p<0.001) were more likely to be loss to follow-up than their counterparts. Conclusion: Loss to follow-up is evident in the cohort of patients in long term comprehensive care. It is, therefore, necessary to design interventions that improve patients’ retention. Suggested solutions include refresher training for health care workers and those responsible for patient follow-up on techniques for retaining patients and comprehensive transition programs to prepare patients who are moving from pediatric to adult clinics

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