Prevalence And Risk Factors Associated With HIV Comorbidities Among Children And Adolescents At The Eastern Regional Hospital, Koforidua
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Date
2022-08
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University of Ghana
Abstract
Background: In the effort to curb HIV/AIDS, children and adolescents remain behind. Children and adolescents living with HIV are primarily at a greater risk of HIV comorbidities because of their susceptibility to infections.
Objective: To determine the prevalence and risk factors associated with HIV comorbidities among children and adolescent patients at the Eastern Regional Hospital, Koforidua.
Method: This is a hospital-based retrospective cross-sectional study, which used clinical record review to obtain retrospective data for 1,437 children and adolescents, from January 2018 to January 2021. Clinical and socio-demographic factors were tabulated and Pearson’s chi square test applied to determine associations between risk factors and HIV comorbidities. Logistic regression was used to determine the socio-demographic and clinical factors associated with the presence of HIV comorbidities as well as the treatment outcomes
Results: A majority of the study population (56.9%) were females. The prevalence of HIV co-morbidities among the study population was 33.0%. The most frequent comorbidity reported was Bronchopneumonia. Age (p=0.014), educational status (p=0.005) and adherence to ARTs (p=0.000) were significantly associated with HIV comorbidities in bivariate analysis. However, sex (p=0.063), level of education of parents or guardians (p=0.484), residence (p=0.845), viral load detection (p=0.308) and viral loads counts (p=0.973) were not significantly associated with HIV comorbidities. Children aged 5 - 9 years old were 30% (cOR = 0.70; 95% CI: 0.52 - 0.93; p= 0.017) less likely to have a comorbidity than children under 5 years old. The odds of having HIV comorbidity was 1.06 (cOR; 95% CI =0.83 - 1.35; p=0.147) times higher among children and adolescents whose parents or guardians attained primary education than those whose parents or guardians attained no formal education, but this was not statistically significant. The odds of having a comorbidity was 45% less likely (cOR = 0.55; 95% CI = 0.42 - 0.71; p= 0.000) among children and adolescents who were not adherent to ARTs than those who were adherent to ARTs. Results from this study showed that there was no significant association between adherence to ARTs and treatment outcomes (p=0.259).
Conclusion: There is a high prevalence of Respiratory comorbidities among children and adolescents with HIV infection. Children and adolescent patients also experience a higher risk of Bronchopneumonia, Pulmonary TB, and Pneumocystis pneumonia. Clinical and Socio-demographic risk factors contribute to the presence of HIV comorbidities and affect their treatment outcomes. There is the need to provide a system that will effectively monitor comorbidities and health conditions of children and adolescent patients living with HIV, whether on admission or not, to inform appropriate management.
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Keywords
HIV Comorbidities, Children, Adolescents, Eastern Regional Hospital, Koforidua