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埃塞俄比亚南部盖德奥地区卫生中心抗逆转录病毒治疗诊所成年患者中的双相谱系障碍及其相关因素

Bipolar spectrum disorders and associated factors among adults attending an antiretroviral therapy clinic in Gedeo zone health centers, southern Ethiopia.

作者信息

Belayneh Zelalem, Alemu Wagaye, Mekuriaw Birhanie, Abebe Zegeye

机构信息

Department of Psychiatry, College of Health and Medical Science, Dilla University, Dilla, Ethiopia,

Department of Epidemiology and Biostatistics, College of Health and Medical Science, Dilla University, Dilla, Ethiopia.

出版信息

Neuropsychiatr Dis Treat. 2019 Feb 20;15:503-509. doi: 10.2147/NDT.S187669. eCollection 2019.

Abstract

BACKGROUND

Bipolar spectrum disorders (BPSDs) are more common among HIV-positive individuals than the general population. Although BPSDs have very diverse and devastating consequences (immune suppression, cognitive impairment and poor medication adherence), little is known about BPSDs among HIV-positive individuals in Ethiopia. Therefore, this study was aimed to assess the prevalence and associated factors of BPSDs among adults attending antiretroviral therapy (ART) clinics in Gedeo zone health centers, southern Ethiopia.

PATIENTS AND METHODS

An institutional-based cross-sectional study was conducted by screening 412 randomly selected HIV-positive individuals using Mood Disorder Questionnaire. SPSS version 20 was used for data analysis. Bivariable and multivariable logistic regression models were fitted to identify factors associated with BPSDs. Adjusted OR (AOR) with corresponding 95% CI was computed to determine the association.

RESULTS

Of the total 412 participants, 11.2% were screened positive for BPSDs. Lower CD4 count (AOR =2.97; 95% CI: 1.11, 7.90), past history of mental health problem (AOR =3.35; 95% CI: 1.576, 7.144), poor social support (AOR =2.6; 95% CI: 1.06, 6.63) and poor ART drug adherence (AOR =3.59; 95% CI: 1.78, 7.21) had a positive association with BPSDs.

CONCLUSION

In this study, the prevalence of BPSDs was high among adult patients attending ART clinics in Gedeo zone health centers. Poor social support, poor ART drug adherence, lower CD4 level and history of mental illness had statistically significant association with BPSDs. This demonstrates a need for the integration of Mental Health and Psycho Social Support with HIV/AIDS care services. Moreover, establishing good social support and controlling ART adherence were found to be very crucial too.

摘要

背景

双相谱系障碍(BPSDs)在艾滋病毒呈阳性的个体中比在普通人群中更为常见。尽管双相谱系障碍会产生非常多样且具有破坏性的后果(免疫抑制、认知障碍和药物依从性差),但在埃塞俄比亚,关于艾滋病毒呈阳性个体中的双相谱系障碍却知之甚少。因此,本研究旨在评估埃塞俄比亚南部盖德奥地区卫生中心接受抗逆转录病毒治疗(ART)门诊的成年人中双相谱系障碍的患病率及相关因素。

患者与方法

采用基于机构的横断面研究,使用心境障碍问卷对412名随机选取的艾滋病毒呈阳性个体进行筛查。使用SPSS 20版进行数据分析。采用双变量和多变量逻辑回归模型来确定与双相谱系障碍相关的因素。计算调整后的比值比(AOR)及相应的95%置信区间(CI)以确定关联。

结果

在412名参与者中,11.2%的人双相谱系障碍筛查呈阳性。较低的CD4细胞计数(AOR = 2.97;95% CI:1.11,7.90)、既往有心理健康问题史(AOR = 3.35;95% CI:1.576,7.144)、社会支持差(AOR = 2.6;95% CI:1.06,6.63)和抗逆转录病毒治疗药物依从性差(AOR = 3.59;95% CI:1.78,7.21)与双相谱系障碍呈正相关。

结论

在本研究中,盖德奥地区卫生中心接受抗逆转录病毒治疗门诊的成年患者中双相谱系障碍的患病率较高。社会支持差、抗逆转录病毒治疗药物依从性差、较低的CD4水平和精神疾病史与双相谱系障碍有统计学上的显著关联。这表明需要将心理健康和心理社会支持与艾滋病毒/艾滋病护理服务相结合。此外,建立良好的社会支持和控制抗逆转录病毒治疗的依从性也非常关键。

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