scholarly journals Determinants of Isoniazid Preventive Therapy Completion among People Living with HIV Attended Care and Treatment  Clinics from 2013 to 2017 in Dar es Salaam Region,Tanzania. A cross-sectional analytical study

2020 ◽  
Author(s):  
Masanja Robert ◽  
Jim Todd ◽  
Bernard J Ngowi ◽  
Sia Msuya ◽  
Angella Ramadhani ◽  
...  
Keyword(s):  
Health Facility ◽  
Analytical Study ◽  
Preventive Therapy ◽  
Dar Es Salaam ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Cd4 Counts ◽  
Factors Associated ◽  
Care And Treatment ◽  
Living With Hiv

Abstract Background: Tuberculosis (TB) disease is a common opportunistic infection among people living with HIV (PLHIV). WHO recommends at least six months of isoniazid Preventive Therapy (IPT) to reduce the risk of active TB. It is important to monitor completion of IPT, as a suboptimal dose may not protect PLHIV from TB infection. This study determined IPT completion and its determinants among PLHIV aged 15 years or more in Dar es Salaam region, Tanzania. Methods: A Cross-sectional analytical study was conducted using secondary analysis of routine data from 58 care and treatment clinics in Dar es Salaam region. The study recruited clients who screened negative for TB symptoms and initiated IPT between January 2013 and June 2017. Modified Poisson regression model with robust standard errors were used to estimate prevalence ratios (PR) and 95% confidence interval (CI) for factors associated with IPT completion. Multilevel analysis was used to account the health facility random effects in order to estimate independent factors associated with IPT completion. Results : A total of 29,382 clients were initiated on IPT, with 21,808 (74%) female. Overall 17,092 (58%) completed IPT, increasing from 42% (773/1,857) in year 2013 to 76% (2,929/3,856) in 2017. Multilevel multivariable model accounting for health facility as clusters, found that clients with CD4 counts between 100 to 349 cells/ had 3% lower prevalence of IPT completion as compared to those with 100 cells/ (PR:0.97: 95%CI:0.94-1.01). Patients who were not on ART had 46% lower IPT completion compared to those were on ART (PR: 0.54: 95%CI: 0.45-0.64). There was lower IPT completion among clients who transferred to another clinic compared to those attended the same clinic where they were initiated IPT (PR: 0.63: 95% CI (0.54-0.74). Conclusion: IPT completion is low at care and treatment clinics although it increased over time. Lower IPT completion was seen in PLHIV with CD4 counts between 100 to 349 cells/ , those who transferred to other clinics and those not on ART. Thus it indicates the need for better IPT interventions with greater support PLHIV in those groups.

scholarly journals Determinants of Isoniazid Preventive Therapy Completion among People Living with HIV Attended Care and Treatment  Clinics from 2013 to 2017 in Dar es Salaam Region,Tanzania. A cross-sectional analytical study

2020 ◽  
Author(s):  
Masanja Robert ◽  
Jim Todd ◽  
Bernard J Ngowi ◽  
Sia Msuya ◽  
Angella Ramadhani ◽  
...  
Keyword(s):  
Health Facility ◽  
Analytical Study ◽  
Preventive Therapy ◽  
Dar Es Salaam ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Cd4 Counts ◽  
Factors Associated ◽  
Care And Treatment ◽  
Living With Hiv

