Prevalence, characteristics and correlates of a positive-dementia screen in patients on antiretroviral therapy in Bamenda, Cameroon: a cross-sectional study

Abstract

BackgroundIn this study we assess the prevalence, characteristics as well as socio-demographic and clinical correlates of a positive screen for HIV-associated dementia in a group of patients on antiretroviral therapy (ART) in Bamenda, Cameroon.MethodsIn a cross-sectional study, a structured questionnaire was used to collect data on 400 patients attending the Bamenda Regional Hospital AIDS-treatment Centre. Patients were assessed for neurocognitive function using the International HIV Dementia Scale (IHDS) to assess finger-tapping (FT), alternating hand sequence (AHS) and a 4-word recall (4WR), each scored on a maximum of four.ResultsA total of 297 (74%) participants were females. The total IHDS score ranged from 6–12 with a mean of 9.02 and 85% of subjects screened positive for dementia (≤10 on IHDS). Participants performed worst in the AHS assessment with a mean of 2.25 (IQR: 2–3). In multivariable analyses, screening positive for dementia was significantly associated with having primary education or less (aOR: 8.33, 95%CI: 3.85, 16.67), and having HIV symptoms (aOR: 12.16, 95%CI: 3.08, 48.05).ConclusionsA very high proportion of patients on ART screened positive for dementia using the IHDS. This could potentially be an indication of a high prevalence of HIV-associated neurocognitive disorders in this population and or a poor performance of the IHDS in patients on ART. Future studies will need to assess the validity of the IHDS in this population of patients on ART and also evaluate long term outcomes in patients with positive dementia screens.

The association between symptoms of mental disorders and health risk behaviours in Vietnamese HIV positive outpatients: a cross-sectional study

“…The HAD prevalence indicated by the IHDS in the current study was higher than the prevalence of 11% identified by psychiatrist’s interview in Vietnam [31] but was similar to prevalences reported in previous studies using the IHDS in the United States of America (37.9%), Canada (39.4%), and India (32.5%) [45, 48, 49], although lower than most studies in Africa, where reported HAD prevalence has ranged from 54.4 to 85% [50, 51]. Since these studies also employed the IHDS the difference in HAD prevalence might be due to HIV severity, especially at ART initiation [50]. Our findings indicate an urgent need for screening for SOMD and provision of appropriate support and treatment for HIV positive outpatients in Vietnam.…”

Prevalence of HIV associated neurocognitive deficit among HIV positive people in Ethiopia: a cross sectional study at Ayder Referral Hospital

“…As compared to prior studies, the current finding is similar with the result of a study conducted in India (32.5%) (18), a study done in Nigeria (34.4%) [28] and an earlier Metaanalysis (systemic review) in Sub-Saharan area (30.9%) (2). However, it is less than the findings of previous studies undertaken in Botswana (38%) (21), a study in the international community (37%) (15), a study done in Cameroon (85%) [29], a study conducted in Asia (90%) (19) and a Ugandan study (46.49%) (30,31,32). …”

Prevalence and Correlates of Probable HIV-Associated Dementia in HIV Outpatients in Ho Chi Minh City, Vietnam

“…21,22 The high prevalence found in African countries could potentially be due to more advanced HIV infection among study participants where only PLWHA with CD4 counts less than 200 or HIV stage 4 were on ART. 18,20 In the current study, the mean CD4 count was approximately 400 and most of the participants (92%) were in HIV stage 1. Alternatively, the high prevalence might also be due to the psychometric properties of the IHDS in different settings such as South Africa where sensitivity and specificity were 45% and 79% at the cutoff at 10.…”

“…With estimated prevalence of 50%, type I error rate of a ¼ 5% and estimation error of 5%, at least 385 participants were required. Since the reported prevalence of probable HAD ranged from 21.1% to 85%, [17][18][19][20][21][22] the sample size was sufficiently large to estimate the prevalence of HAD.…”