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Mutagonda RF, Siril H, Kaaya S, Amborose T, Haruna T, Mhalu A, Urassa D, Mtisi E, Moshiro C, Tarimo E, Mahiti GR, Minja A, Somba M, August F, Mugusi F. Prevalence and determinants of non-communicable diseases including depression among HIV patients on antiretroviral therapy in Dar es Salaam, Tanzania. Trop Med Int Health 2022; 27:742-751. [PMID: 35687423 DOI: 10.1111/tmi.13790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE People living with HIV/AIDS (PLHA) are experiencing growing co-morbidities due to an increase in life expectancy and the use of long-term antiretroviral therapy (ART). The lack of integrated non-communicable diseases (NCDs) screening and management at the HIV care and treatment centres (CTCs) make it difficult to determine the trends of NCD co-morbidity among patients with HIV. This study aimed to assess the burden and determinants of common NCDs, including depression among patients with HIV. METHODS Analytical cross-sectional study of 1318 HIV patients enrolled using systematic random sampling conducted from April to November 2020. Five large CTCs in district referral hospitals were selected representing the five districts of Dar es Salaam including Mwananyamala, Temeke, and Amana regional referral hospitals and Sinza and Vijibweni hospitals. The study population consisted of adult PLHA aged 18 years and above. The primary outcome measure was the prevalence of NCDs among HIV patients. Observation of actual NCD medications or their purchase receipts or booked NCD clinic appointments that PLHA had during the study period was used to verify the reported presence of NCDs. The secondary outcome measure was the prevalence of probable depression among PLHA. The locally validated Swahili Patient Health Questionnaire (PHQ-9) was used to screen for depressive symptom severity. A logistic regression model was used to identify factors associated with common NCDs and those associated with probable depression. Potential risk factors that were statistically significant at a P-value of 0.2 or less in univariable analysis were included as potential confounders in multivariable models. RESULTS The median age of participants was 42 (IQR 35-49) years, with 32.7% in the 36-45 years age group. The majority of patients were women (69%). Most (80.5%) had achieved HIV viral (VL) suppression (a serum HIV VL of <1000 copies/ml). Overall, 14.3% of self-reported an NCD with evidence of their current medication for the NCD from receipts for medication purchased and appointments from NCD clinics they attended. In the multivariable analyses, higher odds of NCDs were in older patients (>45 years) and those with a weight above 75 kg (P < 0.05). Male patients had 51% reduced odds of NCDs (aOR 0.49; 95% CI: 0.32-0.74) than females (P < 0.001). Probable depression prevalence was 11.8%, and depressed patients had more than twice the odds of having NCDs than those without depression (aOR 2.26; 95% CI: 1.45-3.51; P < 0.001). CONCLUSION This study determined co-existing previously diagnosed NCDs among PLHA accessing care and high levels of depressive symptom severity. We recommend additional research on the feasibility, acceptability, and cost implications of screening and treating NCDs on HIV care platforms to provide evidence for Tanzania's integrated HIV/NCD care model.
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Affiliation(s)
- Ritah F Mutagonda
- Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Hellen Siril
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Management and Development for Health, Dar es Salaam, Tanzania
| | - Sylvia Kaaya
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Theresia Amborose
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Tausi Haruna
- Department of Fundamentals of Nursing and Basic Sciences, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Aisa Mhalu
- Management and Development for Health, Dar es Salaam, Tanzania
| | - David Urassa
- Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Expeditho Mtisi
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Department of General Studies, Dar es Salaam Institute of Technology, Dar es Salaam, Tanzania
| | - Candida Moshiro
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Edith Tarimo
- Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gladys Reuben Mahiti
- Department of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Agape Minja
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Magreth Somba
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Francis August
- Department of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ferdinand Mugusi
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Kebede KM, Abateneh DD, Teferi MB, Asres A. Chronic kidney disease and associated factors among adult population in Southwest Ethiopia. PLoS One 2022; 17:e0264611. [PMID: 35239741 PMCID: PMC8893675 DOI: 10.1371/journal.pone.0264611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 02/14/2022] [Indexed: 11/19/2022] Open
Abstract
