scholarly journals Association between Antiretroviral Therapy and Cancers among Children Living with HIV in Sub-Saharan Africa

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1379
Author(s):  
Heather Haq ◽  
Peter Elyanu ◽  
Shaun Bulsara ◽  
Jason M. Bacha ◽  
Liane R. Campbell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Relative Risk ◽  
Sub Saharan Africa ◽  
World Health ◽  
Hiv Care ◽  
Incidence Density ◽  
Cancer Type ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Risk Of Cancer

Approximately 91% of the world’s children living with HIV (CLWH) are in sub-Saharan Africa (SSA). Living with HIV confers a risk of developing HIV-associated cancers. To determine the incidence and risk factors for cancer among CLWH, we conducted a nested case-control study of children 0–18 years from 2004–2014 at five centers in four SSA countries. Incident cases of cancer and HIV were frequency-matched to controls with HIV and no cancer. We calculated the incidence density by cancer type, logistic regression, and relative risk to evaluate risk factors of cancer. The adjusted incidence density of all cancers, Kaposi sarcoma, and lymphoma were 47.6, 36.6, and 8.94 per 100,000 person-years, respectively. Delayed ART until after 2 years of age was associated with cancer (OR = 2.71, 95% CI 1.51, 4.89) even after adjusting for World Health Organization clinical stage at the time of enrolment for HIV care (OR = 2.85, 95% CI 1.57, 5.13). The relative risk of cancer associated with severe CD4 suppression was 6.19 (p = 0.0002), 2.33 (p = 0.0042), and 1.77 (p = 0.0305) at 1, 5, and 10 years of ART, respectively. The study demonstrates the high risk of cancers in CLWH and the potential benefit of reducing this risk by the early initiation of ART.

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

scholarly journals The prevalence, awareness, management and control of hypertension in men and women in Benin, West Africa: the TAHES study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ileana Desormais ◽  
Salimanou Ariyoh Amidou ◽  
Yessito Corine Houehanou ◽  
Stephan Dismand Houinato ◽  
Gwladys Nadia Gbagouidi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Large Population ◽  
Community Dwelling ◽  
Sub Saharan Africa ◽  
Rural Setting ◽  
World Health ◽  
Cross Sectional ◽  
Men And Women ◽  
Sub Saharan

Abstract Background Due to epidemiological transitions, Sub-Saharan Africa is facing a growing burden of non-communicable diseases, including cardiovascular diseases (CVDs). Among their risk factors, hypertension is a major determinant of CVDs, but the prevalence and level of awareness and management of this condition are poorly studied in African populations. The aim of this study was to determine the prevalence of hypertension and identify its associated risk factors as well as the awareness and management of this condition in a community-dwelling cohort in Benin. Methods A cross-sectional door-to-door study was conducted in the population over the age of 25 years in Tanve, a rural setting in Benin. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured using standard procedures. Results The sample included 1777 subjects (60.9% females, mean age was 42.5 ± 16.5 years). The prevalence of hypertension was 32.9%, similar in men (32.8%) and women (33.0%, p = 0.9342). Age and obesity were significantly associated with hypertension. Less than half (42%) of hypertensive people were aware about their condition and only 46.3% of them were treated. Awareness ratios differed between men and women (respectively 32.9% vs. 47.5%; p = 0.0039) and was not influenced by age, education, occupation, marital status or income. Female sex was the only factor associated with better controlled HTN, independent of socio-economic parameters. Conclusion This large population-based study confirms the high prevalence, low awareness, and low control of hypertension in men and women in sub-Saharan Africa. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

scholarly journals The Prevalence, Awareness, Management and Control of Hypertension in Men and Women in Benin, West Africa: the TAHES study.

2019 ◽  
Author(s):  
ILEANA DESORMAIS ◽  
Salimanou Ariyoh Amidou ◽  
Yessito Corine Houehanou ◽  
Stephan Dismand Houinato ◽  
Gwladys Nadia Gbagouidi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Large Population ◽  
Community Dwelling ◽  
Sub Saharan Africa ◽  
Rural Setting ◽  
World Health ◽  
Cross Sectional ◽  
Men And Women ◽  
Sub Saharan

