Kudzai F V Chokuona, Munyaradzi Mukuzunga, Tsitsi P Juru, Addmore Chadambuka, Gerald Shambira, Notion T Gombe, Mufuta Tshimanga
{"title":"超越病毒载量：解开津巴布韦马尼托巴省的非传染性疾病模式。","authors":"Kudzai F V Chokuona, Munyaradzi Mukuzunga, Tsitsi P Juru, Addmore Chadambuka, Gerald Shambira, Notion T Gombe, Mufuta Tshimanga","doi":"10.4102/jphia.v16i1.587","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Non-communicable diseases (NCDs) among people living with human immunodeficient virus (HIV) are emerging and a leading cause of death in this population.</p><p><strong>Aim: </strong>To identify disease trends, prevalence and outcomes of NCDs among PLHIV.</p><p><strong>Setting: </strong>The study was conducted in Manicaland province.</p><p><strong>Methods: </strong>We reviewed secondary data from October 2013 to September 2023. Data on five priority NCDs were analysed: hypertension (HPT), diabetes mellitus (DM), chronic kidney injury (CKD), cancers and chronic respiratory conditions (CRC). Kaplan-Meier analysis and Cox proportional hazard analysis were performed, risk and hazard ratios reported at the 95% confidence level.</p><p><strong>Results: </strong>A total of <i>974</i> patient files were reviewed. The median age was <i>43</i> (<i>Q1 = 35; Q3 = 51</i>) years. A total of <i>409</i> (<i>42.0</i>%) were males and <i>565</i> (<i>58.0</i>%) were females. A total of <i>94</i> (<i>9.7</i>%) patients had HPT, <i>76</i> (<i>7.8</i>%) had DM, <i>6</i> (<i>0.6</i>%) had CKD, <i>9</i> (<i>0.9</i>%) had cancer and <i>3</i> (<i>0.3</i>%) had CRC. Controlling for age, gender and medication use, being on ART for more than 5 years and ageing were hazards to DM and HPT. Protease inhibitor-based regimen was a hazard to DM (hazard ratio [HR] <i>= 4.66, 95</i>% <i>CI: 2.54-8.54, p < 0.001</i>). Efavirenz-based regimen was protective in development of HPT (<i>HR = 0.47, 95</i>% <i>CI: 0.26-0.83</i>), <i>p</i> = 0.01.</p><p><strong>Conclusion: </strong>Hypertension and DM are the most common NCDs among people living with HIV. Prevalence of HPT and DM increased with age and duration on ART. To minimise complications related to NCD and HIV comorbidities, we recommend regular screening of NCDs at least monthly, and personalising treatment for hypertensive patients to efavirenz based regimens. We educated people living with HIV about the risks of NCDs and importance of healthy eating and regular exercise.</p><p><strong>Contribution: </strong>Integrated NCD and HIV care models.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"16 1","pages":"587"},"PeriodicalIF":0.6000,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135096/pdf/","citationCount":"0","resultStr":"{\"title\":\"Beyond viral load: Unravelling non-communicable disease patterns in Manicaland province, Zimbabwe.\",\"authors\":\"Kudzai F V Chokuona, Munyaradzi Mukuzunga, Tsitsi P Juru, Addmore Chadambuka, Gerald Shambira, Notion T Gombe, Mufuta Tshimanga\",\"doi\":\"10.4102/jphia.v16i1.587\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Non-communicable diseases (NCDs) among people living with human immunodeficient virus (HIV) are emerging and a leading cause of death in this population.</p><p><strong>Aim: </strong>To identify disease trends, prevalence and outcomes of NCDs among PLHIV.</p><p><strong>Setting: </strong>The study was conducted in Manicaland province.</p><p><strong>Methods: </strong>We reviewed secondary data from October 2013 to September 2023. Data on five priority NCDs were analysed: hypertension (HPT), diabetes mellitus (DM), chronic kidney injury (CKD), cancers and chronic respiratory conditions (CRC). Kaplan-Meier analysis and Cox proportional hazard analysis were performed, risk and hazard ratios reported at the 95% confidence level.