Magnitude and risk factors of non-communicable diseases among people living with HIV in Tanzania: a cross sectional study from Mbeya and Dar es Salaam regions.

Gibson B Kagaruki,Mary T Mayige,Godlisten S Materu,Andrew M Kilale,Akili K Kalinga,Godfather D Kimaro,Ester S Ngadaya,Sayoki G Mfinanga,Amos M Kahwa

doi:10.1186/1471-2458-14-904

Gibson B Kagaruki, Mary T Mayige + Show 7 more

Open Access

https://doi.org/10.1186/1471-2458-14-904

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Abstract

BackgroundHIV and Non communicable diseases (NCDs) are major problem of public health importance in developing countries. This study was conducted to explore and establish information on the magnitude, distribution of NCDs risk factors among people living with HIV (PLWHIV) which is scarce in Tanzania.MethodA cross sectional study was conducted to PLWHIV from 12 care and treatment clinics in Dar es Salaam and Mbeya regions from October 2011 to February 2012. Data on demographic characteristics, NCD risk factors including behavioral, biochemical tests and physical measurements was collected from PLWHIV.ResultsOf 754 PLWHIV recruited, 671(89.0%) consented to participate in the study and 354/671(52.8%) were on antiretroviral therapy (ART). The following NCD risk factors: raised blood levels of low density lipoprotein (61.3% vs 38.7%, p < 0.001) total cholesterol (TC) (71.6% vs 28.4%, p < 0.001) and triglyceride (67.0% vs 33.0%, p = 0.001) as well as overweight/obesity (61.1% vs 38.9%, p = 0.010), abnormal waist circumference (61.7% vs 38.3%, p < 0.001) and being aged >40 years (63.3% vs 36.7%, p < 0.001) were more prevalent among PLWHIV on ART than ART naïve. The prevalence of Diabetes mellitus among PLWHIV was 4.2% and was slightly high among those ART naïve (4.7% vs 3.7%). The prevalence of hypertension was 26.2% and was high among those on ART (30.0% vs 21.9%, p = 0.010). Being aged >40 years (AOR = 2.52, 95% CI 1.37-4.63), abnormal waist circumference (AOR = 2.37 95% CI 1.13-5.00), overweight/obesity (AOR = 2.71, 95% CI 1.26-5.84) and male sex (AOR = 1.17, 1.02-4.20) were the predictors of hypertension among patients on ART while raised TC (AOR = 1.47 (1.01-2.21) and being aged >40 years (AOR = 3.42, 95% CI 2.06-5.70) were predictors for hypertension among ART naïve patients.ConclusionThis study has revealed that the magnitude of NCD risk factors is significantly higher among PLWHIV on ART than those not on ART. Initiating and strengthening of interventions for minimizing preventable NCD risks should be considered when initiating ART among PLWHIV. Regular monitoring of NCD risk factors is of paramount importance among ART patients.

Highlights

HIV and Non communicable diseases (NCDs) are major problem of public health importance in developing countries
Being aged >40 years (AOR = 2.52, 95% confidence intervals (CI) 1.37-4.63), abnormal waist circumference (AOR = 2.37 95% CI 1.13-5.00), overweight/obesity (AOR = 2.71, 95% CI 1.26-5.84) and male sex (AOR = 1.17, 1.02-4.20) were the predictors of hypertension among patients on antiretroviral therapy (ART) while raised total cholesterol (TC) (AOR = 1.47 (1.01-2.21) and being aged >40 years (AOR = 3.42, 95% CI 2.06-5.70) were predictors for hypertension among ART naïve patients
This study has revealed that the magnitude of NCD risk factors is significantly higher among people living with HIV (PLWHIV) on ART than those not on ART

Summary

Introduction

HIV and Non communicable diseases (NCDs) are major problem of public health importance in developing countries. This study was conducted to explore and establish information on the magnitude, distribution of NCDs risk factors among people living with HIV (PLWHIV) which is scarce in Tanzania. Studies have reported an increased risk of cardiovascular disease (CVDs) among people living with HIV (PLWHIV). This is due to the linkage between HIV/AIDS and noncommunicable diseases (NCDs) [5,6,7]. HIV can directly damage the cells of blood vessels and contribute to atherosclerosis, or hardening of the arteries [8] This is due to inflammation induced by HIV infection or its associated proteins which may promote atherosclerosis and formation of high-risk plaque, increasing the risk of myocardial infarction and stroke [9,10,11]. Being overweight or obese is well known traditional risk factor associated with raises blood pressure (BP) and dyslipidemia [21]

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