Dataset Information

Self reported adherence to antiretroviral treatment and correlates in Hunan province, the Peoples Republic of China.

ABSTRACT:

Aims

This study aimed to describe the adherence level to antiretroviral therapy and its associated factors among people living with HIV in Hunan province, China.

Methods

Across-sectional survey study was done at two major HIV treatment sites within Hunan province in China from July 2011 to Oct 2012 through face-to-face interviews. Adherence measures were captured using a 30-day visual analog scale (VAS).

Results

A total of 418 participants consented and completed the questionnaires with the mean age being 38 years old. Based on VAS, 28% of the participants had lower than 90% ART adherence level. The main reasons for missing drugs were; forgetting, being away from home, being busy and feeling worse after taking drugs. Logistic regression results showed that drug use (B?=?0.68, OR?=?2.11), time on ART (B?=?-0.31, OR?=?0.72) and side effects (B?=?0.64, OR?=?1.82) were significantly associated with adherence to ART.

Conclusion

Patients on ARVs in Hunan province are faced with adherence challenges notably drug abuse, drug regime scheduling challenges at the initial stages of therapy and drug side effects. It is therefore necessary to institute specific adherence interventions that target those who abuse drugs, ART naïve patients, and those experiencing side effects in order to achieve optimal ART adherence.

SUBMITTER: Kipsang J

PROVIDER: S-EPMC6626245 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Self reported adherence to antiretroviral treatment and correlates in Hunan province, the Peoples Republic of China.

Kipsang John J Chen Jia J Tang Chulei C Li Xianhong X Wang Honghong H

International journal of nursing sciences 20180414 2

<h4>Aims</h4>This study aimed to describe the adherence level to antiretroviral therapy and its associated factors among people living with HIV in Hunan province, China.<h4>Methods</h4>Across-sectional survey study was done at two major HIV treatment sites within Hunan province in China from July 2011 to Oct 2012 through face-to-face interviews. Adherence measures were captured using a 30-day visual analog scale (VAS).<h4>Results</h4>A total of 418 participants consented and completed the questi ...[more]

PMID: 31406819

Similar Datasets

Project description:Tuberculosis (TB) is the leading cause of death from a bacterial pathogen worldwide. China has the third highest TB burden in the world, with a high reported burden in Hunan Province (amongst others). This study aimed to investigate the spatial distribution of TB and identify socioeconomic, demographic, and environmental drivers in Hunan Province, China. Numbers of reported cases of TB were obtained from the Tuberculosis Control Institute of Hunan Province, China. A wide range of covariates were collected from different sources, including from the Worldclim database, and the Hunan Bureau of Statistics. These variables were summarized at the county level and linked with TB notification data. Spatial clustering of TB was explored using Moran's I statistic and the Getis-Ord statistic. Poisson regression models were developed with a conditional autoregressive (CAR) prior structure, and with posterior parameters estimated using a Bayesian approach with Markov chain Monte Carlo (MCMC) simulation. A total of 323,340 TB cases were reported to the Hunan TB Control Institute from 2013 to 2018. The mean age of patients was 51.7 years (SD + 17.6 years). The majority of the patients were male (72.6%, n = 234,682) and had pulmonary TB (97.5%, n = 315,350). Of 319,825 TB patients with registered treatment outcomes, 306,107 (95.7%) patients had a successful treatment outcome. The annual incidence of TB decreased over time from 85.5 per 100,000 population in 2013 to 76.9 per 100,000 population in 2018. TB case numbers have shown seasonal variation, with the highest number of cases reported during the end of spring and the beginning of summer. Spatial clustering of TB incidence was observed at the county level, with hotspot areas detected in the west part of Hunan Province. The spatial clustering of TB incidence was significantly associated with low sunshine exposure (RR: 0.86; 95% CrI: 0.74, 0.96) and a low prevalence of contraceptive use (RR: 0.88; 95% CrI: 0.79, 0.98). Substantial spatial clustering and seasonality of TB incidence were observed in Hunan Province, with spatial patterns associated with environmental and health care factors. This research suggests that interventions could be more efficiently targeted at locations and times of the year with the highest transmission risk.

Project description:BackgroundThere are few data on the prevalence of WHO transmitted drug resistance mutations (TDRs) that could affect treatment responses to first line antiretroviral therapy (ART) in Hunan Province, China.ObjectiveDetermine the prevalence of WHO NRTI/NNRTI/PI TDRs in ART-naïve subjects in Hunan Province by deep sequencing.MethodsART-naïve subjects diagnosed in Hunan between 2010-2011 were evaluated by deep sequencing for low-frequency HIV variants possessing WHO TDRs to 1% levels. Mutations were scored using the HIVdb.stanford.edu algorithm to infer drug susceptibility.ResultsDeep sequencing was performed on samples from 90 ART-naïve subjects; 83.3% were AE subtype. All subjects had advanced disease (average CD4 count 134 cells/mm3). Overall 25.6%(23/90) of subjects had HIV with major WHO NRTI/NNRTI TDRs by deep sequencing at a variant frequency level ≥ 1%; 16.7%(15/90) had NRTI TDR and 12.2%(11/90) had a major NNRTI TDR. The majority of NRTI/NNRTI mutations were identified at variant levels <5%. Mutations were analyzed by HIVdb.stanford.edu and 7.8% of subjects had variants with high-level nevirapine resistance; 4.4% had high-level NRTI resistance. Deep sequencing identified 24(27.6%) subjects with variants possessing either a PI TDR or hivdb.stanford.edu PI mutation (algorithm value ≥ 15). 17(19.5%) had PI TDRs at levels >1%.ConclusionsART-naïve subjects from Hunan Province China infected predominantly with subtype AE frequently possessed HIV variants with WHO NRTI/NNRTI TDRs by deep sequencing that would affect the first line ART used in the region. Specific mutations conferring nevirapine high-level resistance were identified in 7.8% of subjects. The majority of TDRs detected were at variant levels <5% likely due to subjects having advanced chronic disease at the time of testing. PI TDRs were identified frequently, but were found in isolation and at low variant frequency. As PI/r use is infrequent in Hunan, the existence of PI mutations likely represent AE subtype natural polymorphism at low variant level frequency.

