Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.
Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana.
PLoS One. 2024 Nov 5;19(11):e0312446. doi: 10.1371/journal.pone.0312446. eCollection 2024.
Metabolic syndrome (MetS) refers to the clustering of three or more metabolic disorders including high blood pressure, glucose impairment, abdominal obesity, high triglycerides, and low high-density lipoproteins. MetS is increasingly being considered an epidemic among People Living With HIV (PLWH) with reports of association between HIV infection and/or antiretroviral therapy (ART) usage and development of MetS. MetS predisposes PLWH to the development of cardiovascular, kidney diseases and diabetes, decreases the quality of life, and burdens the health system. This study aims to establish the incidence, time to development and risk factors for development of MetS and it's components, and to assess the capacity of the health system to manage MetS and it's components among ART naive PLWH in Accra, Ghana.
We will conduct a mixed methods study with quantitative and qualitative data collection. Our prospective cohort study would enroll adults of 18 years and above with none or less than three MetS components at baseline and follow them up at six months and one year. Demographic, lifestyle data, anthropometric, and laboratory data will be collected using an adapted WHO Steps Survey questionnaire. The WHO Service Availability and Readiness Questionnaire (SARA) will be adapted to collect information on capacity across the six WHO building blocks. Key informant interviews will be conducted with HIV coordinators at the national, regional, and facility levels. In-depth interviews will be conducted with PLWH from the cohort who develop MetS or MetS components during their follow-up. Data will be analysed using proportions, Kaplan Mier time to event analysis, fitting of Cox proportional hazard regression models for risk factors, and generation of themes from qualitative data.
This study will generate data on the incidence, time to development, risk factors for MetS and MetS components development, and health systems capacity for MetS management among PLWH. Findings would inform revisions to the guidelines and policies for HIV care in Ghana, Africa, and beyond, ultimately improving MetS prevention and management among the vulnerable population of PLWH.
代谢综合征（MetS）是指三种或更多种代谢紊乱的聚集，包括高血压、葡萄糖损伤、腹部肥胖、高甘油三酯和低高密度脂蛋白。代谢综合征在感染人类免疫缺陷病毒（HIV）的人群中越来越被认为是一种流行疾病，有报道称 HIV 感染和/或抗逆转录病毒治疗（ART）的使用与代谢综合征的发生有关。代谢综合征使 HIV 感染者更容易发生心血管疾病、肾脏疾病和糖尿病，降低生活质量，并给卫生系统带来负担。本研究旨在确定代谢综合征及其各组分的发病率、发生时间和危险因素，并评估加纳阿克拉地区未经 ART 治疗的 HIV 感染者管理代谢综合征及其各组分的卫生系统能力。
我们将进行一项混合方法研究，包括定量和定性数据收集。我们的前瞻性队列研究将招募年龄在 18 岁及以上、基线时无或少于三种代谢综合征成分的成年人，并在六个月和一年时对其进行随访。将使用经过改编的世界卫生组织（WHO）步骤调查问卷收集人口统计学、生活方式、人体测量和实验室数据。将改编 WHO 服务可用性和准备情况调查（SARA）问卷收集关于六个 WHO 构建模块的能力信息。将对国家、区域和机构层面的 HIV 协调员进行关键知情人访谈。将对队列中在随访期间发生代谢综合征或代谢综合征成分的 HIV 感染者进行深入访谈。将使用比例、Kaplan Mier 时间事件分析、Cox 比例风险回归模型拟合进行数据分析，以确定代谢综合征和代谢综合征各组分的发病风险因素，并从定性数据中生成主题。
本研究将提供有关 HIV 感染者代谢综合征及其各组分的发病率、发生时间、发病风险因素以及卫生系统管理代谢综合征能力的数据。研究结果将为加纳、非洲和其他地区的 HIV 护理指南和政策修订提供信息，最终改善 HIV 感染者这一弱势群体的代谢综合征预防和管理。
