Opportunistic Infections and Associated Factors among HIV Infected Patients on Anti-Retroviral Treatment at Bombo Hospital in Tanga Region, Tanzania

Abstract

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.