Abstract Background: Tuberculosis (TB) disease is a common opportunistic infection among people living with HIV (PLHIV). WHO recommends at least six months of isoniazid Preventive Therapy (IPT) to reduce the risk of active TB. It is important to monitor completion of IPT, as a suboptimal dose may not protect PLHIV from TB infection. This study determined IPT completion and its determinants among PLHIV aged 15 years or more in Dar es Salaam region, Tanzania. Methods: A Cross-sectional analytical study was conducted using secondary analysis of routine data from 58 care and treatment clinics in Dar es Salaam region. The study recruited clients who screened negative for TB symptoms and initiated IPT between January 2013 and June 2017. Modified Poisson regression model with robust standard errors were used to estimate prevalence ratios (PR) and 95% confidence interval (CI) for factors associated with IPT completion. Multilevel analysis was used to account the health facility random effects in order to estimate independent factors associated with IPT completion. Results : A total of 29,382 clients were initiated on IPT, with 21,808 (74%) female. Overall 17,092 (58%) completed IPT, increasing from 42% (773/1,857) in year 2013 to 76% (2,929/3,856) in 2017. Multilevel multivariable model accounting for health facility as clusters, found that clients with CD4 counts between 100 to 349 cells/ had 3% lower prevalence of IPT completion as compared to those with 100 cells/ (PR:0.97: 95%CI:0.94-1.01). Patients who were not on ART had 46% lower IPT completion compared to those were on ART (PR: 0.54: 95%CI: 0.45-0.64). There was lower IPT completion among clients who transferred to another clinic compared to those attended the same clinic where they were initiated IPT (PR: 0.63: 95% CI (0.54-0.74). Conclusion: IPT completion is low at care and treatment clinics although it increased over time. Lower IPT completion was seen in PLHIV with CD4 counts between 100 to 349 cells/ , those who transferred to other clinics and those not on ART. Thus it indicates the need for better IPT interventions with greater support PLHIV in those groups.

scholarly journals Determinants of Isoniazid Preventive Therapy Completion among People Living with HIV Attended Care and Treatment from 2013 to 2017 in Dar es Salaam Region,Tanzania. A cross-sectional analytical study

2019 ◽  
Author(s):  
Masanja Robert
Keyword(s):  
Health Facility ◽  
Analytical Study ◽  
Preventive Therapy ◽  
Dar Es Salaam ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Cd4 Counts ◽  
Factors Associated ◽  
Care And Treatment ◽  
Living With Hiv

Abstract Background: Tuberculosis (TB) disease is a common opportunistic infection among people living with HIV (PLHIV). WHO recommends at least six months of isoniazid Preventive Therapy (IPT) to reduce the risk of active TB. It is important to monitor completion of IPT, as a suboptimal dose may not protect PLHIV from TB infection. This study determined IPT completion and its determinants among PLHIV aged 15 years or more in Dar es Salaam region, Tanzania. Methods: A Cross-sectional analytical study was conducted using secondary analysis of routine data from 58 care and treatment clinics in Dar es Salaam region. The study recruited clients who screened negative for TB symptoms and initiated IPT between January 2013 and June 2017. Modified Poisson regression model with robust standard errors were used to estimate prevalence ratios (PR) and 95% confidence interval (CI) for factors associated with IPT completion. Multilevel analysis was used to account the health facility random effects in order to estimate independent factors associated with IPT completion. Results : A total of 29,382 clients were initiated on IPT, with 21,808 (74%) female. Overall 17,092 (58%) completed IPT, increasing from 42% (773/1,857) in year 2013 to 76% (2,929/3,856) in 2017. Multilevel multivariable model accounting for health facility as clusters, found that clients with CD4 counts between 100 to 349 cells/ had 3% lower prevalence of IPT completion as compared to those with 100 cells/ (PR:0.97: 95%CI:0.94-1.01). Patients who were not on ART had 46% lower IPT completion compared to those were on ART (PR: 0.54: 95%CI: 0.45-0.64). There was lower IPT completion among clients who transferred to another clinic compared to those attended the same clinic where they were initiated IPT (PR: 0.63: 95% CI (0.54-0.74). Conclusion: IPT completion is low at care and treatment clinics although it increased over time. Lower IPT completion was seen in PLHIV with CD4 counts between 100 to 349 cells/ , those who transferred to other clinics and those not on ART. Thus it indicates the need for better IPT interventions with greater support PLHIV in those groups. Keywords: IPT completion, HIV, tuberculosis, predictors, Tanzania

scholarly journals Determinants of Isoniazid Preventive Therapy Completion among People Living with HIV Attended Care and Treatment  Clinics from 2013 to 2017 in Dar es Salaam Region,Tanzania. A cross-sectional analytical study

