scholarly journals Beyond biomarkers and towards functional outcomes for adult persons living with HIV. A cross sectional survey in Blantyre Urban, Malawi.

2019 ◽  
Author(s):  
Steven Derrick Manyozo ◽  
Nesto Tarimo ◽  
Gift Kawalazira ◽  
Adamson Sinjani Muula
Keyword(s):  
Risk Factors ◽  
International Classification Of Functioning ◽  
Categorical Variables ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Mental Functions ◽  
Persons Living With Hiv ◽  
Associated Risk Factors ◽  
Study Participants ◽  
Living With Hiv

Abstract Introduction Despite improvements in survival, reports indicate that people living with HIV are experiencing a range of physical, cognitive, mental and social health-related challenges associated with HIV, comorbidities and aging recently termed ‘disability’. Among adult persons living with HIV in Malawi, the prevalence of disability and associated risk factors are not known. This study was designed to assess the prevalence of impairments, activity limitations and associated risk factors among adults living with HIV in Blantyre urban, Malawi. Methods We conducted a quantitative cross sectional study among adult persons living with HIV in Blantyre urban from March to August 2018. Participants were recruited consecutively from 5 health centers. We used the WHO’s International Classification of Functioning, Disability and Health (ICF) for data collection. Written informed consent was sourced from study participants, permission was granted at each study site and the study received ethics approval from the College of Medicine Research Ethics Committee (COMREC). Descriptive statistics were used to summarize the data. Categorical variables were summarized as frequencies and percentages and continuous variables were summarized using means and standard deviation. Univariable and multivariable logistic regression were used to assess association between presence of disability and selected factors. Odds ratios (OR) and their 95% confidence intervals were calculated. Results Of the 277 participants enrolled in the study, 225 (81%) were female and 52 (19%) were male. The mean age of participants was 37 years ( std. dev 9.5 ). Impairments in mental functions were the most prevalent affecting 118 (43%) study participants. Energy and drive (18%), memory (14%) and sleep (13%) were the most affected mental functions. Impairments in the mental functions, genital urinary, reproductive, digestive, metabolic and endocrine systems were associated with higher odds of disability among the participants. Conclusions Our results indicate a high prevalence of impairments among persons living with HIV. Clinicians and rehabilitation personnel need to be proactive in identifying and managing impairments to promote health among HIV patients.

scholarly journals Assessment of HIV Related Disabilities among People Living with HIV Who Are on ART. A Cross Sectional Survey in Blantyre Urban, Malawi

2020 ◽  
Author(s):  
Steven Derrick Manyozo ◽  
Tarimo Nesto ◽  
Gift Kawalazira ◽  
Adamson Sinjani Muula
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Cross Sectional ◽  
Mental Functions ◽  
Persons Living With Hiv ◽  
Health Related ◽  
Associated Risk Factors ◽  
Study Participants ◽  
Living With Hiv ◽  
Sensory Functions

Abstract Background Despite improvements in survival, persons living with HIV experience a range of physical, cognitive, mental and social health-related challenges. Among adult persons living with HIV in Malawi, the prevalence of disability and associated risk factors are not known. This study was designed to assess the prevalence of impairments, activity limitations and associated risk factors among adults living with HIV in Blantyre urban, Malawi. MethodsWe conducted a quantitative cross-sectional study among adult persons aged 18 years and older living with HIV and on ART receiving their care at five government run health facilities in Blantyre urban. We used the WHO’s International Classification of Functioning, Disability and Health (ICF) for data collection. The ICF provides a unified, standard language and framework for the description of health and health-related states. The College of Medicine Research Ethics Committee (COMREC) approved the study and written informed consent was obtained from study participants. Descriptive statistics were used to summarize the data. Univariable and multivariable logistic regression were used to assess association between presence of disability and selected factors. Odds ratios (OR) and their 95% confidence intervals were calculated.Results Of the 277 participants enrolled, 225 (81%) were female and 52 (19%) were male. The mean age of participants was 37 years (std. dev 9.5). Impairments in mental functions (43%) and sensory functions and pain (40%) were the most prevalent among the study participants. Energy and drive (18%), memory (14%) and sleep (13%) were the most affected mental functions. Socio-demographic characteristics were not significantly associated with occurrence of the mental function impairments. Conclusions Our study highlights the level of impairments among person living with HIV especially mental health impairments, sensory functions and pain. Integrated health services including mental health screening and care, physical rehabilitation into all HIV testing and treatment settings are very critical to improve service delivery but also general access to rehabilitation by persons living with HIV.

