Prevalence of non-communicable diseases among HIV positive patients on antiretroviral therapy at joint clinical research centre, Lubowa, Uganda

Abstract

Introduction Antiretroviral therapy (ART) has changed the course of HIV/AIDs by enabling patients to live longer, raising concern of the co- existence of HIV with other chronic illnesses, notably non-communicable diseases (NCDs). NCDs are on the rise in developing countries and evidence shows higher occurrence among people living with HIV (PLHIV). In Uganda, the burden of NCDs among PLHIV remains largely unquantified. Objective To determine the prevalence of hypertension, osteoporosis, diabetes mellitus, renal impairment, asthma, cardiomyopathy and multi-morbidity among HIV positive patients, receiving Anti-Retroviral Therapy at Joint Clinical Research Centre, Lubowa, Uganda. Methods This was a cross-sectional study conducted among 387 systematically sampled patients, receiving ART at the Joint Clinical Research Centre, Lubowa, between March and April 2017. The study used data extracted from routine care patient files to identify individuals with non-communicable diseases. Prevalence of the NCDs was estimated and reported with 95% confidence intervals. Prevalence was also reported at various levels of socio- demographic, behavioural and clinical factors. Results The overall prevalence of having at least one NCD was 20.7% (95% CI: 16.7–24.5). The prevalence of hypertension was 12.4% (95% CI: 9.1–15.7), osteoporosis 6.5% (95% CI: 4.0–8.9), diabetes mellitus 4.7% (95% CI: 2.6–6.8), renal impairment 1.6% (95% CI: 0.3–2.8), asthma 1.6% (95% CI: 0.3–2.8), and cardiomyopathy 1.3% (95% CI: 0.2–2.4). Prevalence of multi-morbidity was 4.7% (95% CI: 2.6–6.8). Prevalence was significantly higher among older participants, widowed participants and individuals with an opportunistic infection. Conclusion Non-communicable diseases are common among people living with HIV. There is need to encourage early diagnosis and treatment of non-communicable diseases in PLHIV in Uganda.

Incidence of non-communicable diseases (NCDs) in HIV patients on ART in a developing country: Case of Zimbabwe’s Chitungwiza Central Hospital—A retrospective cohort study (2010–2019)

“…As people got older they became more prone to different NCDs like hypertension and geriatric diabetes. This was consistent with several studies done in several LMICs where older participants in the cohorts were more likely to be diagnosed with NCDs [15][16][17][18][19][20].…”

“…It is thus imperative to examine the effect of the burden of NCDs on PLHIV in LMICs, focusing on NCDs such as diabetes mellitus, hypertension, cancers, and obesity. Kansiime et al found a 20.7% chance of developing at least one NCD in PLHIV in Uganda, whilst the most prevalent NCD was found to be hypertension [18]. The high prevalence of NCD risk factors and unrecognized and untreated hypertension represent major problems [19].…”

High prevalence of non-communicable diseases among key populations enrolled at a large HIV prevention & treatment program in Kenya

“…systematic reviews outside SSA suggest that sexual minorities exhibit higher rates of NCDs [11]. Contrastingly, study findings from SSA point to comparably lower prevalence rates of NCDs (4.7%, 11.5% and 21.2%) among general population PLHIV clients [5,13,23,24].…”

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

“…COVID-19 poses a particular challenge for the African continent because of existing high prevalence rates of other infectious diseases including human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS), TB, cholera, and malaria, along with high rates of AMR and a disproportionate burden of poverty ( UNAIDS, 2019 ; World Health Organisation, 2019 ; WHO, 2019a ; Ataguba, 2020 ; Godman et al., 2020a ; Simpson, 2020 ; United Nations Economic Commission for Africa, 2020a ; WHO, 2020b ; WHO, 2020c ), with ongoing infectious disease initiatives appreciably challenged by COVID-19 ( Mendelson and Matsoso, 2015 ; Ghana Ministry of Health, 2018 ; Godman et al., 2020a ; Kowalska et al., 2020 ). The presence of multi-morbidity with NCDs will aggravate the situation further ( Oni et al., 2015 ; So-Armah and Freiberg, 2018 ; Achwoka et al., 2019 ; Chang et al., 2019 ; Kansiime et al., 2019 ; Woldesemayat, 2020 ), with already high rates of CVD and diabetes a growing concern across Africa ( Mensah et al., 2015 ; Godman et al., 2020b ; Godman et al., 2020c ).…”