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 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 Renal Dysfunction among HIV-Infected Patients on Antiretroviral Therapy in Dar es Salaam, Tanzania: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Oswin Mwemezi ◽  
Paschal Ruggajo ◽  
Jonathan Mngumi ◽  
Francis F Furia
Keyword(s):  
Diabetes Mellitus ◽  
Renal Dysfunction ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Cross Sectional ◽  
Viral Loads ◽  
Increased Risk ◽  
Living With Hiv

Background. HIV-associated renal dysfunction is common among infected patients; the growing burden of this condition may be partly accounted for by improved survival attributed to sustained viral suppression with antiretroviral therapies (ART). Some ART regimens are nephrotoxic and may potentially contribute to renal dysfunction observed in these patients. This study aimed at investigating the prevalence of renal dysfunction among people living with HIV (PLHIV) on ART attending the care and treatment clinic (CTC). Methods. A cross-sectional study was conducted between June and October 2019 among adults living with HIV on ART for 6 months or more attending CTC at Muhimbili National Hospital in Dar es Salaam, Tanzania. A total of 287 participants were screened for proteinuria and microalbuminuria using the Cybow 300 urine analyzer. Serum creatinine was tested for all participants, and it was used to estimate glomerular filtration rate (eGFR) using the CKD-EPI formula. Results. Out of 287 participants (72.1% female, mean age ± SD: 46.7 ± 10.6 years), about one-third (32.8%) had eGFR less than 90 ml/min, whereas 7% had eGFR less than 60 ml/min. Microalbuminuria and proteinuria were detected in 38.6% and 25.1% of participants, respectively. In the multivariate analysis, predictive determinants for renal dysfunction were higher viral loads (OR 2.5 (1.1–5.8), p=0.031), diabetes mellitus (OR 5.5 (1.6–18.6), p=0.006), and age above 60 years (OR 2.8 (1.0–7.3), p=0.041); however, this was not the case for serum CD4 counts (OR 1.25 (0.7–2.3), p=0.46). Conclusion. High prevalence of renal dysfunction among PLHIV on ART was noted in this study. Viral loads above 1000 cp/ml and diabetes mellitus were noted to be associated with increased risk for renal dysfunction.

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.

Prevalence of COVID-19-like Symptoms among People Living with HIV, and Using Antiretroviral Therapy for Prevention and Treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 373-380 ◽  
Author(s):  
SeyedAhmad SeyedAlinaghi ◽  
Maryam Ghadimi ◽  
Mahboubeh Hajiabdolbaghi ◽  
Mehrnaz Rasoolinejad ◽  
Ladan Abbasian ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Antiretroviral Treatment ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Shortness Of Breath ◽  
Sectional Study ◽  
Limited Data ◽  
Cross Sectional ◽  
Living With Hiv

Background: COVID-19 has spread globally with remarkable speed, and currently, there is limited data available exploring any aspect of the intersection between HIV and SARSCoV- 2 co-infection. Objective: To estimate the prevalence of clinical symptoms associated with COVID-19 among people living with HIV (PLWH) in Tehran, Iran. Design: Cross-sectional study. Methods: A total of 200 PLWH were recruited through the positive club via sampling, and completed the symptom-based questionnaire for COVID-19, which was delivered by trained peers. Results: Of 200 participants, respiratory symptoms, including cough, sputum, and shortness of breath, were the most prevalent among participants, but only one person developed symptoms collectively suggested COVID-19 and sought treatments. Conclusions: It appears that existing infection with HIV or receiving antiretroviral treatment (ART) might reduce the susceptibility to the infection with SARS-CoV-2 or decrease the severity of the infection acquired. Further research is needed to understand causal mechanisms.

Metabolic Syndrome in HIV-patients in Antiretroviral Therapy

2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
International Diabetes Federation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
History Of ◽  
Family History Of Hypertension ◽  
Living With Hiv

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

scholarly journals Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049824
Author(s):  
Andreas D Haas ◽  
Cordelia Kunzekwenyika ◽  
Stefanie Hossmann ◽  
Josphat Manzero ◽  
Janneke van Dijk ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Suicidal Ideation ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Living With Hiv

ObjectivesTo examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART).SettingSixteen government-funded health facilities in the rural Bikita district of Zimbabwe.DesignCross-sectional study.ParticipantsHIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least 6 months.Outcome measuresThe primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms and suboptimal ART adherence.ResultsOut of 3480 adults, 18.8% (95% CI 14.8% to 23.7%) screened positive for CMD, 2.7% (95% CI 1.5% to 4.7%) reported suicidal ideations, and 1.5% (95% CI 0.9% to 2.6%) reported perceptual symptoms. Positive CMD screens were more common in women (aPR 1.67, 95% CI 1.19 to 2.35) than in men and were more common in adults aged 40–49 years (aPR 1.47, 95% CI 1.16 to 1.85) or aged 50–59 years (aPR 1.51, 95% CI 1.05 to 2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37 to 1.70).ConclusionsA substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programmes in rural Zimbabwe.Trial registration numberNCT03704805.

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