Cognitive impairment and its associated factors among HIV/AIDS patients on anti retro -viral therapy in Sub-Saharan Africa: Systematic review and meta-analysis

Abstract

Background

The nature of HIV-related Neurocognitive disorders has rapidly evolved with the widespread use of anti-retro viral treatment. The aim of this study was to estimate the pooled prevalence of cognitive impairment and its associated factors in Sub -Saharan Africa using previous studies.

Methods

Databases, PubMed, Hinari, Google Scholar was used to search for potential studies. Data were extracted using MS excel and exported to STATA/MP version 16.0 for further analysis. Heterogeneity between studies was tested using Cochrane Q test statistics and I² test and small study effect were checked using Egger’s statistical test at 5 % significant level. Sensitivity analysis was checked. A random-effects model was employed to estimate the pooled prevalence of cognitive impairment and its associated factors in Sub Saharan Africa.

Result

Twenty one studies included to estimate the pooled prevalence of cognitive impairment in sub Saharan Africa. In random effects model, the pooled prevalence of cognitive impairment in sub Saharan Africa was 44.46 (95 % CI, 34.22, and 54.69). Level of education had significant association with cognitive impairment and those participants with below secondary education level are two times more likely to develop cognitive impairment compared to those who are diploma and above (POR = 2.33, 95 % CI, 1.42, 3.82). From random effects model estimates, the pooled odds of developing cognitive impairment among female were nearly 3 times than male (POR = 2.87, 95 % CI, 2.09, 3.95).

Conclusion

The pooled prevalence of cognitive impairment in Sub-Saharan Africa was significantly high. Sex and educational level of the participants were statistically significant factors for cognitive impairment. Based on the finding of this review, we recommend that continuous screening of cognitive impairment, identification of the possible risk factors, and proper management strategy should be designed in each Anti retro-viral therapy (ART) centers of Sub Saharan African countries.