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Voundi EV, Kalla GCM, Kenfack JDT, Olen JPK, Essi MJ, Mbopi-Keou FX. [Association between depression and viral load in people on antiretroviral treatment followed at the Yaoundé Central Hospital in Cameroon]. Pan Afr Med J 2022; 41:320. [PMID: 35865857 PMCID: PMC9269042 DOI: 10.11604/pamj.2022.41.320.33056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 03/27/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction depression may be associated with poor immune and virological response, poor quality of life and high medical costs in people living with HIV. The purpose of this study is to investigate the association between depression and viral load in people living with HIV on antiretroviral treatment followed at the Yaounde Central Hospital. Methods we conducted a cross-sectional study of people living with HIV who had their viral load results at the Central Hospital of Yaounde over 8 months (November 2019 to July 2020). Before starting the study, informed consent was obtained from each participant. Sociodemographic, clinical, paraclinical and lifestyle data were collected. Depression was assessed using the Hospital Anxiety and Depression scale (HAD). Consecutive and non-probability sampling was used. Statistical analysis was performed using SPSS software version 23.0. A p-value < 0.05 was considered statistically significant. Results of the 205 participants enrolled, female sex was the most represented (n=153, 74.6%) and the mean age was 46.5 ± 1.8 years. All participants had clinical stage I HIV and most of them had undetectable viral load (n=164, 80.0%). Definite depression was found in 4.8% of cases and people living with HIV with symptoms of definite depression were more likely to have a high viral load (OR = 14.24 [3.61-56.14]; p = <0.001). Conclusion: depression could be a leading cause of high viral load.
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Affiliation(s)
- Esther Voundi Voundi
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
| | | | | | - Jean Pierre Kamga Olen
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
| | - Marie Josée Essi
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
| | - Francois-Xavier Mbopi-Keou
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
- Institut pour le Développement de l´Afrique (The-IDA), Yaoundé, Cameroun
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Lantche MW, Fokam J, Cheudjui AJN, Tchatchueng JBM, Noumsi TSJ, Ateba FN, Koki PN, Billong CS. Factors associated with non-adherence to antiretroviral therapy among HIV-infected adolescents aged 15-19 years: a snapshot from the Mother and Child Center in Yaounde, Cameroon. Pan Afr Med J 2021; 39:154. [PMID: 34539951 PMCID: PMC8434790 DOI: 10.11604/pamj.2021.39.154.27623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/29/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction non-adherence to antiretroviral therapy (ART) constitutes the main cause of therapeutic failure among HIV-infected adolescents, especially in the aged group 15 to 19 years. We aimed to determine factors associated with this non-adherence in this specific population. Methods we conducted a cross-sectional study at the Mother and Child Center in Yaounde from August to October 2018. Delayed clinic appointment was referred to as defaulters. Non-adherence was measured during the 3 days preceding inclusion by self-reported method following quantitative (missing dosage of ART), qualitative (ART taken with a delay of more than 2 hours) and combined measure. A threshold of non-adherence > 20% was considered high, with p<0.05 statistically significant. Results overall, 195 out of 251 (77.7%) eligible adolescents were included, of which 56.9% were girls (sex-ratio = 4/3). The mean age was 16.8 ± 1.5 years. The rate of defaulters was 21.0%. Following quantitative approach, 33.8% were non-adherent. Using combined approach, we had 41.0%. This non-adherence was associated with duration on ART > 5 years (adjusted Odds Ratio [aOR]: 2.33;95% Confidence Interval [CI]: 1.08-5.00; p:0.030), defaulters (aOR: 2.56;95% CI: 1.12-5.82; p:0.025) and HIV Viral Load (VL) ≥ 40 copies/ml (aOR: 0.42; 95% CI: 0.21-0.83; p:0.013). Conclusion at this reference pediatric center, 4 out of 10 adolescents aged 15-19 years on ART are non-adherent, driven by missing dosage of drug intake. Strategies for enhanced adherence for late age adolescents are therefore warranted, by prioritizing interventions on defaulters and duration on ART > 5 years.
