scholarly journals Malnutrition and associated factors among adults starting on antiretroviral therapy at PASADA Hospital in Temeke District, Tanzania

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Titus K. Kabalimu ◽  
Edson Sungwa ◽  
Warles C. Lwabukuna
Keyword(s):  
Nutritional Assessment ◽  
The Body ◽  
Sub Saharan Africa ◽  
Severe Malnutrition ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Cd4 Cell Count ◽  
Art Initiation ◽  
Sub Saharan ◽  
Hiv Aids

Background: Malnutrition is known to play a significant role in HIV/AIDS progression. Severe malnutrition has been previously found to be associated with early mortality among people living with HIV/AIDS (PLHIV) undergoing anti-retroviral therapy (ART) in Sub-Saharan Africa. The objective of this study was to determine the prevalence and factors associated with malnutrition among adult PLHIV attending care and treatment centre (CTC) in Temeke District, Tanzania.Methods: The cross-sectional descriptive study involved consecutive eligible patients attending the CTC for initiating in ART, between January and April, 2014. All participants who agreed to sign a consent form were enrolled. The participants had undergone baseline workup for ART initiation (by CTC), which included blood tests for liver and renal function tests, and CD4+ cell count, using calibrated instruments and standard techniques. In all patients the weight and height were measured to calculate the body mass index (BMI), denoting the nutritional status. This parameter was recorded in the study instrument together with the CD4+ count for each patient. A structured questionnaire was used to obtain more information, namely demographic and lifestyle data.Results:  A total of 125 patients were included in this study. The prevalence of malnutrition among participants was 19.4%.  Those with severe malnutrition comprised of 9%. Significant association was noted between malnutrition and irregular income (OR= 3.8, CI: 1.2-11.5) and also inability to get at least two meals a day (OR= 3.4, CI: 1.2-9.2).  Severe malnutrition was significantly associated with the CD4+ counts of <200 cells/mm(OR =7.6; CI: 1.7-34.6).Conclusion: About 19% of participants were malnourished at the time of initiation of ART and among them 9% were severely malnourished. The most important risks for malnutrition were found to be irregular income and inability to get adequate feeding. This calls for routine nutritional assessment at CTCs prior to initiation of ART so as to identify those who need immediate intervention, including those with severe malnutrition.

scholarly journals Stigmatising Attitudes Towards Co-workers with HIV in the Workplace of a Metropolitan State, Southwestern Nigeria

2017 ◽  
Vol 11 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Idongesit Godwin Utuk ◽  
Kayode Omoniyi Osungbade ◽  
Taiwo Akinyode Obembe ◽  
David Ayobami Adewole ◽  
Victoria Oluwabunmi Oladoyin
Keyword(s):  
Sampling Technique ◽  
Sub Saharan Africa ◽  
Good Knowledge ◽  
People Living With Hiv ◽  
Cross Sectional Survey ◽  
Southwestern Nigeria ◽  
Cross Sectional ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Hiv Aids

Background:Despite demonstrating global concerns about infection in the workplace, very little research has explored how co-workers react to those living with HIV in the workplace in sub-Saharan Africa. This study aimed to assess the level of stigmatising attitude towards co-workers living with HIV in the workplace.Methods:The study was a descriptive cross-sectional survey involving 403 respondents. They were recruited from selected companies through a multistage sampling technique. Survey was carried out using pre-tested semi-structured questionnaires. Data were analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables at 5% level of significance. Logistic regression model was used to determine the predictors at 95% confidence intervals.Results:Mean age of respondents was 32.9 ± 9.4 years with 86.1% being females. Overall, slightly below two-third (63.0%) had good knowledge on transmission of HIV/AIDS while 218 (54.1%) respondents had a high stigmatising attitude towards co-workers with HIV in the workplace. More female respondents (69.6%) demonstrated high stigmatising attitudes towards co-workers with HIV in the workplace (p = 0.012). Female workers were twice more likely to have high stigmatising attitudes towards co-worker with HIV [OR 2.1 (95% CI: 1.13 – 3.83)].Conclusion:Stigma towards people living with HIV/AIDs is still very persistent in different settings. Good knowledge amongst our participants about HIV/AIDs did not translate to low stigmatising attitudes among workers. Concerted efforts and trainings on the transmission of HIV/AIDs are essential to reduce stigma that is still very prevalent in workplace settings.

