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在埃塞俄比亚南部 Gamo 地区接受抗逆转录病毒疗法的 HIV 儿童中的周围神经病及相关因素:一项基于机构的横断面研究。

Peripheral neuropathy and associated factors among children living with HIV on antiretroviral therapy in Gamo zone, Southern Ethiopia: an institution-based cross-sectional study.

机构信息

Department of Human Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.

School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.

出版信息

BMC Infect Dis. 2024 Sep 27;24(1):1059. doi: 10.1186/s12879-024-09984-9.

Abstract

BACKGROUND

Peripheral neuropathy (PN) is a common neurological complication of HIV (Human Immunodeficiency Virus) that can significantly affect patients' quality of life. In Ethiopia, children living with HIV are at an increased risk of developing peripheral neuropathy due to comorbidities such as anemia, tuberculosis, malnutrition, and poor socio-economic status. Our study aims to evaluate the prevalence of peripheral neuropathy among children living with HIV in Ethiopia using a simple clinical screening tool.

METHODS

A health institution-based cross-sectional study was conducted among 148 children aged 5 to 18 years living with HIV who are receiving treatment at the antiretroviral therapy (ART) clinic of the randomly selected public health institutions in the Gamo zone. An interview and neurologic examination were conducted. A binary logistic regression model was used to identify factors associated with the outcome variable. Variables with p-value < 0.25 in the bi-variable logistic regression analysis were entered and checked for association in a multivariable logistic regression model. The level of statistical significance was declared at the p-value < 0.05.

RESULT

In this study, 148 children participated, making a response rate of 97.5%. The mean ± standard deviation (SD) age of the respondents was 15.03 ± 2.99 years, and 81(54.7%) were male. The magnitude of PN was 20.9% (31/148). Children in the age category of 15-18 (adjusted odds ratio (AOR) = 1.88, 95%CI; 1.24-4.60), low BMI for age (AOR = 1.66, 95%CI; 1.12-4.15), last exposure to isoniazid within 1 year (AOR = 2.31, 95%CI; 1.12-8.53). Longer duration of HIV illness (AOR = 2.17, 95%CI; 1.54-4.64), and past tuberculosis (TB) treatment (AOR = 2.11, 95%CI; 1.08-7.48) were significantly associated factors with peripheral neuropathy.

CONCLUSION

Our analysis revealed that being in the age category of 15-18 years, low BMI for age, Isoniazid exposure, longer Duration of HIV illness, and past TB treatment were significantly associated with peripheral neuropathy in children living with HIV. These disease-related factors may contribute to the development and progression of peripheral neuropathy in this population.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

周围神经病变(PN)是 HIV(人类免疫缺陷病毒)的一种常见神经系统并发症,会严重影响患者的生活质量。在埃塞俄比亚,由于贫血、结核病、营养不良和贫困等合并症,感染 HIV 的儿童患周围神经病的风险增加。我们的研究旨在使用简单的临床筛查工具评估埃塞俄比亚感染 HIV 的儿童中周围神经病的患病率。

方法

这是一项在戈马地区随机选择的公共卫生机构的抗逆转录病毒治疗 (ART) 诊所接受治疗的年龄在 5 至 18 岁之间的 148 名感染 HIV 的儿童中进行的医疗机构为基础的横断面研究。进行了访谈和神经系统检查。使用二元逻辑回归模型来确定与结局变量相关的因素。在双变量逻辑回归分析中 p 值 < 0.25 的变量被纳入并在多变量逻辑回归模型中检查关联。统计显著性水平在 p 值 < 0.05 时宣布。

结果

本研究共纳入 148 名儿童,应答率为 97.5%。受访者的平均年龄为 15.03 ± 2.99 岁,81 名(54.7%)为男性。PN 的严重程度为 20.9%(31/148)。年龄在 15-18 岁的儿童(调整后的优势比(AOR)=1.88,95%CI;1.24-4.60)、低年龄别 BMI(AOR=1.66,95%CI;1.12-4.15)、最近一次在一年内接触异烟肼(AOR=2.31,95%CI;1.12-8.53)。HIV 疾病持续时间较长(AOR=2.17,95%CI;1.54-4.64)和过去的结核病(TB)治疗(AOR=2.11,95%CI;1.08-7.48)与周围神经病显著相关。

结论

我们的分析表明,15-18 岁年龄组、低年龄别 BMI、异烟肼接触、HIV 疾病持续时间较长以及过去的结核病治疗与感染 HIV 的儿童的周围神经病显著相关。这些与疾病相关的因素可能导致该人群中周围神经病的发生和发展。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4581/11428338/96f9b7471479/12879_2024_9984_Fig1_HTML.jpg

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