Late-stage disease at presentation to an HIV clinic in eastern Tanzania: A retrospective cross-sectional study

Mhozya, H; Bintabara, Deogratius; Kibusi, Stephen Methew; Mpondo, BC

doi:10.4314/mmj.v27i4.2

Cited by 14 publications

(7 citation statements)

References 10 publications

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“…The prevalence of LHD in the index study is similar to a prevalence rate of 61% reported in 2012 from Mexico (Crabtree-Ramirez et al, 2012). A lower prevalence rate of 40% was reported from a recent study done in eastern Tanzania (Mhozya et al, 2015). The difference in prevalence of LHD could partly be explained by the difference in study setting.…”

Section: Discussionsupporting

confidence: 82%

“…The CD4 counts were stratified into 2 with a cut-off point of 200cells/µl. Accordingly patients with CD4 counts <200cells/µl on diagnosis were coded as having Late HIV diagnosis as used in other studies (Crabtree-Ramirez et al, 2012;Beyene & Beyene 2015;Mhozya, 2015). Continuous variables were expressed as means with interquartile range and categorical data were expressed as frequencies and percentages.…”

Section: Discussionmentioning

confidence: 99%

“…Eligible patients were invited and were asked for a consent to participate in this study. A minimum sample size of 634 patients was calculated assuming 40% of newly diagnosed adult HIV patients had late HIV diagnosis (Mhozya et al, 2015), with an allowable error of 0.04 at 95% CI. Patients were enrolled on routine clinic days and they were serially enrolled until the sample size was reached.…”

Section: Methodsmentioning

confidence: 99%

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Prevalence and associated factors of late HIV diagnosis in north-western rural Tanzania: a cross sectional study

Gunda

Kaganda

Bakshi

et al. 2017

Tanzania J Hlth Res

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Background: Despite scaling up of HIV and treatment services to improve the outcome of people living with HIV, still a high proportion of patients seek out medical attention at late stages of the disease. This contributes to late initiation of ART and poor clinical outcome especially in sub Saharan Africa. The literature on magnitude of this problem in Tanzania is still scarce. This study aimed to determine the prevalence and associated factors of delayed HIV diagnosis in rural Tanzania.Methods: This was a cross sectional study, involving newly diagnosed adult HIV patients sent in for care and treatment linkage. Information regarding age, sex, WHO stage, type of opportunistic condition, HIV testing service and on diagnosis CD4 counts were all collected. On diagnosis CD4 counts <200cells/µl was coded as Late HIV diagnosis. The proportion of with Late HIV diagnosis was calculated and logistic regression modal was used to determine the degree of association of different variables at 95%CI.Results: In total 649 patients were included in this study. The median age of the study participants was 45.5 years most of them being females 396 (61.02%). The median CD4 count was 168 cells/µl and majority of our study participants 468 (72.11%) were in WHO clinical stage 3&4. Overall 385 (59.32%) were found to have Late HIV diagnosis where 303 (78.70%) had stage 3&4 AIDS defining illness (OR=2.2, p<0.001). Male patients were predominantly affected (OR=1.4, p=0.035), who were more likely to be tested following PITC service (OR=30, p<0.001).Conclusions: Late HIV diagnosis is prevalent in our setting with high prevalence of most of the stage 3&4 AIDS defining illnesses. Male patients are predominantly affected as late presenters. There is a need to strengthen and extend the available Provider Initiated Testing and Counselling activities to primary health care level.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Prevalence and associated factors of late HIV diagnosis in north-western rural Tanzania: a cross sectional study

Gunda

Kaganda

Bakshi

et al. 2017

Tanzania J Hlth Res

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“…In a study by Bancos et 10,12,13 and evaluation of adrenal function among critically ill HIV/ AIDS patients is complex. These recent studies suggest decreased cortisol breakdown among critically ill patients as the main contributing factor to elevated cortisol levels and there is need for a well-designed and large sample size research to explore early diagnosis, optimal evaluation and treatment of adrenal insufficiency in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

