Browsing by Author "Nkandala, Igembe"

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    Prevalence and risk factors of active TB among adult HIV patients receiving ART in Northwestern Tanzania: a retrospective cohort study
    (Hindawi, 2018) Gunda, Daniel W.; Maganga, Simon C.; Nkandala, Igembe; Kilonzo, Semvua B.; Mpondo, Bonaventura C.; Shao, Elichilia R.; Kalluvya, Samwel E.
    Although ART has improved the outcome of people living with HIV/AIDS, still some patients develop TB while receiving ART. The literature on the magnitude of this problem is still scarce in our setting especially northwestern Tanzania. This study was designed to determine the prevalence of active TB among HIV patients on ART and assess its potential risk factors. A retrospective cohort study was done among adult HIV-positive patients initiated on ART at Bugando Medical Centre. Patients who were TB positive before ART initiation were excluded. Data regarding demographic, clinical, and laboratory information, TB status on receipt of ART, and time on ART were collected and analyzed using STATA 11 to determine the prevalence of TB and its associated factors. In total, 391 patients were enrolled in this study. The median age was 39 (32–46) years, and a total of 129 (32.99%) participants had CD4 counts <200 cells/µl and 179 (45.78%) had WHO stage 3 and 4 illnesses. A total of 43 (11.0%) participants developed TB while receiving ART which was independently associated with male gender (OR = 2.9;p=0.007 ), WHO clinical stage 3 and 4 (OR = 1.4; p=0.029), baseline CD4 count <200 cells/µl (OR = 9.1; pp<), and having not used IPT (OR = 3.1; p=0.05). Active TB is prevalent among HIV patients while receiving ART in northwestern Tanzania which is independently associated with male gender, advanced HIV disease, and nonuse of IPT. Universal HIV testing could reduce late HIV diagnosis and hence reduce the risk of developing TB while receiving ART in our setting. Also IPT should be widely used for those who are negative for TB on screening.
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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 (27–42) 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/𝜇l. Deaths occurred in 86 (11.6%) patients which were independently associated with male gender (16.0% versus 9.0%, 𝑝 = 0.015), being divorced (OR=2.7,𝑝 < 0.001), WHO stages 3 and 4 (OR=2.3,𝑝 = 0.05), CD4<200 cells/𝜇l (OR=3.4, 𝑝 < 0.001), and severe anemia (OR=6.6, 𝑝 < 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.