In Ethiopia, data on the burden and determinants of chronic kidney disease (CKD) in the general population is limited. This community-based study was conducted to assess the burden and associated factors of CKD among adults in Southwest Ethiopia. The study was conducted from August 23, 2018-October 16, 2018. Study participants were selected using a random sampling method. A structured questionnaire was used to collect relevant data. Blood pressure and anthropometric indices were measured following standard procedures. About 5 ml of urine sample was collected and the dipstick test was performed immediately. A blood sample of 3-5ml was collected for serum creatinine and blood glucose level determination. The three commonest estimators of glomerular filtration rate and the National Kidney Foundation Kidney Disease Outcomes Quality Initiative were used to define and stage CKD. Data were analyzed using SPSS 21. Multivariable logistic regression was employed and p-value <0.05 was used to indicate statistically significant results. A total of 326 participants with a mean age of 39.9(SD±11.2) years were enrolled in the study. The proportions of female participants (59.8%) were relatively higher than male participants (40.2%). The mean eGFR using CKD-EPI, CG and MDRD was 124.34 (SD±23.8) mL/min/1.73m2, 110.67(SD±33.0) mL/min/1.73m2 and 131.29 (SD±32.5) mL/min/1.73m2 respectively. The prevalence of CKD was 7.4% using CKD-EPI & MDRD and 8% using CG. Similar finding using CKD-EPI & MDRD may indicate that either CKD-EPI or MDRD can be used to estimate GFR in this study area. In the age and sex-adjusted logistic regression model, hypertension was significantly associated with CKD using CKD-EPI & MDRD and age ≥40 years old was significantly associated with CKD using CG. Behavioral characteristics and other traditional risk factors were not significantly associated with CKD in the current study. The prevalence of CKD was high in the study area. Only hypertension and age ≥40 years old were significantly associated with CKD. More of the increased prevalence of CKD in the current study remained unexplained and deserves further study.
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Affiliation(s)
- Kindie Mitiku Kebede
- College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
| | - Dejene Derseh Abateneh
- College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
- Menelik II College of Medicine and Health Sciences, Kotebe Metropolitan University, Addis Ababa, Ethiopia
- * E-mail:
| | - Melkamu Beyene Teferi
- College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
| | - Abyot Asres
- College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
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Kefeni BT, Hajito KW, Getnet M. Renal Function Impairment and Associated Factors Among Adult HIV-Positive Patients Attending Antiretroviral Therapy Clinic in Mettu Karl Referral Hospital: Cross-Sectional Study. HIV AIDS (Auckl) 2021; 13:631-640. [PMID: 34135641 PMCID: PMC8200135 DOI: 10.2147/hiv.s301748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/19/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) affects every organ system in the body through impairment or by rendering the patient vulnerable to opportunistic infections. The kidney is the vital organ in the excretion of waste products and toxins (urea, creatinine and uric acid), and regulation of extracellular fluid volume, serum osmolality and electrolyte concentrations. The risk of kidney disease is greater in HIV-infected individuals than in the general population. This study aimed to assess the magnitude of renal function impairment and its associated factors among adult HIV-positive patients attending an ART clinic in Mettu Karl Referral Hospital, Mettu town, south-west Ethiopia. METHODS The institution-based, cross-sectional quantitative study was conducted from March 8 to May 30, 2020. A total of 352 clients participated and a systematic sampling technique was used to allocate study participants. Data were entered into Epi data and exported to SPSS version 22 for analysis. Bivariate analysis was conducted to identify candidate variables for multivariate analysis at P <0.25. Multivariable logistic regression analysis was conducted to determine the predictors of renal function impairment with ART. P value < 0.05 was considered to indicate statistical significance. RESULTS A total of 352 HIV-infected patients participated in this study with a response rate of 98.1%. Out of 352 HIV patients on ART, 73 (20.7%) were found to have renal function impairment. Cigarette smoking [AOR = 9.60, 95% CI: 4.73-19.48], diabetes mellitus [AOR = 6.16, 95% CI: 2.79-13.59], hypertension [AOR = 4.71, 95% CI: 1.98-11.17] and low CD4 count [AOR = 6.47, 95% CI: 3.31-12.64] were found to be independent predictors of renal function impairment among adult HIV positive patients. CONCLUSION The prevalence of renal function impairment among HIV patients on ART is high. Hypertension, diabetes, cigarette smoking and low CD4 count were associated factors of renal function impairment. HIV patients on ART should be regularly screened for early diagnosis and management of renal function impairment.
