Mohamud Abdirahman Khalif, Ahmed Omar Abdullahi, Mohamud Abdulrahman Ahmed, Dirie Najib Isse
Faculty of Medicine, and Health Sciences.
Department of ART Unit, Banadir Hospital, Mogadishu, Somalia.
Ann Med Surg (Lond). 2023 Jun 6;85(7):3364-3371. doi: 10.1097/MS9.0000000000000880. eCollection 2023 Jul.
Opportunistic infections (OIs) remain the leading cause of death among people living with Human immune deficient virus and OIs-related mortality in Africa is estimated at 310 000 cases. Besides, Somalia has scant data about OIs since a high burden of tuberculosis and HIV co-infection has been reported. Hence, up-to-date information is vital for better treatment and interventions and may support national and international HIV strategies and eradication programs. Therefore, this study aims to estimate the magnitude of OIs and determine factors associated with among people living with HIV/AIDs on anti-retroviral therapy (ART) in a selected public hospital in Mogadishu, Somalia.
A hospital-based cross-sectional study was conducted between 1 June and 30 August 2022 by interviewing HIV patients and reviewing case record files using a validated questionnaire containing sociodemographic, clinical, OIs history, behavioural and environmental characteristics. Logistic regression was used to determine factors associated with OIs at the significance level of a=0.05.
The magnitude of OIs among people living with HIV was 37.1% (95% CI=31.6-42.2); major identified OIs were pulmonary tuberculosis 8.2%, Diarrhoea 7.9%, and Pneumonia 4.3%. Based on Multivariable logistic regression drinking non-sterilized water [adjusted odds ratio (AOR)=2.395, 95% CI: 2.010-4.168], living with domestic animals (AOR=4.012, 95% CI: 1.651-4.123), Co-morbidity of chronic disease (AOR=2.910, 95% CI: 1.761-3.450), and poor ART adherence (AOR=3.121, 95% CI: 1.532-6.309) were factors associated with OIs.
Human immune deficient virus patients in Mogadishu, Somalia, suffer from OIs. The OIs reduction strategies should improve drinking water sanitation, provide special consideration for those living with domestic animals and those with a co-morbid chronic disease, and improve ART adherence.
机会性感染（OIs）仍然是人类免疫缺陷病毒感染者死亡的主要原因，据估计非洲与机会性感染相关的死亡率为31万例。此外，由于报告了结核病和艾滋病毒合并感染的高负担情况，索马里关于机会性感染的数据很少。因此，最新信息对于更好的治疗和干预至关重要，可能会支持国家和国际艾滋病毒战略及根除计划。因此，本研究旨在估计索马里摩加迪沙一家选定公立医院中接受抗逆转录病毒治疗（ART）的艾滋病毒/艾滋病感染者中机会性感染的严重程度，并确定与之相关的因素。
2022年6月1日至8月30日进行了一项基于医院的横断面研究，通过访谈艾滋病毒患者并使用包含社会人口统计学、临床、机会性感染病史、行为和环境特征的有效问卷审查病例记录文件。采用逻辑回归分析在显著性水平α = 0.05下确定与机会性感染相关的因素。
艾滋病毒感染者中机会性感染的严重程度为37.1%（95%置信区间=31.6 - 42.2）；主要确定的机会性感染为肺结核8.2%、腹泻7.9%和肺炎4.3%。基于多变量逻辑回归，饮用未消毒水[调整优势比（AOR）=2.395，95%置信区间：2.010 - 4.168]、与家畜一起生活（AOR = 4.012，95%置信区间：1.651 - 4.123）、慢性病合并症（AOR = 2.910，95%置信区间：1.761 - 3.450）以及抗逆转录病毒治疗依从性差（AOR = 3.121，95%置信区间：1.532 - 6.309）是与机会性感染相关的因素。
索马里摩加迪沙的人类免疫缺陷病毒患者患有机会性感染。减少机会性感染的策略应改善饮用水卫生，对与家畜一起生活的人和患有慢性病合并症的人给予特别关注，并提高抗逆转录病毒治疗的依从性。
