Retrospective Assessment Of The Opportunistic Infections Among Hiv/Aids Patients Attending Mbarara Regional Referral Hospital.

ABSTRACT

BACKGROUND People with advanced HIV I AIDS are vulnerable to infections and malignancies that are called opportunistic infections because they have a weakened immune system. Opportunistic infections continue to cause morbidity and mortality in patients with Human Immune Deficiency Virns (HIV)-1 infection. Some Ois only affect women or affect women more than men.Potent combination antiretroviral therapy (ART) has reduced the incidence of Ols for certain patients with access to care. However, certain patients in the developed and developing world do not have access to care and have Ois. OBJECTIVE To assess the occurrence of opportunistic infections among HIV I AIDS patients attending Mbarara Regional Referral Hospital. METHODS A retrospective study covering the period of February 2011 to December 2011. Slovin's formula of sample size determination was used. The population size was 15,000 people, the calculated sample size was 390 people, However this sample size was small and thus was increased to a 1500 and every 1 O'h file was selected. RESULTS 65% females, 35% were males, married (55%), divorced (7%), 22% single, 16% widowed; 20% for WHO stage!, 5% for stage2, 4% for stage3, 8% for stage4. 39% had diarrhea, 28% missing OI, 7% had cryptococcosis, 6% had oral candidiasis, 5% tuberculosis and vaginal candidiasis, 4% herpes zoster, while 3% had herpes simplex, 2% had genital warts and 1% had esophageal candidiasis. Metronidazole and ciprofloxacin were most used drngs, others were nystatin suspension, fluconazole, amphotericin, acyclovir were represented by 5% of the total treatment, 3% represented nystatin pessaries, DOTS and vitamin B complex, 2% for clotrimazole cream and amitryptiline and 1% podophyllum resin. 72% of patients were on HAART, 27% on PreART and 1% on trnvada. CONCLUSION The highest percentage of patients with Ois were from WHO clinical stage one and this could me an important indicator to avoid these 0 Is by careful monitoring of patients in this stage. The drngs most commonly used for the Ois were metronidazole and ciprofloxacin for diarrhea and this call for more procurement of these drngs, so that they are readily available to treat the patients, however proper diagnosis should be done to establish the exact causative agent before treatment. The female gender had the highest percentage as compared to men, similarly, Married had the highest incidence as compared to the divorced thus the married require the health education about fidelity and faithfulness as a method to prevent more problems. The patients on HAART whose combinations contained a protease inhibitor had the lowest incidence of opportunistic infections. 

TABLE OF CONTENTS 

Declaration .... ..... .... ....................................................................... ..... ........ .... .i 

Dedication ..................................... .. ................ ............................... .... ..... ...... .ii 

Acknowledgements ............................................ ... ............................... ......... ... . .iii 

Table of contents ................................................................................. ........... .iv 

List of figures ......................................................... ............ ........................... vii 

List of acronyms .............................................................................................. vii 

Abstract ....................................................... ......... ............................ ........ . .. ix 

Chapter One 

1.0 Introduction .... .................... .... . .............. ... .. ... .. ... .... .... .......... ... .. ....... ...... .. 1 

1.1 0 Background of the Study ............................................................................. 2 

1.20 Problem Statement .................................................................................... 4 

1.30 Purpose of the Study .............................................. r ...... .. . .............................. 5 .

1.40 Objectives ............................................ .... ... .. . · .... ;::;; ~ .. ~ ......... ... .......... 5 

1.4.1 Broad Objective ................................................ ............... 5 

1.50 Justlficatton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . "..!..~-• •• •••••••• •••••••••• 6 

Chapter Two ... ... .. .. ..................... .. .. ..... .. .......... .. .... ............... ..... .. .... .............. 7 

2.0 Literature Review ........................... .. . ................. ........................................ ? 

2.1 Who Clinical Staging ofHIV Disease in Adults and Adolescents (2006 Revision) ....... 7 

2.2 Common Opportunistic Infections in HIV Disease ............................................. 1 0 

Chapter Three 

3.0 Methodology ............................................................................................ 22 

3.1 Study Design and Method ................................. ... ..... ... ............................... 22 

3.2 Sample Collection ..................................................................................... 22 

3.3 Sampling Technique .................................................................................. 22 

3.4 Study Area ............................................................................................... 22 

3.4.1 Inclusion and Exclusion Criteria ............................................................... 23 

3.4.2 Limitation of the Study ........................................................................... 23 

3.4.3 Data Collection .... ............................................... ....... .... ................... ..... . 24 

3.4 .4 Ethical Considerations ........................................ ................... .24 

3.4.5 Dissemination of Results ....................................  .................. 24 

Chapter Four 

4.0 Results .............................................................. ., ....  ................. 25 

4.1 Gender ................................................................  ................. 25 

4.2 Prevalence of Opportunistic InfectiOns ............................... "'::: . ./. ...................... 26 

4.3 Drugs Used In Treatment for the Opportunistic Infections ......................................... 26 

4.4 Marital Status ........................................................................................... 28 

4.5 Who HIV/Aids Clinical Staging ............. .... .... ....................................... ......... 29 

4.6 Antiretroviral Drug Regimens ....................................................................... 30 

4.7 Adherence to the Ministry Of Health HlV Care/ART Card in reporting Opportunistic Infections ....... .32 

Chapter Five 

5.1 Discussion ............................................................................................... 33 

5.2 Conclusion ............................................................................................... 37 

5.3 Recommendations ....................................................................................... 37 

6.0 References ............................................................................................... 40