Abstract Background Sub-Saharan Africa is facing a growing burden of non-communicable diseases, including cardiovascular diseases (CVDs), due to epidemiological transitions. Among their risk factors, hypertension is a major determinant of CVDs, but the prevalence and level of awareness and management of this condition are poorly studied in African populations. The aim of this study was to determine the prevalence of hypertension and identify its associated risk factors as well as the awareness and management of this condition in a community-dwelling cohort in Benin. Methods A cross-sectional door-to-door study was conducted in the population over the age of 25 years in Tanve, a rural setting in Benin. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured using standard procedures. Results The sample included 1777 subjects (60.9% females, mean age was 42.5±16.5 years). The prevalence of hypertension was 32.9%, similar in men (32.8%) and women (33.0%, p=0.9342). Age and obesity were significantly associated with hypertension. Less than half (42%) of hypertensive people were aware about their condition and only 46.3% of them were treated. Awareness ratios differed between men and women (respectively 32.9% vs. 47.5%; p= 0.0039) and was not influenced by age, education, occupation, marital status or income. Female sex was the only factor associated with better controlled HTN, independent of socio-economic parameters. Conclusion This large population-based study confirms the high prevalence, low awareness, and low control of hypertension in men and women in sub-Saharan Africa. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

scholarly journals The Distribution of Work-Related Musculoskeletal Disorders Among Nurses in Sub-Saharan Africa: A Scoping Review Protocol

2020 ◽  
Author(s):  
Kagiso Kgakge ◽  
Mbuzeleni Hlongwa ◽  
Themba Ginindza
Keyword(s):  
Risk Factors ◽  
Musculoskeletal Disorders ◽  
Mortality Risk ◽  
Scoping Review ◽  
Sub Saharan Africa ◽  
World Health ◽  
Work Related ◽  
Work Related Musculoskeletal Disorders ◽  
Sub Saharan ◽  
Health Organization

Abstract Background Globally, work related musculoskeletal disorders (WMSD) have emerged as a major occupational public health concern among healthcare workers (HCW), in particular the nurses who are at the forefront of the healthcare delivery system. The 2016 Global Burden of Disease (GBD) data for non-communicable diseases reports that Disability Adjusted Life Year (DALYs) for musculoskeletal conditions increased by 61.6% between 1990 and 2016, with an increase of 19.6% between 2006 and 2016. Furthermore, World Health Organization (WHO, 2018), states that the sustainable development goals (SDGs) and the Decade of Healthy Ageing (DHA) 2020–2030 offer a timely and favorable opportunity for increased global attention and action on musculoskeletal health both at national and global level because the burden of disease profiles are shifting from communicable conditions to predominantly long-term non-communicable diseases, commonly including musculoskeletal conditions. Literature indicates that musculoskeletal disorders (MSD) constitute a notable occupational problem among the nurses with low back pain (LBP) being the most prevalent with consequent occupational injuries. There is an increase in literature regarding the MSD which poses a major threat to the health of nurses, hence there is need to investigate measures that can be used to mitigate the burden of LBP among nurses. Therefore, the scoping review will map the existing evidence on prevalence, incidence, mortality, risk factors and economic costs associated with MSD among nurses in Sub Saharan Africa (SSA). Methods and analysis Scoping review will be done to explore, describe and map literature on the prevalence, incidence, mortality, risk factors, and economic costs related to MSD among nurses in SSA. The search will be done using databases such as PubMed, MEDLINE, CINAHL, Google Scholar, nursing academic editions and World Health Organization (WHO) library databases. The search will look for primary studies within peer-reviewed articles as well as gray literature. The list of references from included studies will also be searched. This scoping review will be reported in accordance to the MOOSE and PRISMA-ScR guidelines. The NVivo 12 data analysis software will be used to generate themes, and a thematic content analysis will be used to give the narrative account of the review. Discussion At the end, this study anticipates to uncover the relevant literature in SSA in regard to prevalence, incidence, mortality, risk factors and costs related to MSD among nurses, furthermore findings from this study will help in identifying research gaps, informing policy, priority in funding and planning and to guide future research.

scholarly journals Characteristics and impacts ofSystematic review nutritional programmes to address undernutrition of adults living with HIV in sub-Saharan Africa: a systematic review of evidence

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e047205
Author(s):  
Fisaha Haile Tesfay ◽  
Sara Javanparast ◽  
Hailay Gesesew ◽  
Lillian Mwanri ◽  
Anna Ziersch
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Nutritional Recovery ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Nutritional Outcomes