Project description:ObjectivesThis study aims to explore the spatial and spatiotemporal distribution of pertussis in Hunan Province, and provide a scientific basis for targeting preventive measures in areas with a high incidence of pertussis.DesignIn this retrospective spatial and spatiotemporal (ecological) study, the surveillance and population data of Hunan Province from 2009 to 2019 were analysed. The ArcGIS V.10.3 software was used for spatial autocorrelation analysis and visual display, and SaTScan V.9.6 software was used for statistical analysis of spatiotemporal scan data.SettingsConfirmed and suspected pertussis cases with current addresses in Hunan Province and onset dates between 1 January 2009 and 31 December 2019 were included in the study.ParticipantsThe study used aggregated data, including 6796 confirmed and suspected pertussis cases.ResultsThe seasonal peak occurred between March and September, and scattered children were at high risk. The global Moran's I was between 0.107 and 0.341 (p<0.05), which indicated that the incidence of pertussis in Hunan had a positive spatial autocorrelation. The results of local indicators of spatial autocorrelation analysis showed that the hot spots were mainly distributed in the northeast region of Hunan Province. Moreover, both purely space and spatiotemporal scans showed that the central and northeastern parts were the most likely cluster areas with an epidemic period between March and October in 2018 and 2019.ConclusionThe distribution of the pertussis epidemic in Hunan Province from 2009 to 2019 shows spatiotemporal clustering. The clustering areas of the pertussis epidemic were concentrated in the central and northeastern parts of Hunan Province between March and October 2018 and 2019. In areas with low pertussis incidence, the strengthening of the monitoring system may reduce under-reporting. In areas with high pertussis incidence where we could study whether the genes of endemic pertussis strains are mutated and differ from vaccine strains.

Project description:The worldwide emergence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) has posed additional challenges for global tuberculosis (TB) control efforts, as limited treatment options are available and treatment outcomes are often sub-optimal. This study determined treatment outcomes among a cohort of MDR-TB and XDR-TB patients in Hunan Province, China, and identified factors associated with poor treatment outcomes.We conducted a retrospective study using data obtained from medical records of TB patients in Hunan Chest Hospital, and from the internet-based TB management information system managed by the Tuberculosis Control Institute of Hunan Province, for the period 2011 to 2014. Treatment outcomes were assessed for patients diagnosed with MDR-TB (TB resistant to at least isoniazid and rifampicin) and XDR-TB (MDR-TB plus resistance to any fluoroquinolone and at least 1 second-line injectable drug). Cumulative incidence functions were used to estimate time to events (i.e. poor treatment outcomes, loss to follow-up, and unfavourable treatment outcomes); and a competing-risks survival regression model was used to identify predictors of treatment outcomes.Of 481 bacteriologically-confirmed patients, with a mean age of 40 years (standard deviation SD ± 13 years), 10 (2%) had XDR-TB and the remainder (471; 98%) had MDR-TB. For the entire cohort, treatment success was 57% (n = 275); 58% (n = 272) for MDR-TB and 30% (n = 3) for XDR-TB. Overall, 27% were lost to follow-up (n = 130), 27% (n = 126) for MDR-TB and 40% (n = 4) for XDR-TB; and 16% had a poor treatment outcome (n = 76), 15% for MDR-TB and 30% (n = 3) for XDR-TB. Of the 10 XDR-TB patients, 3 (30%) completed treatment, 3 (30%) died and 4 (40%) were lost to follow-up. Of the 471 MDR-TB patients, 258 (57%) were cured, 16 (3%) completed treatment, 13 (3%) died, 60 (13%) experienced treatment failure, and 126 (27%) were lost to follow-up. Resistance to ofloxacin was an independent predictor of poor (AHR = 3.1; 95%CI = 1.5, 6.3), and unfavourable (AHR = 1.7; 95%CI = 1.07, 2.9) treatment outcomes. Patients who started treatment during 2011-2012 (AHR = 2.8; 95% CI = 1.5, 5.3) and 2013 (AHR = 2.1; 95% CI = 1.2, 3.9) had poorer treatment outcomes compared to patients who started treatment during 2014.Patients with MDR-TB and XDR-TB had low rates of treatment success in Hunan Province, especially among patients who started treatment during 2011 to 2013, with evidence of improved treatment outcomes in 2014. Resistance to ofloxacin was an independent predictor of poor treatment outcomes.

Dataset Information

Self reported adherence to antiretroviral treatment and correlates in Hunan province, the Peoples Republic of China.

Aims

Methods

Results

Conclusion

Publications

Self reported adherence to antiretroviral treatment and correlates in Hunan province, the Peoples Republic of China.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets