Background: Tuberculosis (TB) is a preventable and treatable disease but it is the leading cause of death among people living with HIV (PLHIV). In addition, the emergence of the HIV pandemic has also had a major impact on TB incidence rates. There are studies in spatial patterns of TB and HIV separately in Ethiopia; there is, however, no information on spatial patterns of TB-HIV coinfection in the country at the districts level at least using yearly data. This paper, therefore, aimed at determining the spatial clustering of TB-HIV coinfection prevalence rates in the country at the districts level on an annual basis over a four-year period, 2015-2018.
Methods: District-level aggregated data on the number of TB-HIV infections were obtained from the Ethiopian Federal Ministry of Health for 2015 to 2018. The univariate and bivariate global Moran's index, Getis-Ord Gi∗ local statistic, a chi-square test, and a modified t-test statistic for Spearman's correlation coefficient were used to evaluate the spatial clustering and spatial heterogeneity of TB among PLHIV and HIV among TB patients prevalence rates.
Results: The district-level prevalence rate of HIV among TB patients was positively and significantly spatially autocorrelated with global Moran's I values range between 0.021 and 0.134 (p value <0.001); however, the prevalence of TB among PLHIV was significant only for 2015 and 2017 (p value <0.001). Spearman's correlation also shows there was a strong positive association between the two prevalence rates over the study period. The local indicators of spatial analysis using the Getis-Ord statistic revealed that hot-spots for TB among PLHIV and HIV among TB patients have appeared in districts of various regions and the two city administrations in the country over the study period; however, the geographical distribution of hotspots varies over the study period. Similar trends were also observed for the cold-spots except for 2017 and 2018 where there were no cold-spots for TB among PLHIV.
Conclusions: The study presents detailed knowledge about the spatial clustering of TB-HIV coinfection in Ethiopia at the districts level, and the results could provide information for planning coordinated district-specific interventions to jointly control both diseases in Ethiopia.
背景:结核病(TB)是一种可预防和可治疗的疾病，但它是艾滋病毒感染者(PLHIV)死亡的主要原因。此外，艾滋病毒流行病的出现也对结核病发病率产生了重大影响。在埃塞俄比亚，分别对结核病和艾滋病毒的空间格局进行了研究;然而，至少在使用年度数据时，没有关于该国地区一级结核病-艾滋病毒合并感染的空间格局的信息。因此，本文旨在确定2015-2018年4年期间全国各地区结核病-艾滋病毒合并感染患病率的空间聚类。方法:从埃塞俄比亚联邦卫生部获得2015年至2018年结核病-艾滋病毒感染人数的地区级汇总数据。采用单变量和双变量全球Moran's指数、Getis-Ord G i *局部统计量、卡方检验和Spearman相关系数修正t检验来评价PLHIV患者中结核病患病率和HIV患者中结核病患病率的空间聚类和空间异质性。结果:埃塞俄比亚地区结核病患者HIV患病率与全球Moran’s I值在0.021 ~ 0.134之间呈显著正相关(p值p值)。结论:该研究在地区层面上详细了解了埃塞俄比亚结核病-HIV合并感染的空间聚类，可为埃塞俄比亚规划协调的地区特异性干预措施以共同控制这两种疾病提供信息。
{"title":"Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts Level.","authors":"Leta Lencha Gemechu, Legesse Kassa Debusho","doi":"10.1155/2023/5191252","DOIUrl":"https://doi.org/10.1155/2023/5191252","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is a preventable and treatable disease but it is the leading cause of death among people living with HIV (PLHIV). In addition, the emergence of the HIV pandemic has also had a major impact on TB incidence rates. There are studies in spatial patterns of TB and HIV separately in Ethiopia; there is, however, no information on spatial patterns of TB-HIV coinfection in the country at the districts level at least using yearly data. This paper, therefore, aimed at determining the spatial clustering of TB-HIV coinfection prevalence rates in the country at the districts level on an annual basis over a four-year period, 2015-2018.</p><p><strong>Methods: </strong>District-level aggregated data on the number of TB-HIV infections were obtained from the Ethiopian Federal Ministry of Health for 2015 to 2018. The univariate and bivariate global Moran's index, Getis-Ord <i>G</i> <sub><i>i</i></sub> <sup><i>∗</i></sup> local statistic, a chi-square test, and a modified <i>t</i>-test statistic for Spearman's correlation coefficient were used to evaluate the spatial clustering and spatial heterogeneity of TB among PLHIV and HIV among TB patients prevalence rates.</p><p><strong>Results: </strong>The district-level prevalence rate of HIV among TB patients was positively and significantly spatially autocorrelated with global Moran's <i>I</i> values range between 0.021 and 0.134 (<i>p</i> value <0.001); however, the prevalence of TB among PLHIV was significant only for 2015 and 2017 (<i>p</i> value <0.001). Spearman's correlation also shows there was a strong positive association between the two prevalence rates over the study period. The local indicators of spatial analysis using the Getis-Ord statistic revealed that hot-spots for TB among PLHIV and HIV among TB patients have appeared in districts of various regions and the two city administrations in the country over the study period; however, the geographical distribution of hotspots varies over the study period. Similar trends were also observed for the cold-spots except for 2017 and 2018 where there were no cold-spots for TB among PLHIV.</p><p><strong>Conclusions: </strong>The study presents detailed knowledge about the spatial clustering of TB-HIV coinfection in Ethiopia at the districts level, and the results could provide information for planning coordinated district-specific interventions to jointly control both diseases in Ethiopia.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2023 ","pages":"5191252"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9859700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10585893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction In resource-limited settings such as Ethiopia, where the prevalence of HIV/AIDS is high, a number of factors, including economic, demographic, behavioral risk, and health factors, affect how long people with AIDS are treated with antiretroviral therapy. Since several aspects of the clinical setup may have an impact on ART patients' survival, this study was conducted in health centers. Determining the mortality rate and survival factors among adult HIV-infected patients receiving ART at health centers in Addis Abeba's Kirkos subcity is the primary goal of this study. Methods A retrospective cohort study was carried out at the health center in Addis Abeba's Kirkos subcity. The source population consisted of all adult HIV-positive patients who were being followed up between December 1, 2014, and October 30, 2019. A total of 665 samples were collected using a computer-generated simple random sampling method in each of the three health centers that were chosen by a lottery system depending on the number of patients in the follow-up. Trained data collectors took the information out of the patient card and the electronic database. Regressions using the Kaplan‐Meier and Cox proportional hazards were employed. Results The incidence of death rate in adult HIV-positive patients was 55 (8.5%) fatalities, translating to a death rate of 3.25 per 100 person-years. The majority of deaths occurred within 6 months of ART initiation. Predictors of mortality were: age above 50 years (AHR = 4.90, 95% CI: 2.00, 11.98), tuberculosis comorbidity (AHR = 3.46, 95% CI: 1.23, 3.33), lack of drug adherence (AHR = 1.76, 95% CI: 1.23, 3.33), co-trimoxazole therapy (AHR = 2.59, 95% CI: 1.37, 4.90), and CD4 cell count less than 200/dl (AHR = 2.77, 95% CI: 1.30, 5.92). Conclusion and Recommendation. Adult HIV-positive individuals had an incidence of the death rate of 55 (8.5%), which equates to 3.25 deaths per 100 person-years. Age category over 50, TB comorbidity, WHO stage IV, lack of medication adherence, co-trimoxazole therapy, body mass index under 18.5 kg/m2, and CD4 cell count under 200/dl were predictors of mortality. Therefore, it is important to focus on prevention, early identification, and treatment of HIV/AIDS for these predictors at all levels of the HIV/AIDS chronic care package in order to increase survival.
