Prevalence of Advanced HIV Disease and Associated Factors among Newly Diagnosed Patients at Public Hospitals in Addis Ababa, Ethiopia, 2023: Multi-Center Retrospective Cross-Sectional Study
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Date
2024
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Addis Ababa University
Abstract
Background: Many patients having HIV present to the health care system with advanced HIV disease. Patients with advanced HIV disease have CD4 cell count of less than 200cells/mm3 or WHO stage III or IV clinical events. The primary culprits responsible for severe morbidity and mortality are tuberculosis, severe bacterial infections and cryptococcal meningitis.
Objective: The aim of this study was to investigate the prevalence and factors associated with advanced HIV disease among newly diagnosed patients at Public Hospitals in Addis Ababa, Ethiopia, 2023.
Methodology: A retrospective multi-centered facility based cross-sectional study was conducted among newly diagnosed HIV patients whose age was ≥ 15 years over a period of one year (October 2023- January 2024). The prevalence of advanced HIV disease was estimated with advanced HIV disease defined as WHO clinical stage 3, stage 4 or CD4 count less than 200 cells/μ. The baseline characteristic of the study participants was compared with and without advanced HIV disease. Pretested and structured questionnaires were adopted. The completed data was collected via web link after being prepared by kobo toolbox, coded, manually checked, and exported to SPSS version 26 for analysis. Descriptive statistics, chi square test, nonparametric tests and multi variable logistic regression were used for data analysis.
Result: Among the 400 patients, 262(65.5%) had advanced HIV disease at presentation. Patients with low BMI had 3.2 times higher odds of having advanced HIV disease in contrast to other patients with normal or higher BMI (AOR 3.2, 95% CI 1.14-8.9, P =0.03). Patients having bedridden functional status had 10.6 times higher odds of advanced HIV disease as compared to other groups of patients (AOR 10.6, 95% CI 1.24-91, P =0.03). HIV testing reason due to symptoms of opportunistic infections had 44.6 times higher odds of advanced HIV disease as compared to those who had other HIV testing reasons (AOR 44.6, 95% CI 22.8-87.2, P
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Keywords
Advanced HIV disease, Prevalence, Associated factors, CD4 count