Browsing by Author "Kilonzo, Semvua Bukheti"

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    Magnitude and correlates of moderate to severe anemia among adult HIV patients receiving first line HAART in North western Tanzania: a cross sectional clinic based study
    (Pan African Medical Journal, 2016) Gunda, Daniel Wilfred; Kilonzo, Semvua Bukheti; Mpondo, Bonaventura Cornel
    Moderate to severe anemia is an important clinical problem in HIV patients on Highly Active Antiretroviral Therapy. The rate of progression and mortality in this sub group of patients is high compared to non anemic patients. In sub Saharan Africa with scale up of Anti retroviral therapy, the magnitude of this problem is not known especially in Tanzania. This study aimed at determining the magnitude and correlates of moderate to severe anemia in HIV patients receiving first line ART in northwestern Tanzania. This was a cross sectional clinic based study, involving adult HIV patients on first line Highly Active Antiretroviral Therapy at Bugando Medical Centre Care and Treatment Center. The patients' data were analyzed using STATA version 11 to determine the prevalence of moderate to severe anemia and risk factors that could predict occurrence of anemia. Results: In this study 346 patients on Highly Active Anti-Retroviral Therapy were enrolled, of whom 100(40.46%) had moderate to severe anemia. The odds of being anemic were strongly predicted by Zidovudine based regime, low baseline CD4 count (< 200 cells/ยตl) and HIV stage 3&4 at enrollment. Most of the anemic patients had mean corpuscular volume of >100fl. The prevalence of moderate to severe anemia is significantly high in this cohort of HIV-infected patients on first line Anti Retroviral Therapy and it is strongly predicted by Zidovudine based regime, low baseline CD4 and HIV stage 3 and 4. On clinical grounds this suggests that patients who are initiated on Zidovudine based regimen and those in advanced HIV at enrollment should have regular haemoglobin follow up to identify anemia at its earliest stage to improve the clinical outcome of these patients.
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    Prevalence and risk factors of mortality among adult HIV patients initiating ART in rural setting of HIV care and treatment services in North western Tanzania: a retrospective cohort study
    (Hindawi, 2017) Gunda, Daniel Wilfred; Nkandala, Igembe; Kilonzo, Semvua Bukheti; Kilangi, Boniface Bartholomew; Mpondo, Bonaventura Cornel
    Introduction. HIV still causes high mortality despite use of ART. This study was designed to determine the prevalence and risk factors of mortality among HIV patients receiving ART in north western rural Tanzania. A retrospective study of HIV patients on ART was done at Sengerema in Mwanza, Tanzania. The data on demography, date of HIV diagnosis, WHO stage, opportunistic infections, CD4, hemoglobin, ART regimen,and time and outcome on treatment as dead or alive were collected and analyzed using STATA version 11. In total, 740 patients were studied. The median age was 35 (27โ€“42) years with female predominance of 465 (62.8%). Of the participants, 261 (35.3%) had WHO stages 3 and 4 diseases. Most participants, 258 (34.9%), had baseline CD4 counts <200 cells/๐œ‡l. Deaths occurred in 86 (11.6%) patients which were independently associated with male gender (16.0% versus 9.0%, ๐‘ = 0.015), being divorced (OR=2.7,๐‘ < 0.001), WHO stages 3 and 4 (OR=2.3,๐‘ = 0.05), CD4<200 cells/๐œ‡l (OR=3.4, ๐‘ < 0.001), and severe anemia (OR=6.6, ๐‘ < 0.001). The mortality is high among HIV patients receiving ART in north western rural Tanzania. Universal testing could increase early diagnosis and treatment. A close follow-up ofat-risk patients within the first year of ART could reduce the mortality of this sub group of patients.