Prevalence and Risk Factors for Overweight and Obesity among HIV-Infected Adults in Dar es Salaam, Tanzania

Semu, Helen; Zack, Rachel M.; Liu, Enju; Hertzmark, Ellen; Spiegelman, Donna; Sztam, Kevin A.; Hawkins, Claudia; Chalamila, Guerino; Muya, Aisa; Siril, Hellen; Mwiru, Ramadhani S.; Mtasiwa, Deo; Fawzi, Wafaie W.

doi:10.1177/2325957414542574

Cited by 29 publications

(39 citation statements)

References 41 publications

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“…Overweight/obesity was more prevalent among participants on LTART compared to ART naïve study subjects and was higher than the reported prevalence of overweight/obesity in a previous study in Dar es Salaam [44]. In the Temprano trial, the prevalence of overweight/obesity among individuals with HIV infection increased from 27 to 32 percent after 24 months of initiation of ART [45].…”

Section: Plos Onementioning

confidence: 55%

Prevalence of non-communicable diseases among individuals with HIV infection by antiretroviral therapy status in Dar es Salaam, Tanzania

2020

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Background Long-term antiretroviral therapy has modified the clinical course of HIV infection to a chronic condition associated with increased risk of developing non-communicable diseases (NCDs). Information is scant, from sub-Saharan Africa, on the prevalence of NCDs and associated factors among individuals on ART. Methodology We consecutively enrolled individuals with HIV infection who were ART naïve and those on ART for �5 years (LTART) attending health facilities in Dar es Salaam. Participant's blood pressure, anthropometric measurements, and fasting blood glucose were recorded. Participants with impaired fasting blood glucose underwent an oral glucose tolerance test. A venous blood sample was sent to the lab for biochemical tests. Chi-square test was used to compare proportions, Poisson regression with robust standard errors was used to determine associations between variables. Results Overall, 612 individuals with HIV infection were enrolled, half of whom were ART naïve. Females comprised 71.9% and 68.0% of participants in the LTART and ART naïve study arms, respectively, p = 0.290. The mean age (±SD) was 44.9 ± 12.7 years and 37.5 ± 11.8 years among LTART and ART naïve participants, respectively, p<0.001. Hypertension was documented in 25.2% in those on LTART compared to 6.9% among ART naïve subjects, p<0.001. Impaired glucose tolerance was found in 22.9% and 4.6% among LTART compared to ART naïve subjects, p<0.001. Diabetes mellitus was detected in 17.0% of those on LTART compared to 3.9% ART naïve participants, p<0.001. Hypercholesterolemia was found in 30.4% of individuals on LTART compared to 16.7% of ART naïve subjects, p<0.001, and hypertriglyceridemia was found in 16.

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Section: Plos Onementioning

confidence: 55%

Prevalence of non-communicable diseases among individuals with HIV infection by antiretroviral therapy status in Dar es Salaam, Tanzania

2020

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“…3 Several studies have described increasing proportions of overweight and obesity in people living with HIV/AIDS in SSA. 6 In a large cross-sectional study in Dare Salaam, Tanzania, it was found that 18% of HIV-positive individuals were overweight and 7% were obese. 7 Another study in south Africa found the prevalence of overweight as 26.2% and obesity as 46.4%, while in ivory coast it was found that 19.7% of them were overweight, and 7.2% were obese.…”

Section: Introductionmentioning

confidence: 99%

<p>Magnitude of Obesity/Overweight and Its Associated Factors Among HIV/AIDS Patients on Antiretroviral Therapy in Jimma Zone Hospitals, South West Ethiopia: Hospital-Based Cross-Sectional Study</p>