scholarly journals Prevalence of Toxoplasma gondii and Associated Risk Factors among People Living with HIV at Gondar University Hospital, Northwest Ethiopia

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Dagnachew Muluye ◽  
Yitayih Wondimeneh ◽  
Yeshambel Belyhun ◽  
Feleke Moges ◽  
Mengistu Endris ◽  
...  
Keyword(s):  
Risk Factors ◽  
Toxoplasma Gondii ◽  
University Hospital ◽  
People Living With Hiv ◽  
Cd4 Lymphocyte Count ◽  
Gondar University Hospital ◽  
Cd4 Lymphocyte ◽  
Associated Risk Factors ◽  
Study Participants ◽  
Living With Hiv

Background. Toxoplasma gondii is an obligate intracellular protozoan parasite and is a major opportunistic pathogen in immune-compromised hosts. This study assessed the prevalence of T. gondii and associated risk factors among people living with HIV. Methods and Materials. A cross-sectional study was carried out among people living with HIV attending Gondar University Hospital. A structured and pretested questionnaire was used to collect sociodemographic factors, and 10mL of venous blood was collected for anti-Toxoplasma antibody test and determination of CD4 levels. Serum was tested in duplicate for anti-Toxoplasma antibody using rapid slide agglutination test. Results. A total of 170 study subjects were enrolled in the study. Seroprevalence of T. gondii among the study participants was 76.5% (95% CI: 69.0–82.8). High proportions of seropositive individuals (64.7%) were found under the child bearing age groups. The mean CD4+ lymphocyte count of HIV monoinfected participants was cells/mm3 while coinfected study participants had mean CD4+ lymphocyte count of cells/mm3 with value of 0.01. Conclusion. The seroprevalence of T. gondii among people living with HIV was high. Cautious followup of HIV-positive patients is needed to prevent development of toxoplasmic encephalitis and other related complications.

scholarly journals Immunological and virological discordance among people living with HIV on highly active antiretroviral therapy in Tigray, Northern Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Genet Gebrehiwet Hailu ◽  
Araya Gebreyesus Wasihun
Keyword(s):  
Risk Factors ◽  
Treatment Adherence ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Northern Ethiopia ◽  
Highly Active ◽  
Associated Risk Factors ◽  
Study Participants ◽  
Living With Hiv

Abstract Background People living with human immunodeficiency virus (HIV) with immuno-virological discordant responses are at an increased risk to develop acquired immunodeficiency syndrome (AIDS) and severe non AIDS events which are risk factors for death. This study was aimed to assess prevalence of immuno- virological discordant responses and associated risk factors among highly active antiretroviral therapy (HAART) users in Tigray, Northern Ethiopia. Methods A cross sectional study was conducted from September to December 30, 2016 on 260 people living with HIV who started first line HAART from January 2008 to March 2016 at Mekelle hospital and Ayder comprehensive specialized hospital. Baseline and follow-up clinical data and CD4+ result were collected from patient charts. Besides, socio-demographic data and blood samples for CD4 + count and viral load measurement were collected during data collection period. Fisher’s exact test, bivariate and multivariate logistic regressions were used for data analysis. P-value < 0.05 with 95% CI was considered as statistically significant. Result Among the 260 study participants, 8.80% (95% Confidence Interval (CI) =8.77–8.84%) and 2.70% (95% CI = 2.68–2.72%) had virological and immunological discordant responses, respectively with an overall immuno-virological discordance response of 11.50% (95% CI = 11.46–11.54%). The median age of the study participants at HAART initiation was 35 (IQR: 28–44 years). More than half (58.1%) of the study participants were females. Age at or below 35 years old at HAART initiation (AOR ((95% CI) = 4.25(1.48–12.23), p = 0.007)), male gender ((Adjusted Odds Ratio (AOR) (95% CI) =1.71(1.13–1.10), p = 0.029)), type of regimen given ((AOR(95% CI) = 0.30 (0.10–0.88), p = 0.028)) and good treatment adherence ((AOR (95% CI) = 0.12 (0.030–0.0.48), p = 0.003)) were associated risk factors for virological discordant response. Likewise, immunological discordant response was associated with tuberculosis co-infections (p = 0.016), hepatitis B virus co-infections (p = 0.05) and low CD4+ count (≤100 cells/μl) at baseline (p = 0.026). Conclusions Over all, immuno-virological discordance response was 11.5% in the study area. Males, low baseline CD4+ count, poor/fair treatment adherence, and TB and HBV co-infections were significantly associated with higher immuno-virological discordance. We recommend that decision of patient treatment outcome, regimen change and patient management response should be done using trends of both viral load and CD4+ count concurrently.

