Time to Increase WHO Clinical Stage of People Living with HIV in Public Health Facilities of Arba Minch Town, South Ethiopia
Clinical Medicine Research
Volume 3, Issue 5, September 2014, Pages: 119-124
Received: Aug. 2, 2014;
Accepted: Aug. 12, 2014;
Published: Aug. 20, 2014
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Direslgne Misker Abyu, Arba Minch University, Department of Public Health, Arba Minch, Ethiopia
Eskezyiaw Agidew Getahun, Arba Minch University, Department of Public Health, Arba Minch, Ethiopia
Marelgn Tilahun Malaju, Arba Minch University, Department of Public Health, Arba Minch, Ethiopia
Habtamu Mellie Bizuayehu, Debre Markos University, Department of Public Health, Debre Markos, Ethiopia
Background: Highly Active Antiretroviral Therapy improves time to death and recurrence of any opportunistic infections in peoples living with HIV. But little is known about its effect on time to increase WHO clinical stage. Thus, this study was aimed at assessing time to increase WHO clinical stage and associated factors. Method: Retrospective cohort study was used and the required sample size was 464. Study participants were selected randomly from the list of adult people living with HIV attending the public health facilities for ART. Univariate analysis was used to describe patients’ baseline and follow up characteristics. Kaplan-Meier survival and log rank test were used to estimate survival and compare survival curves respectively. Cox proportional-hazard regression model was used to calculate hazard rate and to determine independent predictors of time to increase WHO clinical stage. Result: A total of 464 patients (232 in each cohort) contribute for 898.12 person years of follow up. The overall incidence rate of increased WHO clinical stage was 16.6 per 100 person years of follow up and the incidence of increased WHO clinical stage was 38.5 per 100 person year and 3.8 per 100 person year of follow up in ART and HAART cohorts respectively. Being on Highly Active Antiretroviral Therapy and taking prophylaxis at baseline were the identified predictors’ that prevent increment of WHO clinical stage. In contrary being widowed and single marital status, substance use, rural residence and being in age category 45 years and above were independent predictors for increment of WHO clinical stage. Conclusion: Increment of WHO clinical stage was higher in pre ART cohorts. Special consideration should be given for those who are widowed, substance users and aged 45 years and above.
Direslgne Misker Abyu,
Eskezyiaw Agidew Getahun,
Marelgn Tilahun Malaju,
Habtamu Mellie Bizuayehu,
Time to Increase WHO Clinical Stage of People Living with HIV in Public Health Facilities of Arba Minch Town, South Ethiopia, Clinical Medicine Research.
Vol. 3, No. 5,
2014, pp. 119-124.
U.S. Global Health Policy Fact Sheet the Global HIV/AIDS Epidemic, 2011.
WHO Global HIV/AIDS Response: Epidemic update and health sector progress towards Universal Access WHO, UNICEF UNAIDS, 2011.
UNAIDS Together we will end AIDS. Joint United Nations Programme on HIV/AIDS, Geneva, 2012.
Central Statistical Agency (CSA), Ethiopia Demographic and Health Survey; final draft report. Addis Ababa Ethiopia, ICF International Calverton, Maryland, USA. 2011.
Federal HIV/AIDS Prevention and Control Office Annual Performance Report of Multi-sectoral HIV/ AIDS Response, Federal HIV/AIDS Prevention and Control Office, 2010.
Report on progress towards implementation of the UN Declaration of Commitment on HIV/AIDS. Federal Democratic Republic of Ethiopia Federal HIV/AIDS Prevention and Control Office.
WHO, Interim WHO Clinical Staging of HIV/AIDS and HIV/AIDS Case Definitions for surveillance in Africa Region, 2005.02.
Mariam ZT, Abebe G, Mulu A. Opportunistic and other intestinal parasitic infections in AIDS patients, HIV seropositive healthy carriers and HIV seronegative individuals in southwest Ethiopia. East Afr J Public Health, 2008, 5: 169-173.
Gallant JE, Moore RD, Chaisson RE. Prophylaxis for opportunistic infections in patients with HIV infection. Ann Intern Med, 1994, 120: 932-944.
Candiani TM, Pinto J, Cardoso CA, Carvalho IR, Dias AC. et al. Impact of highly active antiretroviral therapy (HAART) on the incidence of opportunistic infections, hospitalizations and mortality among children and adolescents living with HIV/AIDS in Belo Horizonte, Minas Gerais State, Brazil. Cad Saude Publica. 2007;23
Missaye A, Dagnew M, Alemu A, Alemu A. Prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients with pre-ART and on-ART attending dessie hospital ART clinic, Northeast Ethiopia. AIDS Res Ther. 2013 Feb 25;10(1)
Sun HY, Chen MY, Hsieh SM, Sheng WH, Chang SY. et al. Changes in clinical spectrum of opportunistic illnesses in persons with HIV infection in Taiwan in the era of HAART.. J. Infect. Dis, 2006; 59, 311-316.
Manosuthi W, Chaovavanich A, Tansuphaswadikul S, Prasithsirikul W, Inthong Y. et al. Incidence and risk factors of major opportunistic infections after initiation of antiretroviral therapy among advanced HIV-infected patients in a resource-limited setting. J Infect. 2007 Nov;55(5)
Losina E, Yazdanpanah Y, Wang B, Messou E, Anglaret X. et al. The independent effect of highly active antiretroviral therapy on severe opportunistic disease incidence and mortality in HIV-infected adults in Côte d'Ivoire. Antivir Ther.2007; 12(4): 543–551.
Jerene D, Naess A, Lindtjorn B. Antiretroviral therapy at a district hospital in Ethiopia prevents death and tuberculosis in a cohort of HIV patients. AIDS, 2006; 3:10.
Ghate M, Deshpande S, Tripathy S, Nene M, Gedam P. et al. Incidence of common opportunistic infections in HIV-infected individuals in Pune, India: analysis by stages of immune suppression represented by CD4 counts. International Journal of Infectious Diseases. 2009;13
Badri M WD, Wood R. Effect of highly active antiretroviral therapy on incidence of tuberculosis in South Africa: a cohort study. Lancet 2002;359: 2059-64
Kassa D. The pattern of immunologic and virologic responses to Highly Active Antiretroviral Treatment (HAART): Does success bring further challenges? Ethiop. J. Health Dev. 2011;25(1):61-70
Charles B. Wood R, Badri M, Zilber S, Wang B. et al. CD4 Decline and Incidence of Opportunistic Infections in Cape Town, South Africa: Implications for Prophylaxis and Treatment. J Acquired Immune Deficiency Syndrome. 2006,42 ( 4)
Kibret KT, Yalew AW, Belaineh BG, Asres MM. Determinant Factors Associated with Occurrence of Tuberculosis among Adult People Living with HIV after Antiretroviral Treatment Initiation in Addis Ababa, Ethiopia: A Case Control Study. 2013. doi:10.1371
Biadgilign S, Reda A and Digaffe T. Predictors of mortality among HIV infected patients taking antiretroviral treatment in Ethiopia: a retrospective cohort study. AIDS Research and Therapy , 2012, 9:15
Badri M, Ehrlicha R, Wood R, et al. Initiating co-trimoxazole prophylaxis in HIV-infected patients in Africa: an evaluation of the provisional WHO/UNAIDS recommendations. AIDS. 2001,15:1143-1148.
Anglaret X, Messou E, Ouassa T, et al. Pattern of bacterial diseases in a cohort of HIV-1 infected adults receiving cotrimoxazole prophylaxis in Abidjan, Coˆ te d’Ivoire. AIDS2003, 17:575–584.