2020 ◽  
Author(s):  
Masanja Robert ◽  
Jim Todd ◽  
Bernard J Ngowi ◽  
Sia Msuya ◽  
Angella Ramadhani ◽  
...  
Keyword(s):  
Health Facility ◽  
Analytical Study ◽  
Preventive Therapy ◽  
Dar Es Salaam ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Cd4 Counts ◽  
Factors Associated ◽  
Care And Treatment ◽  
Living With Hiv

Abstract Background: Tuberculosis (TB) disease is a common opportunistic infection among people living with HIV (PLHIV). WHO recommends at least six months of isoniazid Preventive Therapy (IPT) to reduce the risk of active TB. It is important to monitor completion of IPT, as a suboptimal dose may not protect PLHIV from TB infection. This study determined IPT completion and its determinants among PLHIV aged 15 years or more in Dar es Salaam region, Tanzania. Methods: A Cross-sectional analytical study was conducted using secondary analysis of routine data from 58 care and treatment clinics in Dar es Salaam region. The study recruited clients who screened negative for TB symptoms and initiated IPT between January 2013 and June 2017. Modified Poisson regression model with robust standard errors were used to estimate prevalence ratios (PR) and 95% confidence interval (CI) for factors associated with IPT completion. Multilevel analysis was used to account the health facility random effects in order to estimate independent factors associated with IPT completion. Results : A total of 29,382 clients were initiated on IPT, with 21,808 (74%) female. Overall 17,092 (58%) completed IPT, increasing from 42% (773/1,857) in year 2013 to 76% (2,929/3,856) in 2017. Multilevel multivariable model accounting for health facility as clusters, found that clients with CD4 counts between 100 to 349 cells/ had 3% lower prevalence of IPT completion as compared to those with 100 cells/ (PR:0.97: 95%CI:0.94-1.01). Patients who were not on ART had 46% lower IPT completion compared to those were on ART (PR: 0.54: 95%CI: 0.45-0.64). There was lower IPT completion among clients who transferred to another clinic compared to those attended the same clinic where they were initiated IPT (PR: 0.63: 95% CI (0.54-0.74). Conclusion: IPT completion is low at care and treatment clinics although it increased over time. Lower IPT completion was seen in PLHIV with CD4 counts between 100 to 349 cells/ , those who transferred to other clinics and those not on ART. Thus it indicates the need for better IPT interventions with greater support PLHIV in those groups.

Factors influencing adherence to antiretroviral therapy among people living with HIV in an urban and rural setting Tanzania

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Rural Setting ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Early Presentation ◽  
Care And Treatment ◽  
One Year ◽  
Ofthe Time ◽  
Living With Hiv

Adherence is one of the most crucial determinants of treatment response toantiretroviral therapy (ART). An analytical cross-sectional study was conducted in24 Care and Treatment Centres (CTC) in Dar es Salaam and Iringa regions inTanzania. Data was collected using questionnaire and appointments records. A totalof 943 patients attending at the care and treatment sites in Dar es Salaam and Iringawere recruited. Adherence based on keeping appointments and on four days recallwas 65% and 70%, respectively. Adherence based on taking ART more than 95% ofthe time in one month was 83%. Satisfaction with health services, having treatmentsupport, having knowledge on the use of ART, early presentation to CTC, and beingon ART for more than one year, were associated with good adherence. Being in theurban region, using traditional medicine, medicine side effects and alcoholconsumption problems negatively associated with adherence to ART.

scholarly journals Barriers to timely disclosure of HIV serostatus: A qualitative study at care and treatment centers in Dar es Salaam, Tanzania

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256537
Author(s):  
Neelam Ismail ◽  
Nancy Matillya ◽  
Riaz Ratansi ◽  
Columba Mbekenga
Keyword(s):  
Social Status ◽  
Disease Transmission ◽  
Qualitative Content Analysis ◽  
Dar Es Salaam ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Negative Consequences ◽  
Hiv Serostatus ◽  
Care And Treatment ◽  
Living With Hiv