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Affiliation(s)
- Martial Wandji Lantche
- Department of Epidemiology, School of Health Sciences, Catholic University for Central Africa, Yaounde, Cameroon.,Mother and Child Center, Chantal Biya Foundation, Yaounde, Cameroon
| | - Joseph Fokam
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Virology Laboratory, Chantal Biya International Reference Center for research on HIV/AIDS prevention and management, Yaounde, Cameroon.,Department of Microbiology, Heamatology, Immunology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | | | | | | | - Francis Ndongo Ateba
- Mother and Child Center, Chantal Biya Foundation, Yaounde, Cameroon.,Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Ngaoundere, Ngaoundere, Cameroon
| | - Paul Ndombo Koki
- Mother and Child Center, Chantal Biya Foundation, Yaounde, Cameroon.,Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Clotaire Serge Billong
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
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Billong SC, Fokam J, Penda CI, Mvilongo EA, Fodjo R, Messeh A, Anoubissie JDD, Kegne C, Nguekam G, Batamack YA, Billong EJ, Moutapam PR, Ndjolo A, Bonono L, Elat JB, Bissek ACZK. [National profile of early warning indicators of HIV pharmaco-resistance in Cameroon]. Pan Afr Med J 2020; 37:374. [PMID: 33796187 PMCID: PMC7992409 DOI: 10.11604/pamj.2020.37.374.17649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 07/24/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION since the launch of the "Treatment for All in Cameroon" strategy in 2015, an acceleration plan for antiretroviral (ARV) therapy in Cameroon was implemented, with remarkable progresses. These efforts were accompanied by the risk of developing HIV drug resistance. Then, the World Health Organization (WHO) proposed surveillance of early warning indicators (IAP) for HIV drug resistance. The purpose of this study was to assess the national HIV Drug Resistance Early Warning Indicators (EWI) in Cameroon. METHODS we conducted a retrospective study in the ten regions of Cameroon in December 2017 to evaluate the six EWIs recommended by the WHO in 68 randomly selected HIV care sites. The reporting period ranged from July 2016 to June 2017. RESULTS national scores were: drug withdrawal within the estimated time frame (EWI1): 66%; retention on antiretroviral therapy 12 months after treatment initiation (EWI2): 66%; stock-out of antiretroviral drugs over a 12-month period (EWI3): 53%; viral load testing coverage (CV) (EWI4): 10%; coverage suppression after 12 months of antiretroviral therapy (EWI5): 73% and practices for ARV drug delivery (EWI6): (100%). Regional scores were similar. CONCLUSION the evaluation of EWI in Cameroon is limited and requires urgent interventions, primarily viral load testing coverage, optimal ARVs management and patient´s adherence.
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Affiliation(s)
- Serge Clotaire Billong
- Département de Santé Publique, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
- Groupe Technique Central, Comité Nationale de Lutte Contre le SIDA, Yaoundé, Cameroun
- Groupe de Travail National pour la Prévention et la Surveillance de la Pharmaco-résistance du VIH, Ministère de la Santé Publique, Yaoundé, Cameroun
| | - Joseph Fokam
- Département de Santé Publique, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
- Groupe de Travail National pour la Prévention et la Surveillance de la Pharmaco-résistance du VIH, Ministère de la Santé Publique, Yaoundé, Cameroun
- Centre International de Référence Chantal BIYA pour la Recherche sur la Prévention et la Prise en Charge du VIH/SIDA, Yaoundé, Cameroun
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Calixte Ida Penda
- Hôpital de Jour, Hôpital Laquintinie de Douala, Douala, Cameroun
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroun
| | - Ernest Anaba Mvilongo
