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肯尼亚内罗毕肯雅塔国家医院的HIV阳性患者中与HIV相关的机会性感染/病症的类型及流行情况。

Types and prevalence of HIV-related opportunistic infections/conditions among HIV-positive patients attending Kenyatta National Hospital in Nairobi, Kenya.

作者信息

Chepkondol Geoffrey K, Jolly Pauline E, Yatich Nelly, Mbowe Omar, Jaoko Walter G

机构信息

Department of Epidemiology, University of Alabama at Birmingham School of Public Health, 1665 University Blvd Birmingham, Alabama, United States.

Department of Biostatistics, University of Alabama at Birmingham School of Public Health, 1665 University Blvd Birmingham, Alabama, United States.

出版信息

Afr Health Sci. 2020 Jun;20(2):615-624. doi: 10.4314/ahs.v20i2.9.

Abstract

BACKGROUND

Although antiretroviral therapy (ART) has resulted in significant decrease in opportunistic infections (OIs), OIs continue to cause significant morbidity and mortality among HIV patients.

OBJECTIVE

To determine the prevalence and types of HIV/AIDS-related OIs among patients attending Kenyatta National Hospital (KNH) in Nairobi, Kenya.

METHODS

A cross-sectional study was conducted from May to August 2010 among patients ≥19 years. An interviewer-administered questionnaire was used to collect data on socio-demographic factors, HIV and OIs. CD4 data were extracted from clinical records.

RESULTS

Most patients (72%) had lived with HIV for ≤ 5 years and 78.8% had an OI. The 3 most common OIs were TB (35%), Herpes Zoster (HZ; 15.4%) and oral thrush (OT; 8%). Years of HIV infection significantly predicted TB (p=0.01). Patients with CD4 ≤ 349 were almost twice as likely to have TB, than those with CD4 ≥500. Type of occupation predicted OT (p=0.04) with skilled workers less likely to have OT. Patients with primary/vocational/technical education were >3 times more likely to have HZ than those with tertiary education.

CONCLUSION

Due to the complex management of HIV and its associated OIs, appropriate implementation of the recommended guidelines for care and prevention among patients at KNH is important.

摘要

背景

尽管抗逆转录病毒疗法(ART)已使机会性感染(OIs)显著减少,但OIs在HIV患者中仍导致大量发病和死亡。

目的

确定肯尼亚内罗毕肯雅塔国家医院(KNH)就诊患者中与HIV/AIDS相关的OIs的患病率和类型。

方法

2010年5月至8月对≥19岁的患者进行了一项横断面研究。采用访谈式问卷收集社会人口学因素、HIV和OIs的数据。CD4数据从临床记录中提取。

结果

大多数患者(72%)感染HIV的时间≤5年,78.8%的患者患有OIs。3种最常见的OIs是结核病(35%)、带状疱疹(HZ;15.4%)和口腔念珠菌病(OT;8%)。HIV感染年限显著预测结核病(p=0.01)。CD4≤349的患者患结核病的可能性几乎是CD4≥500患者的两倍。职业类型预测OT(p=0.04),技术工人患OT的可能性较小。接受小学/职业/技术教育的患者患HZ的可能性是接受高等教育患者的3倍多。

结论

由于HIV及其相关OIs的管理复杂,在KNH患者中适当实施推荐的护理和预防指南很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5661/7609085/42d89241156e/AFHS2002-0615Fig1.jpg

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