Introduction Disclosure of Human Immunodeficiency Virus (HIV) status is important to prevent the spread of HIV and maintain the health of people living with HIV, their spouses, and the community. Despite the benefits of disclosure, many people living with HIV delay disclosing their status to those close to them thereby increasing the risk for disease transmission. This study aimed to determine the barriers to timely disclosure of HIV serostatus for people living with HIV in Dar es Salaam, Tanzania, and identify what motivated disclosure. Methods A qualitative descriptive study using in-depth individual interviews was conducted with10 participants attending HIV care and treatment centers in Dar es Salaam. The participants were people living with HIV who had delayed disclosing their serostatus for more than one month after diagnosis. Data was analyzed using qualitative content analysis. Results Three categories emerged from the analysis: Barriers hindering timely disclosure, motivation for disclosure of serostatus, and consequences of delayed disclosure. Barriers to timely disclosure included denial of one’s status, the fear of stigmatization, fear of being separated or divorced, the need to protect loved ones, and lack of adequate knowledge about the disease. Reasons that motivated disclosure included gaining social support, preventing disease transmission and wanting to be at peace. Conclusion Timely disclosure is hindered by stigma because HIV is negatively perceived by the public. People living with HIV prefer not to disclose to avoid the negative consequences of disclosure, especially because of fear of being discriminated against and losing their social status, which plays a major role in social status in Tanzania. Trust and adequate counseling from health care workers helps prompt disclosure.

scholarly journals Prevalence and socioeconomic factors associated with smoking in people living with HIV by sex, in Recife, Brazil

2013 ◽  
Vol 16 (2) ◽  
pp. 432-443 ◽  
Author(s):  
Joanna d’Arc Lyra Batista ◽  
Maria de Fátima Pessoa Militão de Albuquerque ◽  
Ricardo Arraes de Alencar Ximenes ◽  
Demócrito de Barros Miranda-Filho ◽  
Heloisa Ramos Lacerda de Melo ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Socioeconomic Factors ◽  
Low Income ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Heavy Alcohol ◽  
Factors Associated ◽  
Risk Of Death ◽  
Living With Hiv ◽  
Hiv Aids

Introduction: Smoking is the leading cause of preventable death in the world. The prevalence of smoking is higher in people infected with HIV than in the general population. Although it is biologically plausible that smoking increases the morbidity and mortality of people living with HIV/AIDS, few studies in developing countries have analyzed the determinants and consequences of smoking in HIV infected people. Objective: To estimate the prevalence of smoking and identify the socioeconomic factors associated with smoking and smoking cessation in patients with HIV by sex. Methods: A cross-sectional study was conducted with baseline data, obtained from an ongoing prospective cohort study of patients with HIV attending two referral centers in Recife, Northeast Region of Brazil, between July 2007 and October 2009. Results: The prevalence of current smoking was 28.9%. For both sexes, smoking was independently associated with heavy alcohol drinking and marijuana use. Among women, smoking was associated with living alone, not being married and illiteracy; and among men, being 40 years or older, low income and using crack. Compared with ex-smokers, current smokers were younger and more likely to be unmarried, heavy drinkers and marijuana users. Conclusions: It is important to incorporate smoking cessation interventions for the treatment of heavy alcohol drinkers and marijuana users with HIV/AIDS, which may increase life expectancy and quality of life, as smoking is related to risk of death, relapse of tuberculosis, and non communicable diseases.

scholarly journals Factors Associated with Anemia among People Living with HIV/AIDS Taking ART in Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Ketema Bizuwork Gebremedhin ◽  
Tadesse Bedada Haye
Keyword(s):  
Addis Ababa ◽  
Clinical Stage ◽  
Public Health Problem ◽  
People Living With Hiv ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Factors Associated ◽  
Living With Hiv ◽  
Hiv Aids