Global prevalence and burden of HIV-associated neurocognitive disorder

Neurology ◽  
2020 ◽  
Vol 95 (19) ◽  
pp. e2610-e2621 ◽  
Author(s):  
Yunhe Wang ◽  
Moxuan Liu ◽  
Qingdong Lu ◽  
Michael Farrell ◽  
Julia M. Lappin ◽  
...  
Keyword(s):  
Data Extraction ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cross Sectional ◽  
Asymptomatic Neurocognitive Impairment ◽  
Cd4 Cell Count ◽  
Hiv Associated Neurocognitive Disorder ◽  
Sub Saharan ◽  
High Level

ObjectiveTo characterize the prevalence and burden of HIV-associated neurocognitive disorder (HAND) and assess associated factors in the global population with HIV.MethodsWe searched PubMed and Embase for cross-sectional or cohort studies reporting the prevalence of HAND or its subtypes in HIV-infected adult populations from January 1, 1996, to May 15, 2020, without language restrictions. Two reviewers independently undertook the study selection, data extraction, and quality assessment. We estimated pooled prevalence of HAND by a random effects model and evaluated its overall burden worldwide.ResultsOf 5,588 records identified, we included 123 studies involving 35,513 participants from 32 countries. The overall prevalence of HAND was 42.6% (95% confidence interval [CI] 39.7–45.5) and did not differ with respect to diagnostic criteria used. The prevalence of asymptomatic neurocognitive impairment, mild neurocognitive disorder, and HIV-associated dementia were 23.5% (20.3–26.8), 13.3% (10.6–16.3), and 5.0% (3.5–6.8) according to the Frascati criteria, respectively. The prevalence of HAND was significantly associated with the level of CD4 nadir, with a prevalence of HAND higher in low CD4 nadir groups (mean/median CD4 nadir <200 45.2% [40.5–49.9]) vs the high CD4 nadir group (mean/median CD4 nadir ≥200 37.1% [32.7–41.7]). Worldwide, we estimated that there were roughly 16,145,400 (95% CI 15,046,300–17,244,500) cases of HAND in HIV-infected adults, with 72% in sub-Saharan Africa (11,571,200 cases, 95% CI 9,600,000–13,568,000).ConclusionsOur findings suggest that people living with HIV have a high burden of HAND in the antiretroviral therapy (ART) era, especially in sub-Saharan Africa and Latin America. Earlier initiation of ART and sustained adherence to maintain a high-level CD4 cell count and prevent severe immunosuppression is likely to reduce the prevalence and severity of HAND.

scholarly journals Pandemics and Burden of Stroke and Epilepsy in Sub-Saharan Africa: Experience from a Longstanding Health Programme

2021 ◽  
Vol 18 (5) ◽  
pp. 2766
Author(s):  
Massimo Leone ◽  
Fausto Ciccacci ◽  
Stefano Orlando ◽  
Sandro Petrolati ◽  
Giovanni Guidotti ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Combined Treatment ◽  
Cerebrovascular Disorders ◽  
Sub Saharan Africa ◽  
Noncommunicable Diseases ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Health Programme ◽  
Excess Deaths ◽  
Hiv Aids

Eighty percent of people with stroke live in low- to middle-income nations, particularly in sub-Saharan Africa (SSA) where stroke has increased by more than 100% in the last decades. More than one-third of all epilepsy−related deaths occur in SSA. HIV infection is a risk factor for neurological disorders, including stroke and epilepsy. The vast majority of the 38 million people living with HIV/AIDS are in SSA, and the burden of neurological disorders in SSA parallels that of HIV/AIDS. Local healthcare systems are weak. Many standalone HIV health centres have become a platform with combined treatment for both HIV and noncommunicable diseases (NCDs), as advised by the United Nations. The COVID-19 pandemic is overwhelming the fragile health systems in SSA, and it is feared it will provoke an upsurge of excess deaths due to the disruption of care for chronic diseases such as HIV, TB, hypertension, diabetes, and cerebrovascular disorders. Disease Relief through Excellent and Advanced Means (DREAM) is a health programme active since 2002 to prevent and treat HIV/AIDS and related disorders in 10 SSA countries. DREAM is scaling up management of NCDs, including neurologic disorders such as stroke and epilepsy. We described challenges and solutions to address disruption and excess deaths from these diseases during the ongoing COVID-19 pandemic.