{"title":"Mortality and Its Predictors among Adult Human Immune-Deficiency Virus-Infected Patients Attending Their Antiretroviral Treatment at Health Centers, Addis Ababa, Ethiopia: Multicenter Retrospective Cohort Study.","authors":"Selam Tesfayohannes, Sisay Shine, Abinet Mekuria, Sisay Moges","doi":"10.1155/2022/6128718","DOIUrl":"https://doi.org/10.1155/2022/6128718","url":null,"abstract":"Introduction In resource-limited settings such as Ethiopia, where the prevalence of HIV/AIDS is high, a number of factors, including economic, demographic, behavioral risk, and health factors, affect how long people with AIDS are treated with antiretroviral therapy. Since several aspects of the clinical setup may have an impact on ART patients' survival, this study was conducted in health centers. Determining the mortality rate and survival factors among adult HIV-infected patients receiving ART at health centers in Addis Abeba's Kirkos subcity is the primary goal of this study. Methods A retrospective cohort study was carried out at the health center in Addis Abeba's Kirkos subcity. The source population consisted of all adult HIV-positive patients who were being followed up between December 1, 2014, and October 30, 2019. A total of 665 samples were collected using a computer-generated simple random sampling method in each of the three health centers that were chosen by a lottery system depending on the number of patients in the follow-up. Trained data collectors took the information out of the patient card and the electronic database. Regressions using the Kaplan‐Meier and Cox proportional hazards were employed. Results The incidence of death rate in adult HIV-positive patients was 55 (8.5%) fatalities, translating to a death rate of 3.25 per 100 person-years. The majority of deaths occurred within 6 months of ART initiation. Predictors of mortality were: age above 50 years (AHR = 4.90, 95% CI: 2.00, 11.98), tuberculosis comorbidity (AHR = 3.46, 95% CI: 1.23, 3.33), lack of drug adherence (AHR = 1.76, 95% CI: 1.23, 3.33), co-trimoxazole therapy (AHR = 2.59, 95% CI: 1.37, 4.90), and CD4 cell count less than 200/dl (AHR = 2.77, 95% CI: 1.30, 5.92). Conclusion and Recommendation. Adult HIV-positive individuals had an incidence of the death rate of 55 (8.5%), which equates to 3.25 deaths per 100 person-years. Age category over 50, TB comorbidity, WHO stage IV, lack of medication adherence, co-trimoxazole therapy, body mass index under 18.5 kg/m2, and CD4 cell count under 200/dl were predictors of mortality. Therefore, it is important to focus on prevention, early identification, and treatment of HIV/AIDS for these predictors at all levels of the HIV/AIDS chronic care package in order to increase survival.","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":" ","pages":"6128718"},"PeriodicalIF":1.7,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40382123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-09eCollection Date: 2022-01-01DOI: 10.1155/2022/9074844
Omoladun O Odediran, Oluwakemi O Odukoya, Mobolanle R Balogun, Jonathan A Colasanti, Alani S Akanmu
Background: In Nigeria, various sociocultural and economic factors may prevent women from being retained in HIV care. This study explores the factors associated with retention in care among women with HIV in a large HIV clinic in Lagos, Nigeria, under the Test and Treat policy.
Methods: Women living with HIV/AIDS (n = 24) enrolled in an HIV study at the AIDS Prevention Initiative in Nigeria (APIN) clinic in Lagos, Nigeria, were interviewed from April 1 to October 31, 2021, using a semistructured interview guide. Interviews were audio-taped, transcribed verbatim, and the themes were analyzed using the framework of Andersen and Newman's Behavioural Model for Healthcare Utilization.
Results: The mean age of the respondents was 37.4 ± 9.27 years. The identified themes were as follows: being aware of the antiretroviral medications and their benefits, the household's awareness of the respondents' HIV status, and the presence of social support. Other themes were the presence of a dependable source of income and the ability to overcome the challenges encountered in obtaining income, ease of travel to and from the clinic (length of travel time and transportation costs), securing support from the clinic, challenges encountered in the process of accessing care at the clinic, and the ability to overcome these challenges. Also mentioned were self-perception of being HIV positive, motivation to remain in care, linkage to care, and intention to stay in care.
Conclusion: Several deterring factors to retention in HIV care, such as nondisclosure of status, absence of social support, and clinic barriers, persist under the Test and Treat policy. Therefore, to achieve the "treatment as prevention" for HIV/AIDS, especially in sub-Saharan Africa, it is essential to employ strategies that address these barriers and leverage the facilitators for better health outcomes among women with HIV/AIDS.
