Prevalence of and Factors Associated with Reoccurrence of Opportunistic Infections Among Adult HIV/AIDS Patients Attending the ART Clinic at Public Health Facilities in Arba Minch Town, Southern Ethiopia

Abstract

Background: Opportunistic infections (OIs) in human immunodeficiency virus (HIV)positive individuals are infections that are more frequent or more severe than normal because of HIV-mediated immunosuppression. When these OIs occur in acquired immune deficiency syndrome (AIDS) patients in the form of relapse or reinfection, they are said to be a reoccurrence of OI. This study will try to identify gaps in addressing the burden in the study area. Methods: This cross-sectional study was conducted among 450 HIV/AIDS patients with previous OIs attending a public health facility in Arba Minch Town, Southern Ethiopia. This study was conducted from 5 April 2020 to 20 April 2020. Computer-generated simple random sampling was used to select the study participants. Analysis was performed using SPSS version 25 statistical software. Bivariate and multivariable logistic regression was used to identify factors associated with the reoccurrence of OIs. A P value of ≤0.05 was used to determine significant association. The results were reported as numerical figures, tables, and diagrams, based on the type of data. Results: The mean ± standard deviation age of the 450 study participants was 34.3±8.47 years. Eighty patients (17.8%) had chronic disease. In total, 119 HIV/AIDS patients (26.4%) were diagnosed with reoccurrence of OIs. Pulmonary tuberculosis was the major reoccurring OI. Age, rural residence, chronic disease, baseline anti-retroviral therapy (ART) adherence, current hemoglobin level, and current cell differentiation-4 (CD4) count were factors significantly associated with reoccurrence. Conclusion:Although the magnitude of reoccurrence of OIs was lower than in previous studies, efforts have to be continued among stakeholders to tackle factors associated with the reoccurrence of OIs.

Risk Factors Associated with Opportunistic Infections among People Living with HIV/AIDS and Receiving an Antiretroviral Therapy in Gabon, Central Africa

“…All these findings could be explained by the difference between a relatively rural area (current study) and more urbanized settlements. This coincided with previous studies from Ethiopia and the USA, where it was demonstrated that rural/countryside patients with lower levels of education, low income, and limited access to healthcare facilities more readily develop OIs than others [25,[47][48][49].…”

Time to occurrence, predictors, and patterns of opportunistic infections incidence among HIV-positive patients attending Antiretroviral Therapy Clinic of Salale University Comprehensive Specialized Hospital: A retrospective cohort study

“…The previous studies from the USA [ 24 , 25 ] confirmed this. Furthermore, rural residents were not only the risky group for the occurrence but also for the recurrence of OIs [ 15 ] due to low income, lower level of education, and limited access to health care. Additionally, patients who had low cd4 counts had a higher hazard of OIs incidence than their counterparts because a weakened cellular immunity increases the risk of OIs incidence.…”

“…Also, as confirmed by a previous study, chronic disease increases the likelihood of OIs recurrence. [ 15 ]…”

“…Because the frequently existing evidence generated so far are cross-sectional surveys with methodological limitations. [5,[15][16][17] Thus, the identification of predictors and patterns of OIs using the most robust study design will help in the prevention of OIs and thus improve the lives of HIV-positive patients. Additionally, understanding the ideal time when OIs are most likely to occur helps tackle the presence of these complications.…”