Magnitude of opportunistic diseases and their predictors among adult people living with HIV enrolled in care: national level cross sectional study, Ethiopia

Abstract

BackgroundOpportunistic diseases cause morbidity and mortality among human immunodeficiency virus (HIV) infected persons. There is dearth of evidence on the magnitude and predictors of opportunistic diseases among PLHIV in Ethiopia. This study was conducted to determine the magnitude and predictors of opportunistic diseases among adults enrolled in the national HIV/AIDS care and treatment services and generate information for program planning and medicine quantification in the country.MethodsA health facility-based cross-sectional study was conducted. Probability proportional to size and random sampling methods were employed to select health facilities and medical records of adult HIV-infected patients respectively. A total of 7826 medical records were reviewed from 60 health facilities nationwide. Socio-demographic and clinical data including diagnosis of opportunistic diseases were collected from the medical records. Period prevalence of opportunistic diseases over one year period was determined. Bivariate and multivariate logistic regression was used to measure associations between independent variables and the dependent variable, occurrence of opportunistic diseases.ResultsOf the total of 7826 study participants, 3748 (47.9%) were from hospitals and 4078 were from health centers. The majority (61.8%) were female. The median age was 32 years with interquartile range (IQR) of 27–40. The median duration of stay in HIV care was 56 (IQR = 28–80) months; 7429 (94.9%) were on antiretroviral treatment. A total of 1665 cases of opportunistic diseases were recorded with an overall prevalence estimated at 21.3% (95% confidence interval (CI): 20.36, 22.18%). Skin diseases (4.1%), diarrhea (4.1%), bacterial pneumonia (3.6%), recurrent upper respiratory tract infections (3.1%) and tuberculosis (2.7%) were the leading opportunistic diseases. Isoniazid preventive therapy coverage among eligible patients was 24.8%. Persons with a CD4 count < 200 cells/mm3 [adjusted odds ratio (AOR) 1.80, 95% CI: 1.45, 2.23]; and who were bed ridden or ambulatory functional status [AOR (95% CI) = 3.19 (2.32, 4.39)] were independent predictors of diagnosis of opportunistic diseases.ConclusionOpportunistic diseases were found to be pervasive among HIV infected adults in Ethiopia. Proactive identification and management, and prevention of opportunistic diseases should be strengthened especially among females, ambulatory or bed-ridden, and patients with low CD4 cell count.

Abacavir versus Zidovudine-based regimens for treatment of HIV-infected children in resource limited settings: a retrospective cohort study

“…Accordingly, there was a 1% reduction in the hazard of OIs development as median baseline CD4 count increased by a unit (AHR = 0.99, 95% CI [0.98-0.99]). Similar findings were found from Ethiopia [26] and Nigeria [27].…”

Prevalence of Opportunistic Infections and Associated Factors Among HIV-infected Patients on Antiretroviral Therapy in Eastern Zone of Tigray, Ethiopia:A Cross-sectional Study

“…In Ethiopia, the burden of OIs increases from time to time alarmingly. The prevalence of OIs was 19.7% and 88.4% in 2012 and 2017 respectively [10,[18][19][20][21][22]. Also, different studies stated the factors associated with the development of OIs were age, gender, poor ART adherence, disease stage, habit of chat chewing, functional status, low CD4 level, hemoglobin level, weight, failure, and cross-resistance [13,16,17,23].…”

“…For the strategies in HIV/AIDS-related morbidity and mortality to be reduced, identifying the prevalence of OIs play a signi cant role. Despite the fact different studies have been done on the prevalence of OIs among people living with HIV on ART in Ethiopia, however, majority of these studies were used only patients' clinical records to collect the data and important records of risk factors of OIs like adherence to AR, substance use, and prophylactic treatments was not studied [10,16,20,22]. Besides, there are limitation of data on the prevalence of OIs and associated factors among HIV-infected patients in northern Ethiopia.…”

Assessment of two POC technologies for CD4 count in Morocco

“…In fact, CD4 count is essential for identifying late presenters that require urgent care, including immediate opportunistic infections treatment, in order to improve their prognosis. Therefore, CD4 count remains an essential tool for HIV management for many low-to-middle income countries, mainly in Sub Saharan African countries, that have adopted "test and treat" approach, but its implementation has been challenging [16][17][18].…”