{"title":"A Qualitative Study Exploring Factors Associated with Retention in HIV Care among Women with HIV in a Large HIV Clinic in Lagos, Nigeria, after Implementing the Test and Treat Policy.","authors":"Omoladun O Odediran, Oluwakemi O Odukoya, Mobolanle R Balogun, Jonathan A Colasanti, Alani S Akanmu","doi":"10.1155/2022/9074844","DOIUrl":"10.1155/2022/9074844","url":null,"abstract":"<p><strong>Background: </strong>In Nigeria, various sociocultural and economic factors may prevent women from being retained in HIV care. This study explores the factors associated with retention in care among women with HIV in a large HIV clinic in Lagos, Nigeria, under the Test and Treat policy.</p><p><strong>Methods: </strong>Women living with HIV/AIDS (<i>n</i> = 24) enrolled in an HIV study at the AIDS Prevention Initiative in Nigeria (APIN) clinic in Lagos, Nigeria, were interviewed from April 1 to October 31, 2021, using a semistructured interview guide. Interviews were audio-taped, transcribed verbatim, and the themes were analyzed using the framework of Andersen and Newman's Behavioural Model for Healthcare Utilization.</p><p><strong>Results: </strong>The mean age of the respondents was 37.4 ± 9.27 years. The identified themes were as follows: being aware of the antiretroviral medications and their benefits, the household's awareness of the respondents' HIV status, and the presence of social support. Other themes were the presence of a dependable source of income and the ability to overcome the challenges encountered in obtaining income, ease of travel to and from the clinic (length of travel time and transportation costs), securing support from the clinic, challenges encountered in the process of accessing care at the clinic, and the ability to overcome these challenges. Also mentioned were self-perception of being HIV positive, motivation to remain in care, linkage to care, and intention to stay in care.</p><p><strong>Conclusion: </strong>Several deterring factors to retention in HIV care, such as nondisclosure of status, absence of social support, and clinic barriers, persist under the Test and Treat policy. Therefore, to achieve the \"treatment as prevention\" for HIV/AIDS, especially in sub-Saharan Africa, it is essential to employ strategies that address these barriers and leverage the facilitators for better health outcomes among women with HIV/AIDS.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2022 ","pages":"9074844"},"PeriodicalIF":1.8,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10575587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Voluntary counseling and testing (VCT) is the primary gateway to HIV prevention, caution, and handling, where people learn whether they are infected. This study was aimed to assess the determinants of voluntary counseling and testing experience among students.
Methods: An institution-based cross-sectional study was conducted between November and January, 2020. A simple random sampling procedure was used to select participants from the target group. The Chi-square test, descriptive analysis, and a binary logistic regression analysis were used to identify the factors associated with VCT experience among students.
Results: Out of 398 participants, 42.5% experienced VCT services. From 59.5% of female participants in the study, only 22.9% experienced VCT services. The logistic regression results revealed that male participants less likely experienced VCT (AOR = 0.549; 95%CI: 0.330, 0.910; p=0.020) compared to female students. Students who had VCT service access in their surroundings (AOR = 2.348; 95%CI: 1.371, 4.020; p=0.002), a sexual partner (AOR = 3.795; 95%CI: 1.214, 11.868; p=0.022), and media access (AOR = 2.374; 95%CI: 1.059, 5.320; p=0.036) were more likely to utilize VCT services than their reference categories.
Conclusions: VCT utilization among students remains limited. In this study, sex, age, region, the education of mother and father, having boy/girlfriend, the source of information, service access, media access, and attitude were the identified factors of VCT utilization. To enhance the usage of VCT services, the facilities should be publicized, and all information regarding VCT should be made available to teenagers.
{"title":"Utilization of Voluntary Counseling and Testing Experience among Mizan-Tepi University Students in Southwestern Ethiopia.","authors":"Lema Abate Adulo, Sali Suleman Hassen, Admasu Markos Kontuab","doi":"10.1155/2022/7911385","DOIUrl":"https://doi.org/10.1155/2022/7911385","url":null,"abstract":"<p><strong>Background: </strong>Voluntary counseling and testing (VCT) is the primary gateway to HIV prevention, caution, and handling, where people learn whether they are infected. This study was aimed to assess the determinants of voluntary counseling and testing experience among students.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted between November and January, 2020. A simple random sampling procedure was used to select participants from the target group. The Chi-square test, descriptive analysis, and a binary logistic regression analysis were used to identify the factors associated with VCT experience among students.</p><p><strong>Results: </strong>Out of 398 participants, 42.5% experienced VCT services. From 59.5% of female participants in the study, only 22.9% experienced VCT services. The logistic regression results revealed that male participants less likely experienced VCT (AOR = 0.549; 95%CI: 0.330, 0.910; <i>p</i>=0.020) compared to female students. Students who had VCT service access in their surroundings (AOR = 2.348; 95%CI: 1.371, 4.020; <i>p</i>=0.002), a sexual partner (AOR = 3.795; 95%CI: 1.214, 11.868; <i>p</i>=0.022), and media access (AOR = 2.374; 95%CI: 1.059, 5.320; <i>p</i>=0.036) were more likely to utilize VCT services than their reference categories.</p><p><strong>Conclusions: </strong>VCT utilization among students remains limited. In this study, sex, age, region, the education of mother and father, having boy/girlfriend, the source of information, service access, media access, and attitude were the identified factors of VCT utilization. To enhance the usage of VCT services, the facilities should be publicized, and all information regarding VCT should be made available to teenagers.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":" ","pages":"7911385"},"PeriodicalIF":1.7,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9314165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The detailed risk assessment of the diagnosed HIV cases in Bhutan is an opportunity to carry out the risk analysis to generate evidence of wherein, under what context, and in which population groups most new infections are occurring. The evidence collected will help to test the current assumption of Bhutan experiencing diffused and generalized HIV epidemic.
Methods: This is a cross-sectional study using a quantitative method to assess the risk behavior of the diagnosed HIV cases from 1993 to 2019. The study also included secondary data analysis of those cases already captured by the routine case-based surveillance from 2020 to 2021. The data collection was done from 1 to 30 January 2022 in all the twenty districts of Bhutan. Descriptive statistical analysis was used to analyze the characteristics of the study population, and relationships were established using the Chi-square Test. We have sought ethics approval and obtained participants' informed consent.
Results: The risk attribution analysis showed that 81.94% of HIV infection among the reported HIV cases in Bhutan has occurred through high-risk heterosexuals and 8.88% through mother-to-child transmission, and parenteral transmission accounts for 1.58% and then 1.35% through homosexual. Of the 81.94% high-risk heterosexuals, 41.08% acquired through sex workers and clients of sex workers, 27.99% from HIV-infected persons, 12.64% from sex work, and 0.23% from injecting drug use.
Conclusions: This study has shed some light on a gradual epidemic shift from the current perceived diffused and generalized to the concentrated epidemic among subpopulation groups like female sex workers and their clients.
{"title":"Redefining the Mode of HIV Transmission through Analysis of Risk Attribution among the Reported HIV Cases from 1993 to 2021 in Bhutan.","authors":"Lekey Khandu, Ngawang Choida, Jurmi Drukpa, Dolley Tsehring, Sonam Wangdi","doi":"10.1155/2022/2137164","DOIUrl":"https://doi.org/10.1155/2022/2137164","url":null,"abstract":"<p><strong>Introduction: </strong>The detailed risk assessment of the diagnosed HIV cases in Bhutan is an opportunity to carry out the risk analysis to generate evidence of wherein, under what context, and in which population groups most new infections are occurring. The evidence collected will help to test the current assumption of Bhutan experiencing diffused and generalized HIV epidemic.</p><p><strong>Methods: </strong>This is a cross-sectional study using a quantitative method to assess the risk behavior of the diagnosed HIV cases from 1993 to 2019. The study also included secondary data analysis of those cases already captured by the routine case-based surveillance from 2020 to 2021. The data collection was done from 1 to 30 January 2022 in all the twenty districts of Bhutan. Descriptive statistical analysis was used to analyze the characteristics of the study population, and relationships were established using the Chi-square Test. We have sought ethics approval and obtained participants' informed consent.</p><p><strong>Results: </strong>The risk attribution analysis showed that 81.94% of HIV infection among the reported HIV cases in Bhutan has occurred through high-risk heterosexuals and 8.88% through mother-to-child transmission, and parenteral transmission accounts for 1.58% and then 1.35% through homosexual. Of the 81.94% high-risk heterosexuals, 41.08% acquired through sex workers and clients of sex workers, 27.99% from HIV-infected persons, 12.64% from sex work, and 0.23% from injecting drug use.</p><p><strong>Conclusions: </strong>This study has shed some light on a gradual epidemic shift from the current perceived diffused and generalized to the concentrated epidemic among subpopulation groups like female sex workers and their clients.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":" ","pages":"2137164"},"PeriodicalIF":1.7,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9288338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40522073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-08eCollection Date: 2022-01-01DOI: 10.1155/2022/3246249
Chalachew Kassaw, Daniel Sisay, Ephrem Awulachew, Habtamu Endashaw Hareru
Background: The psychological experience of being rejected, blamed, and ashamed in relation to a recognized medical disease is known as perceived stigma. It has a close connection to psychological health and therapy afterward. To the best of our knowledge, there has not been any national systematic review and meta-analysis research on this topic. Therefore, we conducted this analysis to thoroughly evaluate the pooled prevalence of perceived stigma among HIV/AIDS patients in Ethiopia who are receiving antiretroviral therapy and its relationship to gender differences and disclosure status.
Method: We investigated the eight databases for quantitative Ethiopian studies published in English from 2008 to 2021 that looked at the relationship between felt stigma, gender, and disclosure status. To meet the statistical requirements of a systematic review and meta-analysis analysis, the random effect model for pooled prevalence of perceived stigma, log odds ratio for associated variables, I-squared statistics for heterogeneity, and Egger's test for publication bias were implemented. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument's standard data extraction method was performed to collect the necessary data, and STATA-14 statistical software was used for analysis.
Result: A total of 8 cross-sectional Ethiopian studies with 3,857 participants were integrated into this systematic review and meta-analysis study. The pooled prevalence of perceived stigma among people living with HIV/AIDS and attending antiretroviral therapy in Ethiopia was OR = 50.36% (95% CI: (40.71, 60.00), I2 = 97.3%, p=0.000 ). The pooled odds ratio of being male was 0.95 (95% CI: 0.53, 1.68, I2 = 86.7%, p=0.000) and disclosure status was 0.84 (95% CI: 0.09, 7.89, I2 = 97.9%, p=0.000).
Conclusion: In this study, half of the participants encountered stigma. There was no statistically significant correlation between gender difference, disclosure status, and the perception of stigma. To address the mental and psychological issues of people living with HIV/AIDS, it is necessary to look into other factors that influence perceived stigma. It is recommended to screen for and treat perceived stigma with prompt examination and follow-up.