scholarly journals Synthesizing evidence on nutrition challenges among people living with HIV/AIDS in sub- Saharan Africa: a protocol for a scoping review

2019 ◽  
Vol 6 (7) ◽  
pp. 3173 ◽  
Author(s):  
Tafadzwa Dzinamarira ◽  
Moreblessing Chipo Mashora
Keyword(s):  
Health Outcomes ◽  
Scoping Review ◽  
Sub Saharan Africa ◽  
Future Research ◽  
People Living With Hiv ◽  
Nutritional Management ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Improve Health ◽  
Hiv Aids

Background: Good nutritional status is highly significant for individuals who are infected with HIV. However, they still face a number of nutritional challenges. The proposed scoping review will map literature on the nutritional challenges facing people living with HIV/AIDS (PLWH) and guide future research in nutritional management to improve health outcomes for PLWH. Here we outline a scoping review protocol designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P 2015 Guidelines).Methods: The Arksey and O’Malley’s 2005 scoping methodological framework further improved by Levac et al. 2010 will guide the search and reporting. Searches will be conducted for eligible articles from MEDLINE (PubMed), MEDLINE, CINAHL, Academic Search Complete and ISI Web of Science (Science Citation Index) electronic databases. Two independent reviewers will conduct the search guided by an inclusion and exclusion criteria. Quality appraisal of the included articles will be conducted guided by the mixed methods appraisal tool 2018 version. We will employ NVivo version 12 for thematic content analysis.Conclusions: The findings of this review will guide future research in nutritional management to improve health outcomes for PLWH in sub-Saharan African. This review will be disseminated electronically in a published peer reviewed article and in print.

scholarly journals Mapping evidence on adolescents’ HIV-positive status disclosure in sub-Saharan Africa: a protocol for a scoping review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Patience Adzordor ◽  
Clement Avoka ◽  
Vitalis Bawontuo ◽  
Silas Agbesi ◽  
Desmond Kuupiel
Keyword(s):  
Hiv Infection ◽  
Scoping Review ◽  
Keyword Search ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Status Disclosure ◽  
Hiv Aids

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.

scholarly journals Validity of hemoglobin A1c for diagnosing diabetes among people with and without HIV in Uganda

2019 ◽  
Vol 30 (5) ◽  
pp. 479-485
Author(s):  
James Muchira ◽  
Eileen Stuart-Shor ◽  
Jen Manne-Goehler ◽  
Janet Lo ◽  
Alexander C Tsai ◽  
...  
Keyword(s):  
Hemoglobin A1c ◽  
Fasting Blood Glucose ◽  
High Specificity ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Cd4 Cell Count ◽  
Sub Saharan ◽  
And Gender ◽  
Living With Hiv ◽  
Cd4 Cell

Sub-Saharan Africa (SSA) is facing a growing co-epidemic of chronic HIV infection and diabetes. Hemoglobin A1c (A1c) may underestimate glycemia among people living with HIV (PLWH). We estimated the validity of A1c to diagnose diabetes among PLWH and HIV-uninfected persons in rural Uganda. Data were derived from a cohort of PLWH and age- and gender-matched HIV-uninfected comparators. We compared A1c to fasting blood glucose (FBG) using Pearson correlations, regression models, and estimated the sensitivity and specificity of A1c for detecting diabetes with FBG ≥126 mg/dL as reference standard. Approximately half (48%) of the 212 participants were female, mean age of 51.7 years (SD = 7.0) at enrollment. All PLWH (n = 118) were on antiretroviral therapy for a median of 7.5 years with mean CD4 cell count of 442 cells/µL. Mean FBG (89.7 mg/dL) and A1c (5.6%) were not different between PLWH and HIV-uninfected ( P > 0.50) groups, but the HIV-uninfected group had a higher prevalence of A1c >5.7% (33% vs. 20%, P = 0.024). We found a relatively strong correlation between A1c and FBG (r = 0.67). An A1c ≥6.5% had a poor sensitivity (46%, 95% CI 26–67%) but high specificity (98%, 95% CI 96–99%) for detecting diabetes. More work is needed to define an optimal A1c for screening diabetes in SSA.

