Browsing by Author "Mkhoi, Mkhoi L"

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    Adrenal insufficiency: A forgotten diagnosis in HIV/AIDS patients in developing countries
    (Hindawi, 2019) Nassoro, David D; Mwakyula, Issakwisa Habakkuk; Mkhoi, Mkhoi L; Sabi, Issa; Merem, Alfred J.; Lawal, Paul S
    Adrenal insufficiency (AI) is one of the most common endocrine diseases in patients with HIV/AIDS, leading to high morbidity and mortality in HIV patients who become critically ill. Various etiologies are associated with the condition, including cytomegalovirus (CMV), Mycobacterium tuberculosis, lymphoma, Kaposi’s sarcoma, and drugs such as rifampin, among others. HIV patients with advanced disease develop relative cortisol deficiency largely due to the reduction of cortisol reserve, which predisposes patients to the adrenal crisis in periods of stress or critical illness. The prevalence of AI in HIV/AIDS patients during HAART era is higher in developing than developed countries, probably due to limited access to both diagnosis and adequate treatments which increases the risk of opportunistic infections. The clinical features of functional adrenal insufficiency in HIV/AIDS patients can be masked by various infectious, noninfectious, and iatrogenic causes, which reduce clinical recognition of the condition. Development of simple screening algorithms may help clinicians reach the diagnosis when approaching these patients. In many low-income countries, most HIV patients are diagnosed with advanced disease; thus, further research is necessary to elucidate the prevalence of adrenal insufficiency in HIV/AIDS patients and the condition’s impact on mortality in this population.
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    Cervical cancer screening among women receiving antiretroviral therapy in a resource-limited environment
    (Asian Pacific Journal of Cancer Prevention, 2020) New-Aaron, Moses; Meza, Jane L; Goedert, Martha H; Kibusi, Stephen M; Mkhoi, Mkhoi L; Mayengo, Caroline Damian; Charles, James; Shabani, Siraji; Musil, Kelsie M; Cheney, Anlan; Sumba, Samwel
    Background: Cervical cancer is among the most prevalent cancer among women worldwide and women living with HIV are at increased risk, especially in a resource-limited environment. Objective: This study aimed to determine levels of awareness, knowledge, uptake, and willingness to screen for cervical cancer among women receiving care in an HIV clinic at Dodoma Regional Referral Hospital (DRRH), Tanzania. Methods: Data were collected for a period of three weeks from July 21 to August 11, 2017, using a mobile phone data collection App. A total of 421 Women aged 18-50 years old were included in the study. Results: Majority of the women interviewed (n=306, 73%) were aware of cervical cancer. Among those who were aware, 84% (n=257) did not recall ever being screened for cervical cancer, and the majority had poor knowledge of cervical cancer. Educational level completed (p=0.01), income per month (p=0.02), age group (p<0.0001), and area of residence (p<0.0001) were all significantly associated to awareness of cervical cancer. Most of the women who have never screened (n=231, 91%) expressed a willingness to be screened. Prior uptake of cervical cancer screening was associated with a number of live births (p=0.001) and area of residence (p=0.04). And Willingness to the screen was significantly associated with age groups (p=0.03) and the number of live births (p=0.03). Moreover, we found that younger age and urban residence was positively associated with awareness and uptake of cervical cancer screening. Willingness was found to decrease as age increased. Conclusion: The study found that despite older women’s higher risk of cervical cancer, those who indicated a willingness to screen were younger. Additional education, health promotion, and integration of cervical cancer screening services are needed to improve cervical cancer awareness and screening uptake at the HIV clinic.