{"title":"Perceived Stigma and Its Association with Gender and Disclosure Status among People Living with HIV/AIDS and Attending Antiretroviral Therapy Clinics in Ethiopia: A Systematic Review and Meta-Analysis.","authors":"Chalachew Kassaw, Daniel Sisay, Ephrem Awulachew, Habtamu Endashaw Hareru","doi":"10.1155/2022/3246249","DOIUrl":"https://doi.org/10.1155/2022/3246249","url":null,"abstract":"<p><strong>Background: </strong>The psychological experience of being rejected, blamed, and ashamed in relation to a recognized medical disease is known as perceived stigma. It has a close connection to psychological health and therapy afterward. To the best of our knowledge, there has not been any national systematic review and meta-analysis research on this topic. Therefore, we conducted this analysis to thoroughly evaluate the pooled prevalence of perceived stigma among HIV/AIDS patients in Ethiopia who are receiving antiretroviral therapy and its relationship to gender differences and disclosure status.</p><p><strong>Method: </strong>We investigated the eight databases for quantitative Ethiopian studies published in English from 2008 to 2021 that looked at the relationship between felt stigma, gender, and disclosure status. To meet the statistical requirements of a systematic review and meta-analysis analysis, the random effect model for pooled prevalence of perceived stigma, log odds ratio for associated variables, <i>I</i>-squared statistics for heterogeneity, and Egger's test for publication bias were implemented. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument's standard data extraction method was performed to collect the necessary data, and STATA-14 statistical software was used for analysis.</p><p><strong>Result: </strong>A total of 8 cross-sectional Ethiopian studies with 3,857 participants were integrated into this systematic review and meta-analysis study. The pooled prevalence of perceived stigma among people living with HIV/AIDS and attending antiretroviral therapy in Ethiopia was OR = 50.36% (95% CI: (40.71, 60.00), <i>I</i> <sup>2</sup> = 97.3%, <i>p</i>=0.000 ). The pooled odds ratio of being male was 0.95 (95% CI: 0.53, 1.68, <i>I</i> <sup>2</sup> = 86.7%, <i>p</i>=0.000) and disclosure status was 0.84 (95% CI: 0.09, 7.89, <i>I</i> <sup>2</sup> = 97.9%, <i>p</i>=0.000).</p><p><strong>Conclusion: </strong>In this study, half of the participants encountered stigma. There was no statistically significant correlation between gender difference, disclosure status, and the perception of stigma. To address the mental and psychological issues of people living with HIV/AIDS, it is necessary to look into other factors that influence perceived stigma. It is recommended to screen for and treat perceived stigma with prompt examination and follow-up.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":" ","pages":"3246249"},"PeriodicalIF":1.7,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40514383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background As of April 2019, the dolutegravir (DTG)-based regimen is replacing the efavirenz-based regimen in Ethiopia, mainly due to its superiority in viral load suppression. However, there is a growing concern about this medication-based regimen, the most serious of which is excessive weight gain. In this study, we looked at weight gain disparities among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients on antiretroviral therapy (ART) who have been shifted to tenofovir/lamivudine/dolutegravir (TLD) from a tenofovir/lamivudine/efavirenz (TLE)-based regimen versus those who are maintained on a tenofovir/lamivudine/efavirenz-based regimen. Methods A facility-based retrospective observational cohort study was conducted in pursuit of weight change disparities between tenofovir/lamivudine/dolutegravir and tenofovir/lamivudine/efavirenz-based regimens among patients who have attained optimal viral suppression at Hawassa University Comprehensive Specialized Hospital antiretroviral clinic. Chi-square and logistic regression were used as appropriate using an SPSS version 21 program to test the association of specific variables to outcome variables, and a P value <0.05 was considered statistically significant. Results This study included 422 patients, 211 of whom were switched from tenofovir/lamivudine/efavirenz to tenofovir/lamivudine/dolutegravir and the remaining were who kept on a tenofovir/lamivudine/efavirenz-based regimen. Patients on a tenofovir/lamivudine/dolutegravir-based regimen had a mean weight gain of 3.88 ± 2.021 kg in one year compared to those on TLE (2.26 ± 2.39). In a bivariate analysis, being male was found to protect against unwanted weight gain at COR 0.531 (0.345, 0.816). A current CD4 count of more than 500 has been found to be strongly correlated with weight gain in multivariate analysis at an AOR of 0.315 (0.188, 0.527) at a P value ≤0.001. Conclusion According to this study, tenofovir/lamivudine/dolutegravir (TLD)-based antiretroviral medication (ART) users are more likely to gain weight, and clinicians should advise them of the risks of weight gain as well as cost-effective ways to prevent weight gain linked to poor health outcomes in these patients. Future investigations should confirm the findings of this study, and more research into the effects of weight gain in these people is required.
截至2019年4月，在埃塞俄比亚，基于dolutegravir (DTG)的方案正在取代基于efavirenz的方案，主要是因为其在病毒载量抑制方面的优势。然而，人们越来越担心这种以药物为基础的疗法，其中最严重的是体重过度增加。在这项研究中，我们观察了接受抗逆转录病毒治疗(ART)的人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者的体重增加差异，这些患者从替诺福韦/拉米夫定/依非韦伦(TLE)为基础的方案转向替诺福韦/拉米夫定/多鲁替韦(TLD)，而那些继续使用替诺福韦/拉米夫定/依非韦伦(TLE)为基础的方案。方法:在阿瓦萨大学综合专科医院抗逆转录病毒门诊，对获得最佳病毒抑制的患者，采用替诺福韦/拉米夫定/多鲁替格拉韦与替诺福韦/拉米夫定/依非韦伦为基础的方案，进行了一项以医院为基础的回顾性观察队列研究。适当采用卡方回归和logistic回归，使用SPSS version 21程序检验特定变量与结果变量的相关性，P值<0.05认为有统计学意义。结果本研究纳入422例患者，其中211例患者由替诺福韦/拉米夫定/依非韦伦改为替诺福韦/拉米夫定/多替格拉韦，其余患者继续使用替诺福韦/拉米夫定/依非韦伦方案。替诺福韦/拉米夫定/多替地韦为基础的方案的患者在一年内平均体重增加3.88±2.021 kg，而TLE组(2.26±2.39)。在双变量分析中，男性可以防止不必要的体重增加，COR为0.531(0.345,0.816)。在多变量分析中发现，当前CD4计数大于500与体重增加密切相关，其AOR为0.315 (0.188,0.527)，P值≤0.001。根据这项研究，以替诺福韦/拉米夫定/多替格拉韦(TLD)为基础的抗逆转录病毒药物(ART)使用者更容易体重增加，临床医生应告知他们体重增加的风险，以及预防这些患者体重增加与不良健康结果相关的经济有效方法。未来的调查应该会证实这项研究的结果，并且需要对这些人体重增加的影响进行更多的研究。
