Correlates of the HIV-associated neurocognitive disorders among adults living with HIV in Dodoma region, central Tanzania: A cross-sectional study.

Journal: PloS one

Volume: 18

Issue: 5

Year of Publication: 2023

Affiliated Institutions:  Department of Psychiatry and Mental Health, School of Medicine, The University of Dodoma, Dodoma, Tanzania.

Abstract summary 

HIV-associated neurocognitive disorders (HAND) continue to manifest despite advancements and improved antiretroviral therapy coverage. Neurocognitive impairment is a significant predictor of poor prognosis related to poor antiretroviral therapy adherence and retention in HIV care.This cross-sectional study examined 397 participants attending cared for and treatment at Dodoma Regional Referral Hospital (DRRH) and selected by systematic sampling. The combination of Montreal Cognitive Assessment (MoCA), International HIV Dementia Scale (IHDS), and The Lawton Instrumental Activity of Daily Living (IADL) were used to assess HIV-associated neurocognitive disorders. Factors associated with HAND were determined using univariate and multivariable logistic regression.Of 397 participants, 234(59.1%) met the criteria for HAND with 231(58.2%) comprising asymptomatic neurocognitive disorder (ANI) or mild neurocognitive disorders (MND), and 3 (0.76%) HIV- associated dementia (HAD). Participants with HAND had significantly poorer performance in each cognitive domain on both MoCA and IHDS. Under multivariable regression, age of 55 years or above with Adjusted Odds Ratio (AOR): 3.5 (95%CI: 1.1, 11.6), p = 0.041 and female gender (AOR): 2.7 (95%CI: 1, 6, 4.5), p<0.001 were significantly associated with HAND. Adherence to antiretroviral therapy AOR: 0.4(95%CI: 0.2, 1.0), p = 0.044, and attaining primary education AOR: 0.3(95%CI: 0.1, 0.8), p = 0.01 or secondary education AOR: 0.1(95%CI: 0.03, 0.2), p<0.001 compared to having no formal education showed good cognitive performance.HIV-associated neurocognitive disorders are common in HIV, especially ANI and MND, are common in HIV infected Tanzanians. Both socio-demographic and clinical variables influence neurocognitive functioning in this population. Screening for mild neurocognitive disorders may be indicated if effective treatment becomes available.

Authors & Co-authors:  Nyundo Azan A AA

Study Outcome 

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Citations :  Shapshak P, Kangueane P, Fujimura RK, Commins D, Chiappelli F, Singer E, et al.. Editorial neuroAIDS review. AIDS Lond Engl. 2011. Jan 14;25(2):123–41. doi: 10.1097/QAD.0b013e328340fd42
Authors :  1
Identifiers
Doi : e0285761
SSN : 1932-6203
Study Population
Female
Mesh Terms
Adult
Other Terms
Study Design
Cross Sectional Study
Study Approach
,Systemic Review
Country of Study
Tanzania
Publication Country
United States