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Affiliation(s)
| | - Kifle Woldemichael Hajito
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, Jimma University, Jimma, Ethiopia
| | - Masrie Getnet
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, Jimma University, Jimma, Ethiopia
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Ekun OA, Fasela EO, Oladele DA, Liboro GO, Raheem TY. Risks of cardio-vascular diseases among highly active antiretroviral therapy (HAART) treated HIV seropositive volunteers at a treatment centre in Lagos, Nigeria. Pan Afr Med J 2021; 38:206. [PMID: 33995812 PMCID: PMC8106780 DOI: 10.11604/pamj.2021.38.206.26791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 02/01/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION highly active antiretroviral therapy (HAART) has led to a decline in HIV-induced morbidity and mortality in recent years. However, it has been opined that this has led to elevated risks of cardiovascular diseases (CVDs). This study assessed the risks of CVDs among HAART experienced individuals living with HIV. METHODS a cross sectional study involving 196 adults consisting of 118 HAART experienced and 78 HAART naïve was conducted. Anthropometric and blood pressure measurements were recorded for all participants. Blood samples obtained from the volunteers were used to determine glucose, creatinine, HIV viral load, CD4 count and lipid profile using standard methods. Lipid ratios, atherogenic indices and QRISK3 risk score were calculated. RESULTS the median CD4 lymphocyte, mean body mass index (BMI) and HDL-c in HAART experienced participants were higher (P<0.05) than HAART naive individuals. The QRISK3 risk score and creatinine were higher (p<0.05) among HAART experienced group. In HAART experienced group, the risk of hypertension, increased low-density lipoprotein (LDL-c), atherogenic index of plasma (AIP) and QRISK3 were 3.7, 2.0, 2.38 and 3.85 times (p<0.05) higher respectively than in HAART naive. Atherogenic coefficient (AC) increase was more prevalent among male (p<0.05) participants. Risk of chronic renal disease (eGFR), hypertension and CVD (as measured by QRISK3) was higher (p<0.05) among the female and older participants respectively. CONCLUSION the risk of CVDs and renal disease appeared to be higher among HAART experienced volunteers and older (>45 years) volunteers. The risk of renal disease appeared higher in females.
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Affiliation(s)
- Oloruntoba Ayodele Ekun
- Department of Medical Laboratory Science, College of Medicine, University of Lagos, Idi-araba, Lagos State, Nigeria
| | - Emmanuel Olusesan Fasela
- Department of Medical Laboratory Science, College of Medicine, University of Lagos, Idi-araba, Lagos State, Nigeria
- Clinical Diagnostic Laboratory, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - David Ayoola Oladele
- Clinical Science Department, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Gideon Odemakpore Liboro
- Department of Medical Laboratory Science, College of Medicine, University of Lagos, Idi-araba, Lagos State, Nigeria
- Center for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Toyosi Yekeen Raheem
- Clinical Diagnostic Laboratory, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
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Manaye GA, Abateneh DD, Niguse W. Chronic Kidney Disease and Associated Factors Among HIV/AIDS Patients on HAART in Ethiopia. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:591-599. [PMID: 33116921 PMCID: PMC7585507 DOI: 10.2147/hiv.s276356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/30/2020] [Indexed: 12/18/2022]
Abstract
Background In developing countries, both opportunistic infections and chronic diseases account a high HIV-associated mortality and morbidity. Chronic kidney disease (CKD) associated with HIV infection has got increased attention in sub-Saharan Africa as a result of the high HIV prevalence and due to the late diagnosis and initiation of HAART. Thus, this study was conducted to assess CKD and associated factors among HIV patients on HAART in Ethiopia. Methods A hospital-based cross-sectional study with a secondary data review was conducted on 336 on HIV/AIDS patients on HAART from February to July 2017 at University of Gondar Referral Hospital. The study participants were selected using a systematic random sampling technique. Socio-demographic and clinical data were collected using a semi-structured questionnaire at their follow-up date with interview and chart review. Three to five milliliters of venous blood and five milliliters of urine specimen were collected for serum creatinine and urine albumin determination, respectively. Data were entered into SPSS version 20 for analysis. Glomerular filtration rate was estimated using the CKD-EPI estimator. Bivariate and multivariate logistic regression was employed and p-value <0.2 and < 0.05, respectively, was considered statistically significant. Results The prevalence of CKD on the study participants was 54 (16.1%) (95% CI, 12.2–20.4%). By stage, about 27 (8.0%) had stage 1 (persistent proteinuria with eGFR ≥ 90 mL/min/1.73 m2), 16 (4.8%) had stage 2 (persistent proteinuria with eGFR of 60–89.9 mL/min/1.73 m2), 6 (1.8%) had stage 3 (eGFR 30–59.9 mL/min/1.73 m2 with or without proteinuria) and 5 (1.5%) had stage 5 ((kidney failure), eGFR<15mL/min/1.73 m2 with or without proteinuria). With multivariate logistic regression analysis, being male (AOR=2.05 (1.03–4.09), p=0.04), being merchant (AOR=2.91 (1.00–8.48), p=0.049) and having viral load≥1000 copies/mm3 (AOR=3.1 (1.38–7.00), P<0.01) were significantly associated with CKD. Conclusion The prevalence of CKD among HIV patients on HARRT is high. Being male, merchant and having viral load ≥1000 copies/mm3 were associated factors of CKD. Patients should be regularly monitored and screened for early diagnosis and management of CKD. Those patients who have being merchant with high viral load and male patients should require close monitoring.
