Magnitude of opportunistic infections and associated factors among HIV-infected individuals attending care and treatment clinics in Dar es Salaam, Tanzania: a hospital-based cross-sectional study

Abstract

Objectives This study aims to assess the magnitude of opportunistic infection (OI) and to identify factors associated with OIs among people living with HIV (PLHIV) on antiretroviral treatment (ART), attending HIV care and treatment clinics.Design A hospital-based cross-sectional study.Setting The study was conducted at Muhimbili National Hospital, Mwananyamala and Temeke Regional Referral Hospitals, in Dar es Salaam, Tanzania.Participants We enrolled 382 PLHIV on ART who were attending HIV care and treatment clinics in Dar es Salaam. Structured questionnaires were used to collect socio-demographic information, and a checklist was used to extract clinical characteristics from the client’s HIV care and treatment clinic cards. Information was subjected to descriptive and regression analysis using Stata V.13. All factors were considered significant at p<0.05.Primary outcome Magnitude, spectrum of OI and associated factors among PLHIV using ART.Results A total of 382 PLHIV on ART were randomly selected and recruited in the study. The overall prevalence of OIs was 25.13%; the leading OI was tuberculosis affecting 58 patients (15.2%). CD4+ T cell counts≤200 cells/µL (aOR=13.61; 95% CI: 6.09 to 30.38) p<0.001, isoniazid preventive treatment (IPT) (aOR=4.10; 95% CI: 1.97 to 8.53) p<0.001, WHO clinical stage 4 (aOR=6.37; 95% CI: 1.47 to 27.61) p=0.013, divorced individuals (aOR=3.57; 95% CI: 1.43 to 8.90) p=0.006, male (aOR=3.04; 95% CI: 1.50 to 6.17) p=0.007, haemoglobin level<11.0 g/dL (aOR=2.25; 95% CI: 1.14 to 4.47) p=0.020 and level of education of primary and below (aOR=4.31; 95% CI: 1.8 to 10.32) p=0.001 showed significant association with OIs.Conclusion There was still a high prevalence of OI observed in this study which needs to be addressed. CD4+ T cell counts of ≤200 cells/µL, advanced WHO clinical stages, no use of IPT prophylaxis, anaemia and low education level were predictors of OIs. Promptly implementing the test-and-treat protocol while an individual’s immunity is still strong and timely screening for OI are critical.