加纳库马西新诊断患者中晚期艾滋病晚期就诊的高患病率及其预测因素。

High prevalence of late presentation with advanced HIV disease and its predictors among newly diagnosed patients in Kumasi, Ghana.

作者信息

Sakyi Samuel Asamoah, Kwarteng Samuel, Senu Ebenezer, Effah Alfred, Opoku Stephen, Oppong Success Acheampomaa, Yeboah Kingsley Takyi, Abutiate Solomon, Lamptey Augustina, Arafat Mohammed, Afari-Gyan Festus Nana, Agordzo Samuel Kekeli, Mensah Oscar Simon Olympio, Owusu Emmauel, Buckman Tonnies Abeku, Amoani Benjamin, Enimil Anthony Kwame

机构信息

Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti region, Ghana.

Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti region, Ghana.

出版信息

BMC Infect Dis. 2024 Jul 31;24(1):764. doi: 10.1186/s12879-024-09682-6.

DOI:10.1186/s12879-024-09682-6

PMID:39085822

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11293094/

Abstract

BACKGROUND

Late presentation with advanced HIV disease (LP-AHD) remains a significant challenge to Human Immunodeficiency Virus (HIV) care, contributing to increased morbidity, mortality, and healthcare costs. Despite global efforts to enhance early diagnosis, a considerable proportion of individuals with HIV infection are unaware of being infected and therefore present late for HIV care. For the first time in Ghana, this study assessed the prevalence of LP-AHD and associated factors among people diagnosed with HIV (PDWH).

METHOD

This bi-center retrospective cross-sectional study included 315 PDWH at the Aniniwah Medical Centre and Komfo Anokye Teaching Hospital, both in Kumasi, Ghana. A well-structured questionnaire was used to collect data on sociodemographic, clinical, lifestyle and psychosocial factors from the study participants. Statistical analyses were done in SPSS version 26.0 and GraphPad Prism version 8.0 at significant p-value of < 0.05 and 95% confidence interval. Predictors of LP-AHD were assessed using binary logistic regression models.

RESULTS

This study observed that, 90 out of the 315 study PDWH (28.6%) reported late with advanced HIV disease (AHD). Participants within the age group of 36-45 years (adjusted Odds Ratio [aOR]: 0.32, 95% CI: 0.14-0.69; p = 0.004) showed a significantly decreased likelihood of LP-AHD. However, participants who perceived cost of HIV care to be high (aOR: 7.04, 95% CI: 1.31-37.91; p = 0.023), who were diagnosed based on clinical suspicion (aOR: 13.86, 95 CI: 1.83-104.80; p = 0.011), and missed opportunities for early diagnosis by clinicians (aOR: 2.47, 95% CI: 1.30-4.74; p = 0.006) were significantly associated with increased likelihood of LP-AHD.

CONCLUSION

The prevalence of LP-AHD among PDWH in Ghana is high. Efforts to improve early initiation of HIV/AIDS care should focus on factors such as the high perceived costs of HIV care, diagnosis based on clinical suspicion, and missed opportunities for early diagnosis by physicians.

摘要

背景

晚期出现的晚期人类免疫缺陷病毒（HIV）疾病（LP-AHD）仍然是HIV治疗面临的重大挑战，导致发病率、死亡率和医疗成本增加。尽管全球致力于加强早期诊断，但仍有相当一部分HIV感染者不知道自己已被感染，因此很晚才接受HIV治疗。本研究首次在加纳评估了晚期出现的晚期HIV疾病（LP-AHD）的患病率以及HIV确诊患者（PDWH）中的相关因素。

方法

这项双中心回顾性横断面研究纳入了加纳库马西的阿尼尼瓦医疗中心和科姆福·阿诺克耶教学医院的315名HIV确诊患者。使用一份结构完善的问卷收集研究参与者的社会人口学、临床、生活方式和心理社会因素数据。在SPSS 26.0版和GraphPad Prism 8.0版中进行统计分析，显著性p值<0.05，置信区间为95%。使用二元逻辑回归模型评估LP-AHD的预测因素。

结果

本研究观察到，315名HIV确诊患者中有90名（28.6%）报告出现晚期HIV疾病（AHD）。36-45岁年龄组的参与者（调整后的优势比[aOR]：0.32，95%置信区间：0.14-0.69；p = 0.004）出现LP-AHD的可能性显著降低。然而，认为HIV治疗成本高的参与者（aOR：7.04，95%置信区间：1.31-37.91；p = 0.023）、基于临床怀疑被诊断的参与者（aOR：13.86，95%置信区间：1.83-104.80；p = 0.011）以及临床医生错过早期诊断机会的参与者（aOR：2.47，95%置信区间：1.30-4.74；p = 0.006）与LP-AHD可能性增加显著相关。