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Affiliation(s)
- Gizachew Ayele Manaye
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Dejene Derseh Abateneh
- Department of Medical Laboratory Science, Menelik II College of Medicine and Health Sciences, Kotebe Metropolitan University, Addis Ababa, Ethiopia
| | - Wondwossen Niguse
- Department of Nursing, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
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Kato I, Tumaini B, Pallangyo K. Prevalence of non-communicable diseases among individuals with HIV infection by antiretroviral therapy status in Dar es Salaam, Tanzania. PLoS One 2020; 15:e0235542. [PMID: 32645054 PMCID: PMC7347196 DOI: 10.1371/journal.pone.0235542] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 06/18/2020] [Indexed: 12/18/2022] Open
Abstract
Background Long-term antiretroviral therapy has modified the clinical course of HIV infection to a chronic condition associated with increased risk of developing non-communicable diseases (NCDs). Information is scant, from sub-Saharan Africa, on the prevalence of NCDs and associated factors among individuals on ART. Methodology We consecutively enrolled individuals with HIV infection who were ART naïve and those on ART for ≥5 years (LTART) attending health facilities in Dar es Salaam. Participant's blood pressure, anthropometric measurements, and fasting blood glucose were recorded. Participants with impaired fasting blood glucose underwent an oral glucose tolerance test. A venous blood sample was sent to the lab for biochemical tests. Chi-square test was used to compare proportions, Poisson regression with robust standard errors was used to determine associations between variables. Results Overall, 612 individuals with HIV infection were enrolled, half of whom were ART naïve. Females comprised 71.9% and 68.0% of participants in the LTART and ART naïve study arms, respectively, p = 0.290. The mean age (±SD) was 44.9 ± 12.7 years and 37.5 ± 11.8 years among LTART and ART naïve participants, respectively, p<0.001. Hypertension was documented in 25.2% in those on LTART compared to 6.9% among ART naïve subjects, p<0.001. Impaired glucose tolerance was found in 22.9% and 4.6% among LTART compared to ART naïve subjects, p<0.001. Diabetes mellitus was detected in 17.0% of those on LTART compared to 3.9% ART naïve participants, p<0.001. Hypercholesterolemia was found in 30.4% of individuals on LTART compared to 16.7% of ART naïve subjects, p<0.001, and hypertriglyceridemia was found in 16.0% of participants on LTART compared to 9.5% of ART naïve, p = 0.015. LTART use, age ≥40 years, history of smoking, and body mass index were independently associated with NCDs. Conclusion Hypertension, impaired glucose tolerance, diabetes mellitus, hypercholesterolemia, and hypertriglyceridemia were associated with long-term use of antiretroviral drugs.
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Affiliation(s)
- Irene Kato
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- * E-mail:
| | - Basil Tumaini
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Kisali Pallangyo
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Yilma D, Abdissa A, Kæstel P, Tesfaye M, Olsen MF, Girma T, Ritz C, Friis H, Andersen ÅB, Kirk O. Serum creatinine and estimated glomerular filtration rates in HIV positive and negative adults in Ethiopia. PLoS One 2019; 14:e0211630. [PMID: 30753190 PMCID: PMC6372225 DOI: 10.1371/journal.pone.0211630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 01/17/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Glomerular filtration rate estimating equations using serum creatinine are not validated in most African settings. We compared serum creatinine and estimated glomerular filtration rate (eGFR) in HIV positive and negative adults and assessed the performance of eGFR equations ((Cockcroft and Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)) compared to 24-hour creatinine clearance in HIV positive adults. METHODS Data were collected on demographic, anthropometric, body composition, clinical parameters and serum creatinine in HIV positive and negative adults. 24-hour urine was collected from some of the HIV positive adults who volunteered. Bias was calculated as mean difference between 24-hr creatinine clearance and eGFR (eGFR- 24 hour creatinine clearance) and the accuracy of each eGFR equation was calculated as the percentage of estimates within 30% of creatinine clearance. RESULTS A total of 340 HIV positive and 100 HIV negative adults were included in this study. Creatinine clearance was determined for 46 of HIV positive adults. Serum creatinine increased with increasing age, weight, height, body surface area, fat free mass and grip strength in both HIV positive and negative adults (P<0.05). No difference was observed in eGFR between HIV positive and HIV negative adults. For all eGFR equations, the correlation between eGFR and 24-hr creatinine clearance was 0.45-0.53 and the accuracy within 30% of 24-hr creatinine clearance was 24-46%. Removing ethnic coefficient reduced the bias and improved accuracy of the CKD-EPI and the MDRD estimates. CONCLUSION Ethiopian HIV positive adults in the present study had good kidney function at the initiation of antiretroviral treatment. However, all eGFR equations overestimated 24-hr creatinine clearance in the study population. Creatinine based eGFR equations that accounts for low muscle mass and body surface area are needed.
