Magnitude of opportunistic infection and associated factors Among HIV infected individuals attending care and treatment Clinics in Dar es salaam region

Abstract

Background: Opportunistic infection is an infection caused by pathogens (bacteria, viruses, fungi, or protozoa) that affect a host with a weakened immune system. Human immunodeficiency virus (HIV) is the most common cause of immunosuppression which exposes individuals to opportunistic infections (OIs). OIs remain the major driver of HIVassociated morbidity and mortality. About 90% of HIV-related morbidity and mortality are caused by OIs. Objective: This study aimed to determine the magnitude and spectrum of OIs and associated factors among HIV infected individuals attending care and treatment clinics in Dar es Salaam region. Methodology: A cross-sectional study was conducted among people living with HIV attending care and treatment clinics in Dar es Salaam region. Structured questionnaires were used to collect social demographic information, while check list were used to extract clinical characteristics from client’s CTC2 card/file. Data were entered, cleaned and analyzed by Epi Info. version7, SPSS version 20 and Stata software version 15. Results: A total of 382 HIV infected individuals were enrolled in this study, the majority 232 (43.19%) were aged between 31-45 years and the mean age was 40 ± 13 years. Sex was disproportionately distributed with female predominance 220 (57.59 %). The overall prevalence of OIs was 89 (23.3%). The leading OI observed in this study was tuberculosis 58(15.2 %), CD4 [aOR = 13.61: 95% CI 6.09 – 30.38] p<0.001, IPT prophylaxis [aOR= 4.10: 95% CI 1.97-8.53] p<0.001, WHO stage 4 [ aOR = 6.37: 95% CI 1.47-27.61] p=0.013, Divorced individuals [aOR= 3.57: 95% CI 1.43- 8.90] p=0.006, male [aOR= 3.04: 95% CI 1.50-6.17] p=0.007, hemoglobin level <11.0 g/dl [aOR=2.25: 95 CI 1.14–4.47] p=0.020, Education of primary and below [ aOR=4.31: 95% CI 1.8-10.32] p=0.001 showed significant association with OIs. Conclusions: There was still remarkable prevalence of OIs observed in this study which need to be addressed. CD4 count of ≤ 200cells/uL, advanced WHO clinical stages, not use of IPT prophylaxis, anemia and low education level were found to be predictors of OIs.