scholarly journals 947. Stroke demographics and risk factor profile in HIV infected individuals in Florida

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S506-S506
Author(s):  
Folusakin Ayoade ◽  
Dushyantha Jayaweera
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Clinical Research ◽  
Stroke Risk ◽  
Research Network ◽  
Categorical Variables ◽  
People Living With Hiv ◽  
Risk Factor Profile ◽  
Stroke Risk Factors ◽  
Living With Hiv

Abstract Background The risk of ischemic stroke (IS) is known to be higher in people living with HIV (PLWH) than uninfected controls. However, information about the demographics and risk factors for hemorrhagic stroke (HS) in PLWH is scant. Specifically, very little is known about the differences in the stroke risk factors between HS and IS in PLWH. The goal of this study was to determine the demographics and risk factor differences between HS and IS in PLWH. Methods We retrospectively analyzed the demographic and clinical data of PLWH in OneFlorida (1FL) Clinical Research Consortium from October 2015 to December 2018. 1FL is a large statewide clinical research network and database which contains health information of over 15 million patients, 1240 clinical practices, and 22 hospitals. We compared HS and IS based on documented ICD 9 and 10 diagnostic codes and extracted information about sociodemographic data, traditional stroke risk factors, Charlson comorbidity scores, habits, HIV factors, diagnostic modalities and medications. Statistical significance was determined using 2-sample T-test for continuous variables and adjusted Pearson chi square for categorical variables. Odds ratio (OR) and 95% confidence intervals (CI) between groups were compared. Results Overall, from 1FL sample of 13986 people living with HIV, 574 subjects had strokes during the study period. The rate of any stroke was 18.2/1000 person-years (PYRS). The rate of IS was 10.8/1000 PYRS while the rate of HS was 3.7/1000 PYRS, corresponding to 25.4% HS of all strokes in the study. Table 1 summarizes the pertinent demographic and risk factors for HS and IS in PLWH in the study. Table 1: Summary of pertinent demographic and risk factors for hemorrhagic and ischemic strokes in people living with HIV from One Florida database Conclusion In this large Floridian health database, demographics and risk factor profile differs between HS and IS in PLWH. Younger age group is associated with HS than IS. However, hypertension, hyperlipidemia and coronary artery disease are more likely to contribute to IS than HS in PLWH. Further research is needed to better understand the interplay between known and yet unidentified risk factors that may be contributing to HS and IS in PLWH. Disclosures All Authors: No reported disclosures

scholarly journals Seroprevalence of AsymptomaticLeishmania donovaniamong Laborers and Associated Risk Factors in Agricultural Camps of West Armachiho District, Northwest Ethiopia: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Animen Ayehu ◽  
Yibeltal Aschale ◽  
Wossenseged Lemma ◽  
Animut Alebel ◽  
Ligabaw Worku ◽  
...  
Keyword(s):  
Risk Factors ◽  
Leishmania Donovani ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Control Measures ◽  
Sectional Study ◽  
Cross Sectional ◽  
Associated Risk Factors ◽  
Study Participants