</p><p><strong>Results: </strong>A total of <i>974</i> patient files were reviewed. The median age was <i>43</i> (<i>Q1 = 35; Q3 = 51</i>) years. A total of <i>409</i> (<i>42.0</i>%) were males and <i>565</i> (<i>58.0</i>%) were females. A total of <i>94</i> (<i>9.7</i>%) patients had HPT, <i>76</i> (<i>7.8</i>%) had DM, <i>6</i> (<i>0.6</i>%) had CKD, <i>9</i> (<i>0.9</i>%) had cancer and <i>3</i> (<i>0.3</i>%) had CRC. Controlling for age, gender and medication use, being on ART for more than 5 years and ageing were hazards to DM and HPT. Protease inhibitor-based regimen was a hazard to DM (hazard ratio [HR] <i>= 4.66, 95</i>% <i>CI: 2.54-8.54, p < 0.001</i>). Efavirenz-based regimen was protective in development of HPT (<i>HR = 0.47, 95</i>% <i>CI: 0.26-0.83</i>), <i>p</i> = 0.01.</p><p><strong>Conclusion: </strong>Hypertension and DM are the most common NCDs among people living with HIV. Prevalence of HPT and DM increased with age and duration on ART. To minimise complications related to NCD and HIV comorbidities, we recommend regular screening of NCDs at least monthly, and personalising treatment for hypertensive patients to efavirenz based regimens. We educated people living with HIV about the risks of NCDs and importance of healthy eating and regular exercise.</p><p><strong>Contribution: </strong>Integrated NCD and HIV care models.</p>\",\"PeriodicalId\":44723,\"journal\":{\"name\":\"Journal of Public Health in Africa\",\"volume\":\"16 1\",\"pages\":\"587\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2025-05-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135096/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Public Health in Africa\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4102/jphia.v16i1.587\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Public Health in Africa","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/jphia.v16i1.587","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Background: Non-communicable diseases (NCDs) among people living with human immunodeficient virus (HIV) are emerging and a leading cause of death in this population.
Aim: To identify disease trends, prevalence and outcomes of NCDs among PLHIV.
Setting: The study was conducted in Manicaland province.
Methods: We reviewed secondary data from October 2013 to September 2023. Data on five priority NCDs were analysed: hypertension (HPT), diabetes mellitus (DM), chronic kidney injury (CKD), cancers and chronic respiratory conditions (CRC). Kaplan-Meier analysis and Cox proportional hazard analysis were performed, risk and hazard ratios reported at the 95% confidence level.
Results: A total of 974 patient files were reviewed. The median age was 43 (Q1 = 35; Q3 = 51) years. A total of 409 (42.0%) were males and 565 (58.0%) were females. A total of 94 (9.7%) patients had HPT, 76 (7.8%) had DM, 6 (0.6%) had CKD, 9 (0.9%) had cancer and 3 (0.3%) had CRC. Controlling for age, gender and medication use, being on ART for more than 5 years and ageing were hazards to DM and HPT. Protease inhibitor-based regimen was a hazard to DM (hazard ratio [HR] = 4.66, 95% CI: 2.54-8.54, p < 0.001). Efavirenz-based regimen was protective in development of HPT (HR = 0.47, 95% CI: 0.26-0.83), p = 0.01.
Conclusion: Hypertension and DM are the most common NCDs among people living with HIV. Prevalence of HPT and DM increased with age and duration on ART. To minimise complications related to NCD and HIV comorbidities, we recommend regular screening of NCDs at least monthly, and personalising treatment for hypertensive patients to efavirenz based regimens. We educated people living with HIV about the risks of NCDs and importance of healthy eating and regular exercise.
期刊介绍：
The Journal of Public Health in Africa (JPHiA) is a peer-reviewed, academic journal that focuses on health issues in the African continent. The journal editors seek high quality original articles on public health related issues, reviews, comments and more. The aim of the journal is to move public health discourse from the background to the forefront. The success of Africa’s struggle against disease depends on public health approaches.
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