Background. Globally, anemia, among people living with HIV/AIDS, is a major public health problem. It has a significant effect on the progression of HIV/AIDS to advanced stages and there are a number of factors that often affect anemia. However, there is little insight regarding factors affecting anemia among HIV/AIDS patients in developing countries, including Ethiopia. Objective. This study aimed at investigating factors affecting anemia among people living with HIV/AIDS taking ART drug at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. A hospital based cross-sectional study design was used to assess factors affecting anemia among people living with HIV/AIDS. Structured checklist was used to gather information from charts of patients selected by simple random sampling method. We analyzed the data to identify factors associated with anemia among people with HIV/AIDS using logistic regression models. Results. A total of 301 selected charts were reviewed. The median age was 38 ± 10.38. The majority (62.5%) of the patients were taking ZDV-containing ART drug (ZDV/3TC/NVP). The overall anemia prevalence was 34.6%, while about 5%, 15.6%, and 14% of the patients had severe, moderate, and mild prevalence of anemia, respectively. Factors that were found to affect anemia among these patients include gender (OR = 2.26 [95% CI: 1.22, 4.16]), occupation (OR: 0.57 [95%CI: 0.35, 0.92]), WBC count (OR = 2.30 [95% CI: 1.29, 4.09]), platelet count (OR = 2.89 [95% CI: 0.99, 8.41]), nutritional status (OR = 2.05 [95% CI: 0.69, 6.02]), and WHO clinical stage of HIV/AIDS (OR = 3.69 [95% CI: 1.86, 7.31]). Conclusions. About one in three patients was found to be anemic. Intervention aimed at diagnosing and treating anemia among people living with HIV/AIDS should be considered.

scholarly journals Impact of Isoniazid Preventive Therapy on Tuberculosis incidence among people living with HIV: A secondary data analysis using Inverse Probability Weighting of individuals attending HIV care and treatment clinics in Tanzania

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254082
Author(s):  
Werner M. Maokola ◽  
Bernard J. Ngowi ◽  
Michael J. Mahande ◽  
Jim Todd ◽  
Masanja Robert ◽  
...  
Keyword(s):  
Observational Studies ◽  
Cox Regression ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Clinical Settings ◽  
Inverse Probability ◽  
Care And Treatment ◽  
Living With Hiv

Background Information on how well Isoniazid Preventive Therapy (IPT) works on reducing TB incidence among people living with HIV (PLHIV) in routine settings using robust statistical methods to establish causality in observational studies is scarce. Objectives To evaluate the effectiveness of IPT in routine clinical settings by comparing TB incidence between IPT and non-IPT groups. Methods We used data from PLHIV enrolled in 315 HIV care and treatment clinic from January 2012 to December 2016. We used Inverse Probability of Treatment Weighting to adjust for the probability of receiving IPT; balancing the baseline covariates between IPT and non-IPT groups. The effectiveness of IPT on TB incidence was estimated using Cox regression using the weighted sample. Results Of 171,743 PLHIV enrolled in the clinics over the five years, 10,326 (6.01%) were excluded leaving 161,417 available for the analysis. Of the 24,800 who received IPT, 1.00% developed TB disease whereas of the 136,617 who never received IPT 6,085 (4.98%) developed TB disease. In 278,545.90 person-years of follow up, a total 7,052 new TB cases were diagnosed. Using the weighted sample, the overall TB incidence was 11.57 (95% CI: 11.09–12.07) per 1,000 person-years. The TB incidence among PLHIV who received IPT was 10.49 (95% CI: 9.11–12.15) per 1,000 person-years and 12.00 (95% CI: 11.69–12.33) per 1,000 person-years in those who never received IPT. After adjusting for other covariates there was 52% lower risk of developing TB disease among those who received IPT compared to those who never received IPT: aHR = 0.48 (95% CI: 0.40–0.58, P<0.001). Conclusion IPT reduced TB incidence by 52% in PLHIV attending routine CTC in Tanzania. IPTW adjusted the groups for imbalances in the covariates associated with receiving IPT to achieve comparable groups of IPT and non-IPT. This study has added evidence on the effectiveness of IPT in routine clinical settings and on the use of IPTW to determine impact of interventions in observational studies.

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