scholarly journals Comparative incidence of adverse drug reaction during the first and subsequent year of antiretroviral therapy in a Nigerian HIV infected cohort

2021 ◽  
Vol 21 (3) ◽  
pp. 1027-1039
Author(s):  
Isaac O Abah ◽  
Wetkos D Dayom ◽  
Dauda A Dangiwa ◽  
Roseline Aderemi-Williams ◽  
Joseph Anejo-Okopi ◽  
...  

Background: Despite close to two decades of antiretroviral therapy (ART) in Nigeria, data on late on-onset ART-associated adverse drug reactions (ADRs) are sparse. Objectives: To describe early and late-onset ADRs and compare their incidence in an outpatient HIV positive Cohort on ART. Method: We described the incidence of clinical ADRs identified and documented in an outpatient clinic cohort of HIV-pos- itive patients treated between June 2004 and December 2015 at a tertiary health facility in Nigeria. Incidence rates of ADRs during the first and subsequent years of ART were compared. Results: of the 13,983 patients’ data analyzed, 9317 were females (66%), and those in the age bracket of 25 to 45 years made up 78% of the studied population. During 52,411 person-years (py) of ART, 1485 incident ADRs were recorded; Incidence rate (IR) 28.3 (95% confidence interval [CI] 26.9:29.8) ADRs per 1000 person-years (py) of ART. The IR of ADRs was about two times higher in the first year of ART compared to subsequent years of treatment; crude incidence rate ratio (IRR) 1.77 (95% CI 1.59:1.97). Anemia, hypersensitivity reactions, and nervous system disorders had 7, 23, and 5 times higher incidence, respectively, in the first year of therapy, compared to subsequent years. Conclusion: The first year of ART is the period of highest risk of ADRs. Individual and programmatic treatment success in resource-limited settings requires strategies for early identification and management of ADR during the period of greatest risk of ADRs. Keywords: Adverse drug events; antiretroviral therapy; drug toxicity; sub- Saharan Africa.

2021 ◽  
Author(s):  
Deepa Jahagirdar ◽  
Magdalene Walters ◽  
Avina Vongpradith ◽  
Xiaochen Dai ◽  
Amanda Novotney ◽  
...  

AbstractHIV incidence in sub-Saharan Africa declined substantially between 2000 and 2015. In this analysis, we consider the relative associations of nine structural and individual determinants with this decline. A linear mixed effects model of logged HIV incidence rates versus determinants was used. The data were from mathematical modelling as part of the 2019 Global Burden of Disease Study in 43 sub-Saharan African countries. We used forwards selection to determine a single final model of HIV incidence rate. The association of economic variables and HIV knowledge with incidence was found to be driven by education, while ART coverage had the largest impact on other determinants’ coefficients. In the final model, education years per capita contributed the most to explaining variation in HIV incidence rates; a 1-year increase in mean education years was associated with a 0.39 (− 0.56; − 0.2, t = − 4.48 p < 0.01) % decline in incidence rate while a unit increase in ART coverage was associated with a 0.81 (− 1.34; − 0.28, t = − 3.01, p < 0.01) % decline in incidence rate.


2010 ◽  
Vol 10 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Anthony D Harries ◽  
Rony Zachariah ◽  
Joep J van Oosterhout ◽  
Steven D Reid ◽  
Mina C Hosseinipour ◽  
...  

2019 ◽  
Vol 4 (6) ◽  
pp. e001922
Author(s):  
Hana Kim ◽  
Adam Branscum ◽  
F DeWolfe Miller ◽  
Diego F Cuadros

IntroductionTanzania is one of the 14 priority countries in sub-Saharan Africa scaling up voluntary medical male circumcision (VMMC) for HIV prevention. In this study, we assessed the progress of VMMC by evaluating changes in the spatial structure of male circumcision (MC) prevalence and identifying age groups with low MC uptake.MethodsWe use data from two waves of the Demographic and Health Survey (DHS) conducted in Tanzania in 2011–2012 and 2015–2016. MC incidence rate was estimated using a method developed to calculate incidence rates from two successive cross-sectional surveys. Continuous surface maps of MC prevalence were generated for both DHS waves and compared with identified areas with high MC prevalence changes and high density of uncircumcised males.ResultsNational MC prevalence in Tanzania increased from 73.5% in 2011–2012 to 80.0% in 2015–2016. The estimated national MC incidence rate was 4.6 circumcisions per 100 person-years (py). The lowest circumcision rate was observed in males aged 20–24 years, with 0.61 circumcisions per 100 py. An estimated 1 567 253 males aged 15–49 years residing in low-MC prevalence areas were uncircumcised in 2015–2016.ConclusionTanzania has shown substantial progress in the implementation of VMMC. However, extensive spatial variation of MC prevalence still exists in the country, with some areas having an MC prevalence <60%. Here, we identified locations where VMMC needs to be intensified to reach the ~1.5 million uncircumcised males age 15–49 living in these low-MC areas, particularly for men aged 20–34.


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