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Affiliation(s)
- Daniel Yilma
- Department of Internal Medicine, Jimma University, Jimma, Ethiopia
- * E-mail:
| | - Alemseged Abdissa
- Department of Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Pernille Kæstel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Markos Tesfaye
- Department of Psychiatry, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mette F. Olsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Tsinuel Girma
- Department of Paediatric and Child Health, Jimma University, Jimma, Ethiopia
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Åse B. Andersen
- Department of Infectious Diseases, Rigshospitalet, Copenhagen and Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Denmark
| | - Ole Kirk
- Department of Infectious Diseases, Rigshospitalet, Copenhagen and Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Denmark
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Abd ElHafeez S, Bolignano D, D’Arrigo G, Dounousi E, Tripepi G, Zoccali C. Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: a systematic review. BMJ Open 2018; 8:e015069. [PMID: 29326180 PMCID: PMC5780690 DOI: 10.1136/bmjopen-2016-015069] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 08/25/2017] [Accepted: 09/01/2017] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES While increasing attention is paid to the rising prevalence of chronic diseases in Africa, there is little focus on chronic kidney disease (CKD). This systematic review assesses CKD burden among the general population and high-risk groups on the entire African continent. DESIGN, SETTING AND PARTICIPANTS We searched Medline and PubMed databases for articles published between 1 January 1995 and 7 April 2017 by sensitive search strategies focusing on CKD surveys at the community level and high-risk groups. In total, 7918 references were evaluated, of which 7766 articles were excluded because they did not meet the inclusion criteria. Thus, 152 studies were included in the final analysis. OUTCOME MEASUREMENT The prevalence of CKD in each study group was expressed as a range and pooled prevalence rate of CKD was calculated as a point estimate and 95% CI. No meta-analysis was done. Data were presented for different populations. RESULTS In the community-level studies, based on available medium-quality and high-quality studies, the prevalence of CKD ranged from 2% to 41% (pooled prevalence: 10.1%; 95% CI 9.8% to 10.5%). The prevalence of CKD in the high-risk groups ranged from 1% to 46% (pooled prevalence: 5.6%; 95% CI 5.4% to 5.8%) in patients with HIV (based on available medium-quality and high-quality studies), 11%-90% (pooled prevalence: 24.7%; 95% CI 23.6% to 25.7%) in patients with diabetes (based on all available studies which are of low quality except four of medium quality) and 13%-51% (pooled prevalence: 34.5%; 95 % CI 34.04% to 36%) in patients with hypertension (based on all available studies which are of low quality except two of medium quality). CONCLUSION In Africa, CKD is a public health problem, mainly attributed to high-risk conditions as hypertension and diabetes. The poor data quality restricts the validity of the findings and draws the attention to the importance of designing future robust studies.
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Affiliation(s)
- Samar Abd ElHafeez
- Department of Epidemiology, High Institute of Public Health – Alexandria University, Alexandria, Egypt
| | - Davide Bolignano
- Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, CNR/IFC, Reggio Calabria, Italy
| | - Graziella D’Arrigo
- Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, CNR/IFC, Reggio Calabria, Italy
| | - Evangelia Dounousi
- Department of Nephrology, School of Health Sciences – University of Ioannina, Ioannina, Greece
| | - Giovanni Tripepi
- Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, CNR/IFC, Reggio Calabria, Italy
| | - Carmine Zoccali
- Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, CNR/IFC, Reggio Calabria, Italy
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