Prevalence of Opportunistic Infections and Determinants Among HIV-Positive Patients in Ethiopia: A Systematic Review and Meta-Analysis

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Health Science Reports Pub Date : 2025-02-03 DOI:10.1002/hsr2.70418

Aleka Aemiro, Abayeneh Girma, Demsew Beletew

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Abstract

Background and Aims

Opportunistic infections (OIs) associated with HIV are the primary cause of morbidity and mortality among individuals living with HIV/AIDS. Evaluating the extent of OIs at the national level is essential for developing targeted interventions and effective control measures. Therefore, the aim of this study was to evaluate the pooled prevalence and identify the associated factors of OIs among HIV-positive individuals across all age groups.

Methods

This systematic review and meta-analysis was conducted following the PRISMA guidelines. It included studies published in English, research articles conducted in Ethiopia, and articles released between 2013 and 2023. A systematic search of articles on the prevalence and determinants of OIs among patients living with HIV in Ethiopia was conducted across four databases (PubMed, ScienceDirect, Scopus, and the Cochrane Library). To evaluate heterogeneity and publication bias, the study employed Cochran's Q, inverse variance (I²), sensitivity analysis, funnel plots, and Begg and Egger regression tests. The meta-analysis was executed using STATA software, version 14.

Results

Of the 207 articles examined, only 26 met the inclusion requirements. The overall prevalence of OIs among HIV-positive patients was 42.71% (95% CI: 36.87–48.56). OIs among HIV-positive individuals were significantly associated with baseline WHO clinical stage II and above (OR: 2.83; 95% CI: 1.93–3.73), khat chewers (OR: 1.94; 95% CI: 1.21–2.66), poor adherence to ART (OR: 2.32; 95% CI: 1.51–3.13), and individuals with an initial CD4 number less than 200 cells/mm³ (OR: 2.32; 95% CI: 1.55–3.09).

Conclusion

Chewing khat, poor adherence, low CD4 count, and WHO stage II and above were found to be predictors of OIs. A constant state of awareness is required for healthcare providers to improve decisions about the proper diagnosis and management of OIs among HIV-positive individuals.

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