Abstract
BackgroundPredicting future prevalence of any opportunistic infection (OI) among persons infected with the human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART) in resource poor settings is important for proper planning, advocacy and resource allocation. We conducted a study to forecast 5-years prevalence of any OI among HIV-infected individuals on HAART in Uganda.MethodsMonthly observational data collected over a 10-years period (2004–2013) by the AIDS support organization (TASO) in Uganda were used to forecast 5-years annual prevalence of any OI covering the period 2014–2018. The OIs considered include 14 AIDS-defining OIs, two non-AIDS defining OIs (malaria & geohelminths) and HIV-associated Kaposi’s sarcoma. Box-Jenkins autoregressive integrated moving average (ARIMA) forecasting methodology was used.ResultsBetween 2004 and 2013, a total of 36,133 HIV patients were enrolled on HAART of which two thirds (66 %) were female. Mean annual prevalence for any OI in 2004 was 57.6 % and in 2013 was 27.5 % (X2trend = 122, b = −0.0283, p <0.0001). ARIMA (1, 1, 1) model was the most parsimonious and best fit for the data. The forecasted mean annual prevalence of any OI was 26.1 % (95 % CI 21.1–31.0 %) in 2014 and 15.3 % (95 % CI 10.4–20.3 %) in 2018.ConclusionsWhile the prevalence of any OI among HIV positive individuals on HAART in Uganda is expected to decrease overall, it’s unlikely that OIs will be completely eliminated in the foreseeable future. There is therefore need for continued efforts in prevention and control of opportunistic infections in all HIV/AIDS care programmes in these settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3455-5) contains supplementary material, which is available to authorized users.
Highlights
Predicting future prevalence of any opportunistic infection (OI) among persons infected with the human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART) in resource poor settings is important for proper planning, advocacy and resource allocation
Since the introduction of highly active antiretroviral therapy (HAART) in resource poor settings, there has been tremendous reduction in the incidence and overall prevalence OIs among persons living with HIV/acquired immuno-deficiency syndrome (AIDS) [1]
the AIDS Support Organization (TASO) HIV/ AIDS care and treatment programme offers a wide range of services include HIV testing and counseling, antiretroviral therapy, primary and secondary prophylaxis, OI diagnosis and treatment, home based care and psycho-social support
Summary
Predicting future prevalence of any opportunistic infection (OI) among persons infected with the human immunodeficiency virus (HIV) on highly active antiretroviral therapy (HAART) in resource poor settings is important for proper planning, advocacy and resource allocation. In 2014, UNAIDS came up with very ambitious programme code named “90-90-90” meaning 90 % of all the people living with HIV to be diagnosed, 90 % of all diagnosed to receive ART and 90 % of all on ART to have a fully suppressed viral load by 2020 [2]. Basing on these targets and past achievements, there is global consensus that the HIV/AIDS epidemic could be halted. Despite these impressive gains, there are still disparities in HAART usage by geographical area, sex and age [5] and the effect of increasing HAART coverage on frequency and patterns of OIs among HIV positive individuals over time and in different geographical areas is not well known
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