{"title":"Could a Dolutegravir-Based Antiretroviral Therapy Lead to Clinical Obesity? A Retrospective Cohort Study Conducted at Hawassa University Comprehensive Specialized Hospital in Hawassa, Sidama, Ethiopia","authors":"By Aberash Eifa, Worku Ketema","doi":"10.1155/2022/2965325","DOIUrl":"https://doi.org/10.1155/2022/2965325","url":null,"abstract":"Background As of April 2019, the dolutegravir (DTG)-based regimen is replacing the efavirenz-based regimen in Ethiopia, mainly due to its superiority in viral load suppression. However, there is a growing concern about this medication-based regimen, the most serious of which is excessive weight gain. In this study, we looked at weight gain disparities among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients on antiretroviral therapy (ART) who have been shifted to tenofovir/lamivudine/dolutegravir (TLD) from a tenofovir/lamivudine/efavirenz (TLE)-based regimen versus those who are maintained on a tenofovir/lamivudine/efavirenz-based regimen. Methods A facility-based retrospective observational cohort study was conducted in pursuit of weight change disparities between tenofovir/lamivudine/dolutegravir and tenofovir/lamivudine/efavirenz-based regimens among patients who have attained optimal viral suppression at Hawassa University Comprehensive Specialized Hospital antiretroviral clinic. Chi-square and logistic regression were used as appropriate using an SPSS version 21 program to test the association of specific variables to outcome variables, and a P value <0.05 was considered statistically significant. Results This study included 422 patients, 211 of whom were switched from tenofovir/lamivudine/efavirenz to tenofovir/lamivudine/dolutegravir and the remaining were who kept on a tenofovir/lamivudine/efavirenz-based regimen. Patients on a tenofovir/lamivudine/dolutegravir-based regimen had a mean weight gain of 3.88 ± 2.021 kg in one year compared to those on TLE (2.26 ± 2.39). In a bivariate analysis, being male was found to protect against unwanted weight gain at COR 0.531 (0.345, 0.816). A current CD4 count of more than 500 has been found to be strongly correlated with weight gain in multivariate analysis at an AOR of 0.315 (0.188, 0.527) at a P value ≤0.001. Conclusion According to this study, tenofovir/lamivudine/dolutegravir (TLD)-based antiretroviral medication (ART) users are more likely to gain weight, and clinicians should advise them of the risks of weight gain as well as cost-effective ways to prevent weight gain linked to poor health outcomes in these patients. Future investigations should confirm the findings of this study, and more research into the effects of weight gain in these people is required.","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":"2022 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45045118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Coagulation abnormalities are common complications of human immunodeficiency virus (HIV) infection. Highly active antiretroviral treatment (HAART) decreased the mortality of HIV but increased coagulopathies. HIV-related thrombocytopenia, prolonged prothrombin time (PT), activated partial thromboplastin time (APTT), and high D-dimer level commonly manifested in patients with HIV. Thus, this study is aimed to compare coagulation parameters of HAART-treated and HAART-naïve HIV-infected patients with HIV-seronegative controls. Methods A systematic literature search was conducted using the databases PubMed/MEDLINE, Embase, Web of Science, and Google Scholar of studies published until July 2021. The primary outcome of interest was determining the pooled mean difference of coagulation parameters between HIV-infected patients and seronegative controls. The Joana Briggs Institute (JBI) critical appraisal tool was used for quality appraisal. Statistical analyses were performed using Stata11.0 software. The statistical results were expressed as the effect measured by standardized mean difference (SMD) with their related 95% confidence interval (CI). Results A total of 7,498 participants (1,144 HAART-naïve patients and 2,270 HAART-treated HIV-infected patients and 3,584 HIV-seronegative controls) from 18 studies were included. HIV-infected patients (both on HAART and HAART-naive) exhibited significantly higher levels of PT than HIV-seronegative controls (SMD = 0.66; 95% CI: 0.53–0.80 and SMD = 1.13; 95% CI: 0.60–2.0, respectively). The value of APTT was significantly higher in patients with HIV on HAART than in seronegative controls. However, the values of PLT count, APTT, and fibrinogen level were significantly higher in seronegative controls. Besides, the level of fibrinogen was significantly higher in HAART-treated than treatment-naïve patients (SMD = 0.32; 95%CI: 0.08, 0.57). Moreover, the level of APTT and PT had no statistical difference between HAART and HAART-naïve HIV-infected patients. Conclusions This study identified that HIV-infected patients are more likely to develop coagulation abnormalities than HIV-seronegative controls. Therefore, coagulation parameters should be assessed regularly to prevent and monitor coagulation disorders in HIV-infected patients.
{"title":"Coagulation Parameters in Human Immunodeficiency Virus Infected Patients: A Systematic Review and Meta-Analysis","authors":"Solomon Getawa, Tiruneh Adane","doi":"10.1155/2022/6782595","DOIUrl":"https://doi.org/10.1155/2022/6782595","url":null,"abstract":"Background Coagulation abnormalities are common complications of human immunodeficiency virus (HIV) infection. Highly active antiretroviral treatment (HAART) decreased the mortality of HIV but increased coagulopathies. HIV-related thrombocytopenia, prolonged prothrombin time (PT), activated partial thromboplastin time (APTT), and high D-dimer level commonly manifested in patients with HIV. Thus, this study is aimed to compare coagulation parameters of HAART-treated and HAART-naïve HIV-infected patients with HIV-seronegative controls. Methods A systematic literature search was conducted using the databases PubMed/MEDLINE, Embase, Web of Science, and Google Scholar of studies published until July 2021. The primary outcome of interest was determining the pooled mean difference of coagulation parameters between HIV-infected patients and seronegative controls. The Joana Briggs Institute (JBI) critical appraisal tool was used for quality appraisal. Statistical analyses were performed using Stata11.0 software. The statistical results were expressed as the effect measured by standardized mean difference (SMD) with their related 95% confidence interval (CI). Results A total of 7,498 participants (1,144 HAART-naïve patients and 2,270 HAART-treated HIV-infected patients and 3,584 HIV-seronegative controls) from 18 studies were included. HIV-infected patients (both on HAART and HAART-naive) exhibited significantly higher levels of PT than HIV-seronegative controls (SMD = 0.66; 95% CI: 0.53–0.80 and SMD = 1.13; 95% CI: 0.60–2.0, respectively). The value of APTT was significantly higher in patients with HIV on HAART than in seronegative controls. However, the values of PLT count, APTT, and fibrinogen level were significantly higher in seronegative controls. Besides, the level of fibrinogen was significantly higher in HAART-treated than treatment-naïve patients (SMD = 0.32; 95%CI: 0.08, 0.57). Moreover, the level of APTT and PT had no statistical difference between HAART and HAART-naïve HIV-infected patients. Conclusions This study identified that HIV-infected patients are more likely to develop coagulation abnormalities than HIV-seronegative controls. Therefore, coagulation parameters should be assessed regularly to prevent and monitor coagulation disorders in HIV-infected patients.","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46331605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Girish Degavi, Boko Loka Safayi, Shiferaw Gelchu Adola, Biniyam Demisse, Takala Utura, Udessa Gemeda, Sarah Ezhil Kelna Edwin, F. Demissie
