Background. Factors associated with overweight/obesity among antiretroviral therapy (ART) recipients have not been sufficiently studied in Botswana. Objectives. To: (i) estimate the prevalence and trends in overweight/obesity by duration of exposure to ART among recipients, (ii) assess changes in BMI categories among ART recipients between their first clinic visit (BMI-1) and their last clinic visit (BMI-2), (iii) identify ART regimen that predicts overweight/obesity better than the others and factors associated with BMI changes among ART recipients. Methods. A 12-year retrospective record-based review was conducted. Potential predictors of BMI change among patients after at least three years of ART exposure were examined using a multiple logistic regression model. Adjusted odds ratios (AOR) and their 95% confidence intervals (CIs) were computed. ART regimens, duration of exposure to ART, and recipients’ demographic and biomedical characteristics including the presence or absence of diabetes mellitus-related comorbidities (DRC), defined as any morbidity associated with type 2 diabetes as described in the international statistical classification of diseases and related health problems (ICD-10-CM) codebook index, were investigated as potential predictors of overweight/obesity. Results. Twenty-nine percent of recipients were overweight, 16.6% had obesity of whom 2.4% were morbidly-obese at the last clinic visit. Overweight/obese recipients were more likely to be female, to have DRC and less likely to have CD4 count between 201 and 249 cells/mm3. Neither the first-line nor the second-, third-line ART regimens predicted overweight/obesity better than the other and neither did the duration of exposure to ART. No significant linear trends were observed in the prevalence of overweight/obesity by the duration of exposure to ART. Conclusion. These results suggest that the ART regimens studied have a comparable effect on overweight/obesity and that the duration of exposure does not affect the outcome. This study calls for further research to elucidate the relative contribution of various factors to BMI change among recipients, including ART regimens.
ObjectivesExposure to combination antiretroviral therapy (cART) is associated with the development of diabetes mellitus related comorbidities (DRCs). This study aims to: (i) estimate the incidence of DRCs among cART recipients, (ii) assess the time-to-event (development of DRC) and, (iii) compare survival function between recipients on first-line regimen and those on second-, third-line cART regimen.ResultsThe incidence of DRCs was 26.8/1000 person-years, with total time of exposure of 3316 person-years. The average time to event for all the three regimens was 11.72 ± 0.20 years. The first-line cART regimen had a shorter mean ± SE of 10.59 ± 0.26 years to the event compared to 12.69 ± 0.24 years for the second-, third-line cART regimen. Recipients on the first-line had a shorter survival than recipients on second-, third-line cART (Log-rank X2 = 8.98, p < 0.003). Data from this study showed that the risk of developing DRCs per year of exposure was significantly greater for patients on first-line compared to those who were on second-, third-line regimen; which, suggests that monitoring of cART long-term side effects and regular reviewing of cART regimens is important. Meticulous selection of drug combinations is a key to improving recipients’ survival.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3144-9) contains supplementary material, which is available to authorized users.
Background. Policy changes are often necessary to contain the detrimental impact of epidemics such as those brought about by coronavirus disease (COVID-19). In the earlier phases of the emergence of COVID-19, China was the first to impose strict restrictions on movement (lockdown) on January 23rd, 2020. A strategy whose effectiveness in curtailing COVID-19 was yet to be determined. We, therefore, sought to study the impact of the lockdown in reducing the incidence of COVID-19. Methods. Daily cases of COVID-19 that occurred in China which were registered between January 12th and March 30th, 2020, were extracted from the Johns Hopkins CSSE team COVID-19 ArcGIS® dashboards. Daily cases reported were used as data points in the series. Two interrupted series models were run: one with an interruption point of 23 January 2020 (model 1) and the other with a 14-day deferred interruption point of 6th February (model 2). For both models, the magnitude of change (before and after) and linear trend analyses were measured, and β-coefficients reported with 95% confidence interval (CI) for the precision. Results. Seventy-eight data points were used in the analysis. There was an 11% versus a 163% increase in daily cases in models 1 and 2, respectively, in the preintervention periods ( p ≤ 0.001 ). Comparing the period immediately following the intervention points to the counterfactual, there was a daily increase of 2,746% ( p < 0.001 ) versus a decline of 207% ( p = 0.802 ) in model 2. However, in both scenarios, there was a statistically significant drop in the daily cases predicted for this data and beyond when comparing the preintervention periods and postintervention periods ( p < 0.001 ). Conclusion. There was a significant decrease the COVID-19 daily cases reported in China following the institution of a lockdown, and therefore, lockdown may be used to curtail the burden of COVID-19.
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