MST-Department of Environmental Health

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Browsing MST-Department of Environmental Health by Subject "Associated Factors"

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    Prevalence of HIV Associated Neurocognitive Disorders and its Associated Factors in Nairobi City County, Kenya
    (Kenyatta University, 2021) Githire, Margaret Mumbi; Kitur Esther; Muiruri King'ang'a
    Human Immunodeficiency Virus associated Neurocognitive disorders are often undiagnosed in HIV-infected persons. Recent publications approximate the prevalence of Hiv associated neurocognitive disorder has always been under reported, and this is likely more among those who have had exposure to the virus for longer. Hiv associated neurocognitive disorder and its related effects on the daily life of a person may pose a great impact on medication adherence and may lead to mortality if not detected and managed early. In Kenya there are few studies published on the prevalence and dangers that Hiv associated neurocognitive disorder pose to the individual, the family and the rest of the public. The aim of this study was to determine the prevalence of HIV-associated neurocognitive disorders and its associated factors among people living with HIV in Dream Center, Nairobi City County. The study was a cross-sectional, descriptive survey of HIV-positive patients that seek care at the Center. 374 Participants were selected randomly during the clinic appointment. Two neurocognitive screening tools were administered: The Montreal Cognitive Assessment tool was used to assess the primary outcomes while the Katz index of independence in activities of daily living tool was used to analyze the secondary outcomes. A medication possession rate was used to assess the adherence among the patients. The data was processed using a multi-variate statistical analysis to assess relationship between the different variables. Prevalence rate of HIV associated neurocognitive disorder in Nairobi City County was concluded from the study as 62 % (n= 218) for mild neurocognitive impairments, 32.3% (n=114) for Asymptomatic Neuro cognitive disorder and 5.7% (n=20) for HIV associated Dementia. On Socio-demographic characteristics, there was no significant association between age, gender, education level and marital status in the study. Majority of the respondents were female (69.3%, n=244) and the predominant age range was 25-34 years (52.6%, n=184). The youngest respondent was 19 years and the oldest was 63 years. The mean age of the respondents was 33. There was no statistically significant (p=0.880) association between WHO clinical staging of HIV and Hiv associated neurocognitive disorder among the participants. There was significant association between the highly active antiretroviral therapy (HAART) regimen and Montreal Cognitive Assessment score at p value of 0.028. 53.9% (n=165). Most clients were on TDF/3TC/EFV as the dominant regimen at 53.9 %(n=190) and 31.3% (n=110) were on TDF/3TC/DTG regimen. There was no association between the viral load and the Mo CA scores (p-value of 0.252). The respondents with low detectable level of virus were 80.7 % (n=284). The adherence rates of the participants were optimal as shown by the majority (75%, n=264) of the participants who scored adherence rates above 95%, There was no statistically significant association observed between the neurocognitive disorders and adherence to HAART (p value=0.32). The results indicate that the prevalence of HIV Associated Neurocognitive Disorder is high among the patients attending Dream Center, Nairobi City County and there is a significant correlation between the HAART regimen and HIV associated neurocognitive disorder.