Background The transmission of HIV from mother to child among HIV-positive infants is estimated to be higher than 20%, despite the fact that antiretroviral treatment is available for antenatal mothers with HIV. In Ethiopia, the prevalence of HIV transmission from mother to child among infants aged one and a half years is estimated to be approximately 15.7 percent. Methods A retrospective cohort analysis using a simple random sampling technique was incorporated among 422 HIV-exposed babies and their mothers who were randomly chosen and screened using OPD (outpatient card) from March 2019 to March 2021 in the general hospitals of West Guji zone, Oromia, Ethiopia. The data were coded and entered into EpiData version 4.6.1 and exported to SPSS version 23 for cleaning and analysis. Result The study revealed that at the end of follow-up, 3.8% of the HIV-exposed infants were found to be HIV positive. Poor adherence of infant for CPT (AOR: 5.6; 95% CI: 1.010–27.24), father not enrolled to ART (AOR: 4.4; 95% CI: 1.187–15.724), age of infants at enrollment >6 weeks (AOR: 4.5; 95% CI: 1.102–16.1), mother's enrollment to PMTCT during labor and delivery or after (AOR: 6.84; 95% CI: 1.316–42.743), and mothers on the WHO clinical stage mild or advanced (AOR: 3.6; 95% CI: 1.146–16.842) was found to be the most important significant predictors of mother-to-child transmission of HIV. Conclusion Several factors included in the study were the main predictors of mother-to-child transmission of HIV. The study concluded that there are some lacunae in the prevention of MTCT of HIV but that the incidence of MTCT of HIV was significantly lower in this part of the world.
{"title":"A Retrospective Study of Incidence and Predictors on Mother-to-Child Transmission of HIV among HIV-Exposed Infants in West Guji Zone, Southern Ethiopia","authors":"Girish Degavi, Boko Loka Safayi, Shiferaw Gelchu Adola, Biniyam Demisse, Takala Utura, Udessa Gemeda, Sarah Ezhil Kelna Edwin, F. Demissie","doi":"10.1155/2022/2906490","DOIUrl":"https://doi.org/10.1155/2022/2906490","url":null,"abstract":"Background The transmission of HIV from mother to child among HIV-positive infants is estimated to be higher than 20%, despite the fact that antiretroviral treatment is available for antenatal mothers with HIV. In Ethiopia, the prevalence of HIV transmission from mother to child among infants aged one and a half years is estimated to be approximately 15.7 percent. Methods A retrospective cohort analysis using a simple random sampling technique was incorporated among 422 HIV-exposed babies and their mothers who were randomly chosen and screened using OPD (outpatient card) from March 2019 to March 2021 in the general hospitals of West Guji zone, Oromia, Ethiopia. The data were coded and entered into EpiData version 4.6.1 and exported to SPSS version 23 for cleaning and analysis. Result The study revealed that at the end of follow-up, 3.8% of the HIV-exposed infants were found to be HIV positive. Poor adherence of infant for CPT (AOR: 5.6; 95% CI: 1.010–27.24), father not enrolled to ART (AOR: 4.4; 95% CI: 1.187–15.724), age of infants at enrollment >6 weeks (AOR: 4.5; 95% CI: 1.102–16.1), mother's enrollment to PMTCT during labor and delivery or after (AOR: 6.84; 95% CI: 1.316–42.743), and mothers on the WHO clinical stage mild or advanced (AOR: 3.6; 95% CI: 1.146–16.842) was found to be the most important significant predictors of mother-to-child transmission of HIV. Conclusion Several factors included in the study were the main predictors of mother-to-child transmission of HIV. The study concluded that there are some lacunae in the prevention of MTCT of HIV but that the incidence of MTCT of HIV was significantly lower in this part of the world.","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48936760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-28eCollection Date: 2022-01-01DOI: 10.1155/2022/9659871
Onalethata Lesetedi, Jose Gaby Tshikuka, Shimeles G Hamda, Mgaywa Gilbert Mjungu Damas Magafu, Roy Tapera, Tiny Masupe, Julius Chacha Mwita
Background: Child mortality is a core indicator for child health and wellness. Botswana reported an under-five-year-old children (UFC) mortality rate of 48 deaths per 1000 live births in 2017 against 152 deaths per 1000 live births in 1971. This was a commendable accomplishment. However, given the current country situation whereby 23% of children are born to women living with HIV, the incidence of mortality among UFC born to women living with and not living with HIV and their survival are better health metrics to inform decision making. Nevertheless, such data are still very scarce in Botswana. The study's objective was to estimate the incidence of UFC mortality among children born to women living with and not living with HIV and to compare UFC survival between the two groups.
Methods: A retrospective cohort study of mortality among UFC was conducted in Botswana, including all UFC born between January 2014 and June 2018. Data were extracted from the National Under-Five Mortality Audit Committee (NUFMAC) database using a standardized data collection tool. The incidence rate of UFC death was estimated as a function of the duration from birth to death. Survival functions of UFC born to women living with and not living with HIV were plotted and compared using Kaplan-Meier survival analysis.
Results: The overall incidence of UFC death was 4.63/1000 child months (CM) (95% CI 4.36-4.90). The incidence of UFC death among children born to women living with HIV was 6.96/1000 CM (95% CI 6.47-7.45) and that of UFC born to women not living with HIV was 4.34/1000 CM (95% CI 4.03-4.65). The overall average and standard error (SE) time to event/death for UFC born to women living with and not living with HIV was 54.80 (0.18) months. The mean (SE) time to death for UFC born to women living with HIV was 52.79 (0.41) months and that of UFC born to women not living with HIV was 55.44 (0.19) months (log-rank X2 = 37.59, p < 0.001). Prematurity or low birth weight was the leading cause of UFC death in both groups; but, it was higher in UFC born to women not living with HIV subgroup than their counterparts. Four cases only or 0.5% of the 806 death cases reported by reporting physicians were attributable to HIV-related complications.