- Groupe Technique Central, Comité Nationale de Lutte Contre le SIDA, Yaoundé, Cameroun
| | - Raoul Fodjo
- Groupe Technique Central, Comité Nationale de Lutte Contre le SIDA, Yaoundé, Cameroun
| | - Arlette Messeh
- Groupe Technique Central, Comité Nationale de Lutte Contre le SIDA, Yaoundé, Cameroun
| | | | - Cyprien Kegne
- Groupe Technique Central, Comité Nationale de Lutte Contre le SIDA, Yaoundé, Cameroun
| | - Gildas Nguekam
- Division de la Recherche Opérationnelle en Santé, Ministère de la Santé Publique, Yaoundé, Cameroun
| | - Yannick Aimé Batamack
- Groupe Technique Central, Comité Nationale de Lutte Contre le SIDA, Yaoundé, Cameroun
| | - Edson Joan Billong
- Faculté de Médecine, Université d’Antananarivo, Antananarivo, Madagascar
| | - Pamela Reine Moutapam
- Groupe Technique Central, Comité Nationale de Lutte Contre le SIDA, Yaoundé, Cameroun
| | - Alexis Ndjolo
- Département de Santé Publique, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
- Centre International de Référence Chantal BIYA pour la Recherche sur la Prévention et la Prise en Charge du VIH/SIDA, Yaoundé, Cameroun
| | - Leonard Bonono
- Groupe Technique Central, Comité Nationale de Lutte Contre le SIDA, Yaoundé, Cameroun
| | - Jean Bosco Elat
- Groupe Technique Central, Comité Nationale de Lutte Contre le SIDA, Yaoundé, Cameroun
- George Town University, Yaoundé, Cameroun
| | - Anne Cécilé Zoung-Kanyi Bissek
- Département de Santé Publique, Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé I, Yaoundé, Cameroun
- Groupe de Travail National pour la Prévention et la Surveillance de la Pharmaco-résistance du VIH, Ministère de la Santé Publique, Yaoundé, Cameroun
- Division de la Recherche Opérationnelle en Santé, Ministère de la Santé Publique, Yaoundé, Cameroun
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Izizag BB, Situakibanza H, Kiazayawoko F, Nkodila A, Mafuta E, Lukanu P, Mukumbi H, Longokolo M, Mandina M, Mayasi N, Kinuka A, Amaela E, Kazadi W, Mbula M. [Determinants of non-compliance with antiretroviral therapy in adult patients in Kinshasa]. Pan Afr Med J 2020; 37:157. [PMID: 33425190 PMCID: PMC7757311 DOI: 10.11604/pamj.2020.37.157.13261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 05/08/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction l´objectif de cette étude était d´identifier les déterminants de non-observance des patients vivant avec le VIH (PVVIH) au TAR (traitement antirétroviral) à Kinshasa. Méthodes dans une étude transversale conduite à Kinshasa du 1ermai au 31 août 2015 chez des PVVIH âgées d´au moins 18 ans et sous traitement antirétroviral depuis au moins 3 mois. Un échantillon probabiliste de 400 patients a été pris en compte. Le CASE Adherence Index (méthode subjective) et le renouvellement d´ordonnance (méthode objective) ont évalué l´observance. Les déterminants de la non-observance ont été recherchés par régression logistique multiple. Résultats les 400 PVVIH avaient un âge médian de 43 ans (18-75). La fréquence de non-observance globale était de 25,5%. La fréquence de la non-observance objective était plus élevée que celle de la non-observance subjective (29% vs 21%, p = 0,01). Le paiement de la consultation (ORaj: 1,70; IC95%: 1,02-2,81; p = 0,042), les effets indésirables (ORaj: 2,23; IC95%: 1,33-3,75; p = 0,002) et le manque de perception tel que l´oubli d´une dose qui peut aggraver la maladie (ORaj: 4,16; IC95%: 1,04-16,68; p=0,045) ont émergé comme déterminants de la non-observance. La présence d´une personne de confiance était un facteur protecteur contre la non-observance (ORaj: 0,54; IC95%: 0,39-0,93; p = 0,004). Conclusion la fréquence de la non-observance au TAR demeure élevée à Kinshasa. La différence de fréquence entre l´appréciation objective et subjective de l´observance indique l´importance de la biologie dans le suivi des PVVIH sous antirétroviraux. La prise en compte des déterminants sera nécessaire pour définir des stratégies qui permettront l´amélioration de l´observance.
