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

Abstract

Background: Opportunistic infections are diseases that cause infections in people whose immune systems are weakened. It is the most public health problem and the leading cause of morbidity and mortality of AIDS-related infections in developing countries. Identification of opportunistic infections is the core for developing a specific intervention. Despite this fact, information about the burden of opportunistic infections is lacking in the particular study. Therefore, this study aimed to assess the prevalence and associated factors of opportunistic infections among HIV-infected patients in Eastern zone of Tigray, northern Ethiopia. Methods: An institutional-based cross-sectional study was done among HIV/AIDS patients taking antiretroviral therapy in Northern Ethiopia. A total of 394 study subjects was selected using a systematic random sampling method. Data was collected using a structured questionnaire. The collected data was entered and analyzed by SPSS version 22. Bivariate and multivariable logistic regression analysis with 95% confidence interval were used to find factors associated with opportunistic infections. The adjusted odds ratio was calculated to show the strength of the association. Variables with p-value of < 0.05 were considered statically significant. Results: The mean age of the respondents was 41 (± 10). Of the study participants, about 52% (95% CI: 47.5-57.1) developed opportunistic infections. Being housewife occupation (AOR = 0.17; 95% CI: 0.07-0.46), CD4+ count < 200 cells/µl (AOR = 2.38; 95% CI: 1.3-4.67), poor adherence (AOR = 4; 95% CI: 1.95-8.2), and bedridden functional status (AOR = 13.9; 95% CI: 5.2-37) were independently associated with opportunistic infections. Conclusion: This study stated the prevalence of opportunistic infections among HIV-infected patients is high. Being housewife occupation, poor ART adherence, low CD4+ count, and bedridden functional status were found to be associated with development of opportunistic infections. Therefore, health care providers must give continuous health education on primary prevention of opportunistic infections.

Opportunistic Infections and Associated Factors among HIV-Infected Adult Persons on Antiretroviral Therapy at Ruhengeri Referral Hospital, Rwanda: A cross-sectional study

“…[18] Starting ART at clinical stage 3 was identified by this study as a risk factor to developing OIs. Similar findings were observed in a study conducted in Southern zone Tigray, Ethiopia, [10] and at Debre Markos referral hospital, Northwest Ethiopia among HIV-infected children on ART. [19] In our study, bivariate analysis shows that good adherence to ART protects PLWHIV from developing OIs, which corroborates other studies whereby poor adherence remains quite a negative factor.…”

“…This prevalence is quite low compared to the rest of the countries in the region, namely in Ethiopia, where it stands at 39.6% in selected public hospitals in Sidima National Regional State; [7] 33.6% in Addis Ababa, [8] 88.4% in Dawro Zone hospital [9] and 52% in Eastern Zone of Tigray. [10] The OIs prevalence remains higher in many other countries, such as in South-West Nigeria (Ibadan) with 46.6% among newly enrolled PLWHIV aged 50 years or above, [11] and 78.8% among older adults in Kenya. [12] This lower prevalence in Rwanda when compared with similar countries results from efforts made by the Rwanda Biomedical Center and other agencies in the management of PLWHIV in different angles of their life including medical, psychosocial and nutritional care as per the national guidelines; with rigorous mentorship from the national level, the HIV/ AIDS and STIs.…”

Prevalence and determinants of opportunistic infections among HIV infected adults after initiation of antiretroviral therapy in Ethiopia: A systematic review and Meta-analysis

“…More than 50% (n= 3558) of the participants were female. Thirteen studies employed a cross-sectional study design [18,19,[37][38][39][40][41][42][43][44][45][46][47]. The remaining two were cohort studies [26,28], and one was a case control study [48].…”

“…All studies were conducted from 2013 to 2021 in different geographic locations of Ethiopia. Four of the primary studies included were based in Ethiopia's Southern Nations Nationalities Peoples' Regional States (SNNPRs) [18,28,42,44], three in Amhara [19,45,48], three in Addis Ababa [37,38,43], three in Tigrai [26,41,46], one in Oromia [47], one in Sidama [39], and one in Harari [40].The highest (88.44%) [18] and the lowest (19.72%) [19] Prevalence of OIs was reported in studies conducted in Tercha Hospital, southern Ethiopia, and Gonder University Hospital, northern Ethiopia, respectively (Table 1). Furthermore, authors of 13 primary studies assessed the spectrum of OIs [18,19,26,[37][38][39][40][41][42][43][44][45]47].…”

“…About fifteen primary studies included in this meta-analysis have reported various factors as determinants of OIs among HIV-infected adult patients who were taking antiretroviral therapy in Ethiopia [18,19,26,28,[37][38][39][40][41][43][44][45][46][47][48]. We identified five predictor variables out of seven extracted variables, each reported by at least three primary studies, that were found to be associated with the development of OIs .These include level of adherence to ART, body mass index, baseline CD4 T lymphocytes count, and WHO HIV clinical stage.…”