Background. Visceral leishmaniasis (VL, also called kala-azar) is a public health problem in Ethiopia, especially in sesame and sorghum growing areas. Compared to other populations, labor migrants are the most exposed. Knowing the seroprevalence ofLeishmania donovaniand associated risk factors is essential to design appropriate control measures. The main aim of this study was to assess the seroprevalence of asymptomaticL. donovaniamong laborers and associated risk factors in agricultural camps of West Armachiho district, Northwest Ethiopia. Therefore, this study was conducted to know the seroprevalence and associated risk factors ofL. donovaniinfection.Method. A cross-sectional study was conducted among 185 laborers from October to December 2017. A simple random sampling technique was used to select study participants from selected agricultural camps. After obtaining written informed consent, data were collected using a structured pretested Amharic version questionnaire using the interview technique. A single finger prick blood sample was collected from the study participants and the blood samples were subjected to the serological diagnostic method using the rk39 kit. The multivariable logistic regression model was used to identify risk factors associated withL. donovaniinfection.Result. Among 185 participants examined using rk39, 14 (7.6%) were seroreactive forL. donovani.Leishmania donovaniinfection had a statistically significant association with sleeping underBalanitestrees (AOR: 4.36, 95%CI: 1.186-16.06), presence of domestic animals near sleeping place (AOR: 4.68, 95% CI: 1.25-17.56), and lack of knowledge about VL transmission (AOR: 3.79, 95% CI: 1.07-13.47).Conclusion. Seroprevalence of asymptomaticL. donovaniamong laborers in agricultural camps of West Armachiho was low. Prevention measures and health education about risk factors that expose toL. donovaniinfection for the laborers are essential to prevent the spread of the disease.

scholarly journals Estimating the burden of pediatric HIV in an ‘A’ category district in India: an epidemiological study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anju Sinha ◽  
Reynold Washington ◽  
Rajeev Sethumadhavan ◽  
Rajaram Subramanian Potty ◽  
Shajy Isac ◽  
...  
Keyword(s):  
Disease Burden ◽  
Control Program ◽  
Hiv Prevalence ◽  
Pediatric Hiv ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Longitudinal Methods ◽  
Persons Living With Hiv ◽  
Living With Hiv

Abstract Background India lacks epidemiological information on the disease burden of pediatric HIV. The National AIDS Control Program (NACP) estimates the numbers of HIV-positive children as a proportion of adult persons living with HIV. A third of HIV-positive children die before their first birthday and a half before they reach their second birthday. The early detection of HIV is crucial for the prevention of morbidities, growth delays, and death among HIV-positive children. Methods The study aimed to estimate the disease burden of pediatric HIV among children in ‘A’ category district of a high HIV prevalence state. An ‘A’ category district is defined by the presence of > 1% HIV prevalence among the general population, as estimated by HIV Sentinel Surveillance. The study used an innovative three-pronged strategy combining cross-sectional and longitudinal methods. The overall burden of pediatric HIV was calculated as a product of cases detected multiplied by a net inflation factor, for each of three strategies. Results The existing pool of HIV infection in the district is estimated to be 3266 (95% CI: 2621–4197) HIV positive children < 15 years of age, in a mid-year (2013) projected child population of about 1.4 million, thus giving an HIV prevalence of 0.23% (CI: 0.19–0.30) among children (0–14 years of age). The proportion of children among all people living with HIV in the district works out to 10.4% (CI: 8.6–13.5%). Conclusions The study estimate of 0.23% HIV prevalence among children (0–14 years of age) is higher than the NACP estimates (0.02) and is 2.5 higher than the Karnataka state estimate (0.09)22. Similarly, the proportion of children among all persons living with HIV in Belgaum district is 10.4% in this study, as against 6.54% for India. The study methodology is replicable for other settings and other diseases.

scholarly journals Prevalence of Diabetes Mellitus and its associated risk factors

2020 ◽  
Vol 32 (1) ◽  
pp. 97-100
Author(s):  
Mahendra Singh ◽  
Surekha Kishore ◽  
Bhavan Jain ◽  
Sanjeev Kishore ◽  
Pradeep Aggarwal ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Public Health Education ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Balanced Diet ◽  
Four Blocks ◽  
Associated Risk Factors ◽  
Study Participants

Background: Type 2 diabetes mellitus (T2DM) is a chronic, debilitating non communicable diseases (NCDs) which has emerged as a leading global health problem. Aim & Objective: To find out the prevalence of known cases of diabetes mellitus and associated risk factors in the study area. Material & Methods: Community-based cross-sectional study was conducted among people living in Barrage colony of Rishikesh, Uttarakhand for a period of 3 months from December 2018 to February 2019. House to house survey was done in all the four blocks (A, B, C, D) of Barrage colony. Total of 815 study participants (both male and female) ≥ 20 years of age were surveyed. Data collected was entered into Microsoft Excel and analyzed using epi info software version 7. Results: The prevalence of DM was found to be high i.e 5.6% among the study participants. Prevalence was significantly more among females as compared to males and significantly increased by aging in both genders. Conclusions: It seems that the prevalence of diabetes is increasing in our region as well as our country and the world. To control DM public health education regarding consumption of balanced diet, increasing physical activity and leading a stress-free life is needed.