Conclusion: Despite the commendable efforts made in reducing UFC death, the incidence of UFC death among UFC born to women living with HIV in Botswana is still higher, and their survival is shorter compared to UFC born to women not living with HIV. Child survival interventions should prioritize UFC born to women living with HIV to improve their survival.
背景：儿童死亡率是儿童健康和保健的核心指标。博茨瓦纳报告称，2017年5岁以下儿童死亡率为每1000例活产死亡48例，而1971年为每1000例活产死亡152例。这是一项值得称赞的成就。然而，鉴于该国目前23%的儿童是由感染艾滋病毒的妇女所生的情况，感染艾滋病毒和未感染艾滋病毒的妇女所生的UFC的死亡率及其存活率是更好的健康指标，可为决策提供信息。然而，这类数据在博茨瓦纳仍然非常稀少。该研究的目的是估计艾滋病毒感染者和非艾滋病毒感染者所生儿童的UFC死亡率，并比较两组之间的UFC存活率。方法：在博茨瓦纳进行了一项UFC死亡率的回顾性队列研究，包括2014年1月至2018年6月出生的所有UFC。数据采用标准化数据收集工具从全国五岁以下儿童死亡率审计委员会（NUFMAC）数据库中提取。UFC死亡的发生率被估计为从出生到死亡持续时间的函数。使用Kaplan-Meier生存分析对感染和未感染艾滋病毒的妇女所生UFC的生存功能进行了绘制和比较。结果：UFC总死亡率为4.63/1000个月（CM） （95% CI 4.36-4.90）。感染艾滋病毒的妇女所生儿童的UFC死亡率为6.96/1000 CM (95% CI 6.47-7.45)，未感染艾滋病毒的妇女所生儿童的UFC死亡率为4.34/1000 CM （95% CI 4.03-4.65）。感染和未感染艾滋病毒的妇女所生的UFC事件/死亡的总体平均和标准误差（SE）时间为54.80（0.18）个月。感染艾滋病毒妇女所生UFC的平均（SE）死亡时间为52.79（0.41）个月，未感染艾滋病毒妇女所生UFC的平均（SE）死亡时间为55.44（0.19）个月（log-rank x2 = 37.59, p < 0.001）。早产或低出生体重是两组中UFC死亡的主要原因；但是，没有感染艾滋病毒的妇女所生的UFC比她们的同龄人要高。在报告医生报告的806例死亡病例中，只有4例或0.5%可归因于艾滋病毒相关并发症。结论：尽管在减少UFC死亡率方面作出了值得赞扬的努力，但博茨瓦纳感染艾滋病毒的妇女所生的UFC死亡率仍然较高，与未感染艾滋病毒的妇女所生的UFC相比，她们的生存时间更短。儿童生存干预措施应优先考虑感染艾滋病毒的妇女所生的UFC，以改善她们的生存。
{"title":"Incidence of Mortality among Under-Five-Year-Old Children Born to Women Living with HIV and Those Born to Women Not Living with HIV in Botswana: A 5-Year Retrospective Study.","authors":"Onalethata Lesetedi, Jose Gaby Tshikuka, Shimeles G Hamda, Mgaywa Gilbert Mjungu Damas Magafu, Roy Tapera, Tiny Masupe, Julius Chacha Mwita","doi":"10.1155/2022/9659871","DOIUrl":"10.1155/2022/9659871","url":null,"abstract":"<p><strong>Background: </strong>Child mortality is a core indicator for child health and wellness. Botswana reported an under-five-year-old children (UFC) mortality rate of 48 deaths per 1000 live births in 2017 against 152 deaths per 1000 live births in 1971. This was a commendable accomplishment. However, given the current country situation whereby 23% of children are born to women living with HIV, the incidence of mortality among UFC born to women living with and not living with HIV and their survival are better health metrics to inform decision making. Nevertheless, such data are still very scarce in Botswana. The study's objective was to estimate the incidence of UFC mortality among children born to women living with and not living with HIV and to compare UFC survival between the two groups.</p><p><strong>Methods: </strong>A retrospective cohort study of mortality among UFC was conducted in Botswana, including all UFC born between January 2014 and June 2018. Data were extracted from the National Under-Five Mortality Audit Committee (NUFMAC) database using a standardized data collection tool. The incidence rate of UFC death was estimated as a function of the duration from birth to death. Survival functions of UFC born to women living with and not living with HIV were plotted and compared using Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>The overall incidence of UFC death was 4.63/1000 child months (CM) (95% CI 4.36-4.90). The incidence of UFC death among children born to women living with HIV was 6.96/1000 CM (95% CI 6.47-7.45) and that of UFC born to women not living with HIV was 4.34/1000 CM (95% CI 4.03-4.65). The overall average and standard error (SE) time to event/death for UFC born to women living with and not living with HIV was 54.80 (0.18) months. The mean (SE) time to death for UFC born to women living with HIV was 52.79 (0.41) months and that of UFC born to women not living with HIV was 55.44 (0.19) months (log-rank <i>X</i> <sup>2</sup> = 37.59, <i>p</i> < 0.001). Prematurity or low birth weight was the leading cause of UFC death in both groups; but, it was higher in UFC born to women not living with HIV subgroup than their counterparts. Four cases only or 0.5% of the 806 death cases reported by reporting physicians were attributable to HIV-related complications.</p><p><strong>Conclusion: </strong>Despite the commendable efforts made in reducing UFC death, the incidence of UFC death among UFC born to women living with HIV in Botswana is still higher, and their survival is shorter compared to UFC born to women not living with HIV. Child survival interventions should prioritize UFC born to women living with HIV to improve their survival.</p>","PeriodicalId":46303,"journal":{"name":"AIDS Research and Treatment","volume":" ","pages":"9659871"},"PeriodicalIF":1.1,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8816585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39894777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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