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Affiliation(s)
- Benilde Bepouka Izizag
- Service des Maladies Infectieuses et Tropicales, Département de Médecine Interne, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, République Démocratique du Congo
| | - Hippolyte Situakibanza
- Service des Maladies Infectieuses et Tropicales, Département de Médecine Interne, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, République Démocratique du Congo
| | - Florian Kiazayawoko
- Service des Maladies Infectieuses et Tropicales, Département de Médecine Interne, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, République Démocratique du Congo
| | - Aliocha Nkodila
- Cités des Aveugles, Kinshasa, République Démocratique du Congo
| | - Eric Mafuta
- Ecole de Santé Publique, Faculté de Médecine, Université de Kinshasa, Kinshasa, République Démocratique du Congo
| | - Philippe Lukanu
- Département de Médecine de Famille, Université Protestante au Congo, Kinshasa, République Démocratique du Congo
| | - Henry Mukumbi
- ACS AMO-CONGO (ONG-ASBL/Santé), Kinshasa, République Démocratique du Congo
| | - Murielle Longokolo
- Service des Maladies Infectieuses et Tropicales, Département de Médecine Interne, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, République Démocratique du Congo
| | - Madone Mandina
- Service des Maladies Infectieuses et Tropicales, Département de Médecine Interne, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, République Démocratique du Congo
| | - Nadine Mayasi
- Service des Maladies Infectieuses et Tropicales, Département de Médecine Interne, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, République Démocratique du Congo
| | - Amede Kinuka
- Cliniques Rapha, Kinshasa, République Démocratique du Congo
| | - Evelyne Amaela
- Cliniques Rapha, Kinshasa, République Démocratique du Congo
| | - Willy Kazadi
- Cliniques Rapha, Kinshasa, République Démocratique du Congo
| | - Marcel Mbula
- Service des Maladies Infectieuses et Tropicales, Département de Médecine Interne, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, République Démocratique du Congo
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Freitas JPD, Sousa LRM, Cruz MCMDA, Caldeira NMVP, Gir E. Terapia com antirretrovirais: grau de adesão e a percepção dos indivíduos com HIV/Aids. ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Apreender os aspectos relacionados ao grau de adesão de pessoas vivendo com HIV/aids aos antirretrovirais. Métodos Estudo com abordagem qualitativa desenvolvido em duas unidades de internação de um hospital universitário do interior paulista. A produção dos dados ocorreu no período de outubro de 2017 a abril de 2018 com 40 participantes entrevistados, cujo material produzido foi gravado e posteriormente transcrito. A análise e o processamento dos dados foram realizados com apoio na técnica da Classificação Hierárquica Descendente e base fundamentada no Discurso do Sujeito Coletivo. Resultados Após análise e processamento, obtiveram-se cinco classes de palavras: 1. Questões sócio-econômicas como motivos fundamentais da não adesão aos antirretrovirais; 2. O apoio familiar para o enfrentamento da condição e estímulo para a adesão ao tratamento; 3. Consequências do grau de adesão aos antirretrovirais; 4. Dificuldades de adesão à terapia antirretroviral relacionadas aos efeitos adversos e apresentação medicamentosa; e 5. Possíveis mudanças para melhorar a adesão ao tratamento do HIV. Conclusão As principais dificuldades enfrentadas por pessoas vivendo com HIV/aids hospitalizadas e que estão em adesão irregular são questões sócio-econômicas, apoio familiar e efeitos adversos.
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Abstract
OBJECTIVE The aim of this study was to identify the range and frequency of patient-reported barriers and facilitators to antiretroviral treatment (ART) adherence in sub-Saharan Africa (SSA). DESIGN Studies from 2005 to 2016 were identified by searching 10 electronic databases and through additional hand and web-searching. METHODS Inclusion criteria were HIV-positive adults taking ART based in any SSA country, qualitative study or quantitative survey and included at least one patient-reported barrier or facilitator to ART adherence. Exclusion criteria were only including data from treatment-naive patients initiating ART, only single-dose treatment, participants residing outside of SSA and reviews. RESULTS After screening 11 283 records, 154 studies (161 papers) were included in this review. Forty-three barriers and 30 facilitators were reported across 24 SSA countries. The most frequently identified barriers across studies were forgetting (n = 76), lack of access to adequate food (n = 72), stigma and discrimination (n = 68), side effects (n = 67) and being outside the house or travelling (n = 60). The most frequently identified facilitators across studies were social support (n = 60), reminders (n = 55), feeling better or healthier after taking ART (n = 35), disclosing their HIV status (n = 26) and having a good relationship with a health provider (n = 22). CONCLUSION This review addresses the gap in knowledge by collating all the patient-reported barriers and facilitators to ART adherence in SSA. Current barriers measures need to be adapted or new tools developed to include the wide variety of factors identified. The factors that have the greatest impact need to be isolated so interventions are developed that reduce the barriers and enhance the facilitators.
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