scholarly journals Identifying asymptomatic infections of visceral leishmaniasis in non-endemic regions with the associated risk factors in Gedaref state, Sudan

2019 ◽  
Author(s):  
Nouh Saad Mohamed ◽  
Hussam A. Osman ◽  
Mohamed S. Muneer ◽  
Abdallah M. Samy ◽  
Ayman Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visceral Leishmaniasis ◽  
Detection Method ◽  
Cross Sectional Study ◽  
Asymptomatic Infection ◽  
Cross Sectional ◽  
Asymptomatic Infections ◽  
Associated Risk Factors ◽  
Study Participants ◽  
Planted Tree

Abstract Objectives Visceral Leishmaniasis (VL) can be symptomatic and asymptomatic infection. In this study we aimed at investigating the prevalence of asymptomatic infections and to study risk factors of VL in non-endemic regions in Gedaref state, Sudan. A descriptive cross-sectional study conducted during 2014. Blood samples were collected to serological and molecular analysis. Sticky traps, knockdown spray and CDC miniature light traps were used for the collection of sandflies. Results Ninety-Five participants were included; 52 from Abukishma, 15 Algadamblia Tirfa, 25 Abualnaja and 3 were from Algadamblia Aljabal. Most of the study participants were belonging to the Belala tribe (74.3%). The most frequent reported age was above 40-years old (9.5%). Females were (61.1%) and males were (38.9%). B. aeygptica was the most planted tree in/around the houses (46.3%). 73 (76.8%) of the participants bred more than two types of animals in the house. DAT test revealed 5 positive participants (5.2%). 4/5 DAT positive were past VL infection. PCR detected 35 (36.8%) positive patients. A total of 31 (32.6%) were considered asymptomatic infections based on PCR detection method. Households planted Balanites/Acacia trees or breed domestic animals were found in high percentages with VL PCR positive participants (60.1%, 91.4%).

scholarly journals Prevalence and predictors of HIV-associated Neurocognitive Disorder in Ethiopians

2020 ◽  
Author(s):  
Mohammed Salahuddin ◽  
Md Dilshad Manzar ◽  
Hamid Yimam Hassen ◽  
Mihretu Ashuro ◽  
Aleem Unissa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vulnerable Groups ◽  
Binary Logistic Regression Analysis ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cross Sectional ◽  
Targeted Screening ◽  
Independent Risk Factors ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv

Abstract Background Modern antiretroviral therapy has extended the life expectancies of people living with HIV; the prevention and treatment of their associated neurocognitive decline has remained a challenge. Consequently, it is desirable to investigate the prevalence and predictors of HIV-associated Neurocognitive Disorder (HAND) to help in targeted screening and disease prevention. Methods: Two hundred and forty-four people living with HIV were interviewed in a study using a cross-sectional design and International HIV Dementia scale (IHDS). Additionally, the sociodemographic, clinical and psychosocial characteristics of the patients were recorded. Chi-square and binary logistic regression analysis were used to determine the level of significance among the independent risk factors and probable HAND. Results The point prevalence of HAND was found to be 39.3%. Participants’ characteristics of being older than 40 years (AOR = 2.81 (95% CI; 1.11–7.15)), having a history of recreational drug use (AOR = 13.67 (95% CI; 6.42–29.13)), and being non-compliant with prescribed medications (AOR = 2.99 (95% CI; 1.01–8.87)) were independent risk factors for HAND. Conclusion The identification of predictors, some of which may be more closely related to the Ethiopian people living with HIV, may help in targeted screening of vulnerable groups during cART follow-up visits. This may greatly help in strategizing and implementation of the prevention program, more so, because: (i) HAND is an asymptomatic condition for considerable durations, and (ii) clinical trials of HAND therapies have been unsuccessful.

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