ObjectivesAlthough some studies have identified various challenges affecting nutritional programmes to effectively tackle undernutrition among people living with HIV, evidence about the characteristics and impacts of these programmes on weight-related nutritional outcomes varies based on country contexts, specific programme goals and the implementation processes. This systematic review sought to synthesise evidence on the characteristics and impact of nutritional programmes on weight-related nutritional outcomes of people living with HIV in sub-Saharan Africa.DesignSystematic review.Data sourcesWe searched for primary studies published in the following databases: Web of Science, Medline, Scopus, ScienceDirect, ProQuest and Google Scholar, supplemented by checking reference lists of included papers.Eligibility criteriaStudies published from 2005 to 10 July 2020 and reporting on the weight-related nutritional outcomes of undernourished people enrolled in nutritional programmes in HIV care in sub-Saharan Africa were included.Data extraction and synthesisData were extracted using a data extraction proforma. Weight-related nutritional outcomes of people living with HIV before and after enrolment in a nutritional programme were compared and narratively synthesised.ResultsSixteen studies assessing the impact of nutritional programmes in HIV care on weight-related nutritional outcomes were included. Of these, 13 examined nutritional programmes implemented in health facilities and the remaining three were delivered outside of health facilities. Nutritional recovery (defined differently in the studies) ranged from 13.1% to 67.9%. Overall programme failure rate, which included default after enrolment in a nutritional programme or non-response, ranged from 37.6% to 48.0%. More specifically, non-response to a nutritional programme ranged from 21.0% to 67.4% and default from the programme ranged from 19.0% to 70.6%. Key sociodemographic, clinical and nutritional characteristics that affect nutritional recovery, non-response and default were also identified.Conclusions and recommendationsNutritional programmes in HIV care have led to some improvements in weight-related nutritional outcomes among people living with HIV. However, the programmes were characterised by a high magnitude of default and non-response. To improve desired weight-related nutritional outcomes of people living with HIV, a holistic approach that addresses longer-term determinants of undernutrition is needed.PROSPERO registration numberCRD42020196827.

Growing Up with HIV/AIDS

2019 ◽  
Author(s):  
Stephanie Shiau ◽  
Lindsey Reif
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Hiv Infections ◽  
Pediatric Hiv ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Close Monitoring ◽  
Sub Saharan ◽  
Pediatric Hiv Care ◽  
Living With Hiv

Largely due to increased success in prevention of mother-to-child transmission, new HIV infections among children globally have declined by 47 percent since 2010, from 300,000 in 2010 to 160,000 in 2016. However, the epidemic continues. In 2016 2.1 million children under fifteen years old were estimated to be living with HIV globally, with 85 percent living in sub-Saharan Africa. Without access to HIV care and antiretroviral therapy (ART), infants and younger children living with HIV are at high risk for mortality, with a mortality rate of about 30 percent by the first year of life and 50 percent by their second year. Therefore, prompt diagnosis and adherence to effective ART is critical. Early infant diagnosis is becoming more widely available globally, allowing for earlier identification of infection close to birth and opportunities to start treatment early in infants and the potential for cure strategies. With effective treatment, pediatric HIV infection has been transformed from a fatal disease to a lifelong chronic disease. Much of pediatric HIV care focuses on co-morbidities related to long-term HIV infection and its treatment. In addition, children living with HIV require close monitoring as they age into adolescence, a high-risk period when they navigate mental, physical, and emotional development. As adolescents become independent from parents or guardians and face choices regarding relationships, sexual behavior, and alcohol and drug use, they are at high risk for poor adherence to ART.

scholarly journals Examining the relationship between interpersonal support and retention in HIV care among HIV+ nursing mothers in Uganda

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Jerry John Nutor ◽  
Pascal Agbadi ◽  
Thomas J. Hoffmann ◽  
Geoffrey Anguyo ◽  
Carol S. Camlin
Keyword(s):  
Sub Saharan Africa ◽  
Hiv Care ◽  
Interpersonal Support ◽  
Women Living With Hiv ◽  
Retention In Hiv Care ◽  
Nursing Mothers ◽  
Pediatric Populations ◽  
Sub Saharan ◽  
Living With Hiv ◽  
The Relationship

