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Browsing Journals by Author "Sungwa, Edson."
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Item Malnutrition and associated factors among adults starting on antiretroviral therapy at PASADA Hospital in Temeke District, Tanzania(Tanzania Journal of Health Research, 2018) Kabalimu, Titus K.; Sungwa, Edson.; Lwabukuna, Warles C.Background: Malnutrition is known to play a significant role in HIV/AIDS progression. Severe malnutrition has been previously found to be associated with early mortality among people living with HIV/AIDS (PLHIV) undergoing anti-retroviral therapy (ART) in Sub-Saharan Africa. The objective of this study was to determine the prevalence and factors associated with malnutrition among adult PLHIV attending care and treatment centre (CTC) in Temeke District, Tanzania. Methods: The cross-sectional descriptive study involved consecutive eligible patients attending the CTC for initiating in ART, between January and April, 2014. All participants who agreed to sign a consent form were enrolled. The participants had undergone baseline workup for ART initiation (by CTC), which included blood tests for liver and renal function tests, and CD4+ cell count, using calibrated instruments and standard techniques. In all patients the weight and height were measured to calculate the body mass index (BMI), denoting the nutritional status. This parameter was recorded in the study instrument together with the CD4+ count for each patient. A structured questionnaire was used to obtain more information, namely demographic and lifestyle data. Results: A total of 125 patients were included in this study. The prevalence of malnutrition among participants was 19.4%. Those with severe malnutrition comprised of 9%. Significant association was noted between malnutrition and irregular income (OR= 3.8, CI: 1.2-11.5) and also inability to get at least two meals a day (OR= 3.4, CI: 1.2-9.2). Severe malnutrition was significantly associated with the CD4+ counts of <200 cells/mm (OR =7.6; CI: 1.7-34.6). Conclusion: About 19% of participants were malnourished at the time of initiation of ART and among them 9% were severely malnourished. The most important risks for malnutrition were found to be irregular income and inability to get adequate feeding. This calls for routine nutritional assessment at CTCs prior to initiation of ART so as to identify those who need immediate intervention, including those with severe malnutrition.Item Opportunistic Infections and Associated Factors among HIV Infected Patients on anti-retroviral treatment at Bombo Hospital in Tanga Region, Tanzania(African Journal of Health Sciences, 2022) Kabalimu, Titus K.; Sungwa, Edson.; ;BACKGROUND A substantive number of People Living with HIV (PLHIV) develop Opportunistic Infections (OIs). The introduction of Anti-Retroviral Therapy (ART) in Tanzania led to a significant decline in opportunistic infections and a slower progression to AIDS, but OIs are still prevalent. This study was set to determine the magnitude of OIs and associated factors among HIV/AIDS patients on Anti-Retroviral Therapy (ART) attending care and treatment clinic at Bombo Regional Referral hospital, Tanga region. MATERIALS AND METHODS A cross‐sectional descriptive study was conducted on HIV/AIDS patients on ART attending Bombo Hospital in Tanga from July to October 2019. A non-probability, consecutive sampling technique was employed to obtain study participants. Data were collected using available data obtained from the patients’ files, hospital record books and interviews of study participants by using semi-structured questionnaires. Data were entered into the computer using Excel 2013, cleaned and analysed using Epi Info version 7.2.2.6. Any p-value of < 0.05, at a 95% confidence interval was regarded as statistically significant. RESULTS The study showed that out of the 360 participants, 126 cases (35.0%) of OIs were reported. Pulmonary Tuberculosis had the highest prevalence of 18.0% among PLHIV while other opportunistic Infections altogether contributed 17.0%. Late ART initiation (OR=10.9, 95% CI: 6.5 – 18.3, p-value <0.001), Poor drug adherence (OR=19, 95% CI: 9.0 – 39.7, p-value <0.001), female gender (69% vs. 31%), which was however, not statistically significant (p-value – 0.904), Informal and Primary School education (OR = 1.6, 95% CI: 1.1 – 1.6, p-value 0.04) being married (OR=2.1, 95% CI: 1.3 – 3.4, p – value 0.004) and widowed/widower (OR=7.7, 95% CI: 1.7 – 33.7, p – value 0.007) respectively were found to be associated with OIs to PLHIV. CONCLUSION The rate of OIs still high among PLHIV, Pulmonary Tuberculosis is the leading disease with 18.0% of all OIs symptomatic patients. Delay in ART initiation after positive test results, poor drug adherence and moderate malnutrition have been identified as major risk factors affecting 66.0%, 70.0%, 71%of PLWHA with OIs. We recommend early initiation of ART, Education on ART adherence and refilling of large quantities of ARV drugs to individuals working far from their homes.