“…11 In patients with HIV/AIDS, AI is one of the common endocrine manifestation and in developing countries, almost half of these newly diagnosed HIV and hospitalized HIV patient with advanced disease have AI and majority of these patients also have TB/HIV coinfection. 12 With almost 50% prevalence of adrenal insufficiency in patients with advanced HIV disease, it is worrisome that adrenal insufficiency diagnosis and evaluation is neglected in these patients that poses a major contributing factors in morbidity and mortality in this population. [11][12][13]…”

Section: Discussionmentioning

confidence: 99%

Frequency of Adrenal Insufficiency Among Patients of Human Immunodeficiency Virus

Shahid

Aftab

Kataria³

et al. 2021

Pak Postgrad Med J.

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Background: Human immunodeficiency virus (HIV) has emerged as a major public health problem worldwide over the last two decades. Many complications and problems are associated with HIV like lipodystrophy, retarded growth in young patients, impaired endocrine and renal functioning and cardiovascular diseases. Objective: To determine the frequency of adrenal insufficiency among patients of human immunodeficiency virus presenting to HIV clinic in a tertiary care hospital. Study Design: Cross Sectional Study. Setting: HIV clinic, Jinnah Hospital Lahore. Study Duration: August, 2019 to February, 2020. Material and Methods: A total of 180 patients of HIV presenting to HIV clinic of Jinnah hospital Lahore and fulfilling the selection criteria were approached after approval from ethical review board an informed consent was taken from the subject and an ACTH stimulation test was performed and adrenal Insufficiency was diagnosed. Intramuscular injection of 0.25 mg of synthetic ACTH was administered to all patients; and after 60 minutes serum cortisol was measured. A peak stimulated cortisol of less than 20 mcg/dl was labeled as adrenal insufficiency. Results: Mean and standard deviation of the age was 42.16 ± 17.31 years. Male patients were 56.1% while female patients were 43.9%. Adrenal insufficiency was present in 38.3% patients while it was absent in 61.7% patients. No significant association found between age and presence of adrenal insufficiency (p=0.280). Also no significant association found between duration of disease and adrenal insufficiency (p=.557). There was a significant association found between intake of antiretroviral therapy and presence of adrenal insufficiency having (p<0.005) Conclusion: Adrenal insufficiency was found in significant number of HIV patients but effect modifiers like age, duration of disease did not show significant association except intake of antiretroviral therapy.

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Understanding the Time Needed to Link to Care and Start ART in Seven HPTN 071 (PopART) Study Communities in Zambia and South Africa

Seeley

Bond²,

Yang

et al. 2018

AIDS Behav

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To achieve UNAIDS 90:90:90 targets at population-level, knowledge of HIV status must be followed by timely linkage to care, initiation and maintenance of antiretroviral therapy (ART) for all people living with HIV (PLHIV). Interpreting quantitative patterns using qualitative data, we investigate time taken to link to care and initiate ART amongst individuals aware of their HIV-status in high HIV-prevalence urban communities in the HPTN 071 (PopART) study, a community-randomised trial of a combination HIV prevention package, including universal testing and treatment, in 21 communities in Zambia and South Africa. Data are drawn from the seven intervention communities where immediate ART irrespective if CD4 count was offered from the trial-start in 2014. Median time from HIV-diagnosis to ART initiation reduced after 2 years of delivering the intervention from 10 to 6 months in both countries but varied by gender and community of residence. Social and health system realities impact decisions made by PLHIV about ART initiation. Electronic supplementary material The online version of this article (10.1007/s10461-018-2335-7) contains supplementary material, which is available to authorized users.

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Late-stage disease at presentation to an HIV clinic in eastern Tanzania: A retrospective cross-sectional study

Cited by 14 publications

References 10 publications

Prevalence and associated factors of late HIV diagnosis in north-western rural Tanzania: a cross sectional study

Prevalence and associated factors of late HIV diagnosis in north-western rural Tanzania: a cross sectional study

Frequency of Adrenal Insufficiency Among Patients of Human Immunodeficiency Virus

Understanding the Time Needed to Link to Care and Start ART in Seven HPTN 071 (PopART) Study Communities in Zambia and South Africa

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