Self-esteem and motivation with adherence of people living with HIV/AIDS (PLWHA) in Indonesia with antiretroviral therapy: a cross-sectional study

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Purwaningsih Purwaningsih ◽  
Candra Panji Asmoro ◽  
Yenis Anggi Prastiwi
Keyword(s):  
Antiretroviral Therapy ◽  
Self Esteem ◽  
Cross Sectional Study ◽  
The Body ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Sectional Study ◽  
Cross Sectional ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Introduction Antiretroviral therapy (ART) helps reduce the amount of human immunodeficiency virus (HIV) that enters the body in order to avoid acquired immune deficiency syndrome (AIDS) and prevents the occurrence of opportunistic infections and complications. This study aims to describe the correlation between self-esteem and motivation with adherence of people living with HIV/AIDS (PLWHA) in ART. Methods This cross-sectional study involved 91 PLWHA who joined a non-government organization (NGO) support group, determined through a purposive sampling technique. The demography, and questionnaires about self-esteem, motivation and adherence to ART were employed to collect the raw data. The data were then analyzed using Spearman’s rho test with the degree of significance at p < 0.05. Results The result showed that self-esteem (p = 0.000, r = 0.445) and motivation (p = 0.019, r = 0.246) had correlation with adherence of PLWHA with ART. Conclusion PLWHA can increase self-esteem and motivation so that they can improve ART adherence. Further research is expected to use an instrument more objectively as a measurement tool for ART adherence in addition to a questionnaire so as to obtain more accurate and specific results.

scholarly journals The impact of the availability of antiretroviral therapy on personal and community fear of HIV/AIDS, and HIV prevention practices in Rwimi, Uganda: A mixed-method study

2018 ◽  
Vol 1 (1) ◽  
pp. 1-14
Author(s):  
Nicole Naadu Ofosu ◽  
L. Duncan Saunders ◽  
Gian Jhangri ◽  
Afif Alibhai
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Prevention ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Sub Saharan Africa ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Sub Saharan ◽  
The Impact ◽  
Hiv Aids

The impact of the widespread availability of antiretroviral therapy (ART) on the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) related attitudes, behaviours and practices of the general population in Sub-Saharan Africa is understudied. We assessed the impact of ART availability on the fear of HIV/ AIDS (measured at both community and personal levels) and HIV prevention practices in Rwimi, Uganda using a cross-sectional survey. The fear of HIV/AIDS was described as a perceived threat to either self and/or community regarding the risk of contracting the disease, whereby the higher the perception of the threat, the greater the fear. We assessed associations between the outcomes of the dependent variables on both the community and personal fear of HIV/AIDS, and the independent variables of HIV/AIDS-related knowledge and demographics. Qualitative data was also generated from focus group discussions (FGD) on the context of the fear of HIV/AIDS and HIV pre- vention practices. The majority of participants (89.4%; males - 86.8%; females - 90.8%) felt that ART availability has reduced the fear of HIV/AIDS in the community. In contrast, fewer participants (22.4%; males - 24.4%; females – 21.2%) mentioned that their personal fear of HIV/AIDS has been reduced with the availability of ART. From the qualitative study, factors identified as influencing the fear of HIV/AIDS included stigma, fear of infection, and the inconvenience of being on ART. Although fear of HIV/AIDS persists, the fear is reduced because of the availability of life-prolonging ART. HIV prevention practices are influenced by socio-cultural norms (gender roles, relationship dynamics, power and trust), which, we argue, should be considered when de-signing sustainable HIV/AIDS prevention programs.

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