Abstract Objective The global burden of HIV on women and pediatric populations are severe in sub-Saharan Africa. Global child HIV infection rates have declined, but this rate remains quite high in sub-Saharan Africa due to Mother-to-child transmission (MTCT). To prevent MTCT of HIV, postpartum women living with HIV (WLHIV) are required to return to a health facility for HIV care within 60 days after childbirth (Retention in HIV care). Studies suggest that interpersonal support was positively associated with retention in HIV care. However, information on this association is lacking among postpartum WLHIV in Uganda. Therefore, this study investigates the relationship between interpersonal support, measured with the Interpersonal Support Evaluation List (ISEL-12), and retention in HIV care. Results In a total of 155 postpartum WLHIV, 84% were retained in HIV care. ISEL-12 was negatively associated with retention in HIV care. Postpartum WLHIV retained in care (24.984 ± 4.549) have lower ISEL-12 scores compared to the non-retained group (27.520 ± 4.224), t(35.572) = − 2.714, p = 0.01. In the non-income earning sample, respondents retained in care (24.110 ± 4.974) have lower ISEL scores compared to the non-retained group (27.000 ± 4.855), t(20.504) = -2.019, p = 0.049. This was not significant among income earning WLHIV.

scholarly journals Physiotherapists’ awareness of risk of bone demineralisation and falls in people living with HIV: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Y. Charumbira ◽  
Karina Berner ◽  
Quinette Louw
Keyword(s):  
Falls Prevention ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Primary Study ◽  
People Living With Hiv ◽  
Falls Risk ◽  
Risk Of Falls ◽  
Patient Assessments ◽  
Sub Saharan ◽  
Living With Hiv

Abstract Background Recent research has indicated a seemingly increased propensity for both falls and accelerated bone loss in people living with HIV (PLWH). Physiotherapists play a crucial role in optimising function and quality of life of PLWH through prevention of falls and reducing the harm that results. Aim This study aimed to explore physiotherapists’ awareness of falls risk and accelerated bone demineralisation in PLWH and their perceptions of current falls prevention strategies in the care of PLWH in selected regions of sub-Saharan Africa. Method An exploratory descriptive qualitative research method was employed to explore physiotherapists’ perceptions and experiences regarding bone health and falls in PLWH. In-depth semi-structured telephonic interviews were used to collect data from 21 physiotherapists working in primary HIV care. Transcribed interview data were coded in Atlas.ti.8® and analysed using inductive thematic analysis. Results The primary study revealed a lack of awareness by physiotherapists of falls risk and bone demineralisation in PLWH. As such, physiotherapists did not link falls or fractures to HIV or antiretroviral therapy (ART) when they did observe such events during their general patient assessments. However, in retrospect, some physiotherapists were able to recognise risk factors linked to falls in those with HIV. Current services for falls prevention, as perceived by the physiotherapists, were sub-optimal. Conclusion Physiotherapists may need to be more aware of the potential risk of falls and bone demineralisation in PLWH and routinely assess for these phenomena in both older and younger PLWH.

scholarly journals Sexually transmitted infections in pregnant women from sub-Saharan Africa

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Bongekile Ngobese ◽  
Nathlee S. Abbai
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Sub Saharan Africa ◽  
Sexually Transmitted ◽  
Women Living With Hiv ◽  
Pregnancy And Birth Outcomes ◽  
Sub Saharan ◽  
Stis And Hiv ◽  
Living With Hiv ◽  
Pregnancy And Birth

Background: Sexually transmitted infections (STIs) are a major health problem in most countries of the world, particularly in developing countries where the resources and technology to diagnose and treat them are limited. Currently, there is limited data on STIs and risk factors for these infections in pregnant women living with human immunodeficiency virus (HIV), especially in sub-Saharan Africa (SSA). This review provides data on the prevalence and risk factors for STIs in pregnant women living with HIV from SSA. This review also describes the association between STIs and HIV on pregnancy and birth outcomes as well as highlights the importance of laboratory-based diagnosis of STIs.Method: An electronic search of online databases was used to find and collect relevant research articles connected to the prevalence, adverse pregnancy and birth outcomes, health complications and risk factors associated with STIs and HIV in pregnant women from SSA. The search was limited to articles published in English. Relevant studies were identified by searching literature from January 2001 to date. The search yielded 4709 results.Results: In SSA, STIs are highly prevalent in pregnant women and are widely known to be linked with an increased risk of poor maternal and neonatal outcomes. These infections are often asymptomatic and highly prevalent in pregnant women. The screening of STIs in pregnant women living with HIV can reduce the risk of mother-to-child transmission (MTCT) and screening and treatment for STIs can also prevent adverse perinatal outcomes. It is important to recognise regional and national STI epidemics in order to promote STI prevention and control interventions considering the test and treat approach as opposed to syndromic management.Conclusion: This review highlights the need to use diagnostic screening methods instead of syndromic STI management in SSA. Moreover, more research into effective prevention and treatment measures for STIs in pregnant women is urgently required.

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