Yitbarek¹,

Engidaw²,

Ayele³

et al. 2020

DMSO

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Purpose: Obesity is on the rise worldwide, not only in the general population but also in PLWHA. Being overweight and obese are themselves risk factors for cardiovascular and other diseases. Despite this, few studies have been conducted to determine the magnitude of obesity/overweight and its associated factors among HIV/AIDS patients in Ethiopia, which necessitates this study. Methods: Hospital-based cross-sectional study was conducted from December to January 2019 at selected Jimma zone hospitals. WHO STEP-wise approach to chronic disease risk factor surveillance (STEPS) questionnaire and document review for HIV-related clinical factors was applied. Weight, height and waist circumference and hip circumference were measured. Data were analyzed using SPSS version 20. Results: A total of 252 participants with a response rate of 95.8% were included. The prevalence of obesity/overweight was 21%. After adjusting for these variables, age category of greater than 50 years [AOR = 0.4, 95% CI (0.2, 0.9), p = 0.03], WHO clinical stage III and above [AOR = 0.04, 95% CI (0.002, 0.6), p = 0.02], presence of mild to moderate physical activity [AOR = 1.3, 95% CI (5.5, 33.3), p ≤ 0.001)], plasma CD4 count between 351 and 500 copies/mL [AOR=0.15, 95% CI (0.04, 0.6) p=0.024], and female sex [AOR = 2.6, 95% CI (1.25, 10) p=0.03)] were significantly associated with obesity/overweight. Conclusion: There was a high prevalence of obesity/overweight among HIV/AIDS patients. It was found that older age, female sex, early stage of the disease, lower CD4 count and presence of mild to moderate physical activity were significant predictors of obesity/overweight. Clinicians should be aware of the health consequence of obesity and consider instituting targeted weight management programs as a part of routine HIV care.

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“…Outcomes included in this paper had been previously studied in this cohort, and data collection methods are described in detail elsewhere [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] . Briefly, patients received treatment according to Tanzanian National and World Health Organization guidelines [29] , [30] .…”

Section: Methodsmentioning

confidence: 99%

Intra-cluster correlation estimates for HIV-related outcomes from care and treatment clinics in Dar es Salaam, Tanzania

Barnhart

Hertzmark

Liu

et al. 2016

Contemporary Clinical Trials Communications

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Introduction Researchers planning cluster-randomized controlled trials (cRCTs) require estimates of the intra-cluster correlation coefficient (ICC) from previous studies for sample size calculations. This paper fills a persistent gap in the literature by providing estimates of ICCs for many key HIV-related clinical outcomes. Methods Data from HIV-positive patients from 47 HIV care and treatment clinics in Dar es Salaam, Tanzania were used to calculate ICCs by site of enrollment or site of ART initiation for various clinical outcomes using cross-sectional and longitudinal data. ICCs were estimated using linear mixed models where either clinic of enrollment or clinic of ART initiation served as the random effect. Results ICCs ranged from 0 to 0.0706 (95% CI: 0.0447, 0.1098). For most outcomes, the ICCs were large enough to meaningfully affect sample size calculations. For binary outcomes, the ICCs for event prevalence at baseline tended to be larger than the ICCs for later cumulative incidences. For continuous outcomes, the ICCs for baseline values tended to be larger than the ICCs for the change in values from baseline. Conclusion The ICCs for HIV-related outcomes cannot be ignored when calculating sample sizes for future cluster-randomized trials. The differences between ICCs calculated from baseline data alone and ICCs calculated using longitudinal data demonstrate the importance of selecting an ICC that reflects a study’s intended design and duration for sample size calculations. While not generalizable to all contexts, these estimates provide guidance for future researchers seeking to design adequately powered cRCTs in Sub-Saharan African HIV treatment and care clinics.

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Prevalence and Risk Factors for Overweight and Obesity among HIV-Infected Adults in Dar es Salaam, Tanzania

Cited by 29 publications

References 41 publications

Prevalence of non-communicable diseases among individuals with HIV infection by antiretroviral therapy status in Dar es Salaam, Tanzania

Prevalence of non-communicable diseases among individuals with HIV infection by antiretroviral therapy status in Dar es Salaam, Tanzania

<p>Magnitude of Obesity/Overweight and Its Associated Factors Among HIV/AIDS Patients on Antiretroviral Therapy in Jimma Zone Hospitals, South West Ethiopia: Hospital-Based Cross-Sectional Study</p>

Intra-cluster correlation estimates for HIV-related outcomes from care and treatment clinics in Dar es Salaam, Tanzania

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