Prevalence of Opportunistic Infections Among Patients Attending Art Clinic at Ruhiira Health Centre Three, Isingiro District

TABLE OF CONTENTS

DECLARATION.................................................................................................................................................i

APPROVAL........................................................................................................................................................ii

DEDICATION.................................................................................................................................................. iii

ACKNOWLEDGEMENT ................................................................................................................................iv

LIST OF ABBREVIATIONS............................................................................................................................v

TABLE OF CONTENTS..................................................................................................................................vi

LIST OF TABLES.............................................................................................................................................ix

DEFINITION OF TERMS.................................................................................................................................x

ABSTRACT.......................................................................................................................................................xi

CHAPTER ONE.................................................................................................................................................1

1.0 Introduction.......................................................................................................................................................1

1.1 Background .......................................................................................................................................................1

1.2 Problem statement ............................................................................................................................................3

1.3 Justification of the study ..................................................................................................................................4

1.4 General objective ..............................................................................................................................................4

1.5 Specific objectives............................................................................................................................................4

1.6 Research questions ...........................................................................................................................................5

1.7 Conceptual frame work ....................................................................................................................................6

1.8 SCOPE OF THE STUDY. ...............................................................................................................................7

CHAPTER TWO ................................................................................................................................................8

2.0 Introduction.......................................................................................................................................................8

2.1 Prevalence of opportunistic infections among patients with HIV in Uganda. ..........................................8

2.1.1 Status of the HIV epidemic in Uganda ........................................................................................................8

2.1.1.1 HIV prevalence in Uganda ........................................................................................................................8

2.1.1.2 HIV burden in Uganda ...............................................................................................................................8

2.1.1.3 Prevalence of opportunistic infections among patients on ART in Uganda ...........................................9

2.2 RISK FACTORS FOR OPPORTUNISTIC INFECTIONS AMONG PATIENTS WITH HIV. .............10

2.2.1 WHO staging and CD4 count .....................................................................................................................10

2.2.2 Age ...............................................................................................................................................................10

2.2.3 Malnutrition .................................................................................................................................................10

2.3 HIGH RISK BEHAVIORS FOR OPPORTUNISTIC INFECTIONS AMONG PATIENTS WITH HIV.

................................................................................................................................................................................11

2.3.1 Sex workers..................................................................................................................................................11

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2.3.2 Alcohol consumption ..................................................................................................................................11

2.3.3 Tobacco smoking.........................................................................................................................................12

2.3.4 Unprotected sex. ..........................................................................................................................................12

CHAPTER THREE ..........................................................................................................................................14

3.0 General Introduction.......................................................................................................................................14

3.1 Study Design...................................................................................................................................................14

3.2 Study area........................................................................................................................................................14

3.3 Study population.............................................................................................................................................14

3.3.1 Inclusion criteria ..........................................................................................................................................15

3.3.2 Exclusion criteria .........................................................................................................................................15

3.4 Sample size determination .............................................................................................................................15

3.5 Sampling procedure........................................................................................................................................15

3.6 Study variables................................................................................................................................................15

3.6.1 Dependent variable......................................................................................................................................15

3.6.2 Independent variable ...................................................................................................................................16

3.7 Data collection and management...................................................................................................................16

3.8 Data analysis...............................................................................................................................................16

3.9 Ethical considerations ................................................................................................................................16

CHAPTER FOUR ............................................................................................................................................17

4.0 Introduction.....................................................................................................................................................17

4.1 RESPONDENTS’ DEMOGRAPHIC CHARACTERISTICS. ...................................................................17

4.2 PREVALENCE OF OPPORTUNISTIC INFECTIONS. ............................................................................18

4.2 Distribution of OIs with socio-demographic characteristics of the Participants attending ART clinic at

Ruhiira HC III, Isingiro District...........................................................................................................................18

4.3 CLINICAL VARIABLES..............................................................................................................................19

4.3.1 Distribution of OIs with Clinical variables of the participants.................................................................19

4.4 HIGH RISK BEHAVIOUR...........................................................................................................................20

4.4.1 Distribution of OIs with different high risk behaviors exhibited by the study participants. ..................20

4.4.2 Distribution of specific OIs with different high risk behaviors exhibited by the study participants. ....21

CHAPTER FIVE ..............................................................................................................................................22

5.1 INTRODUCTION..........................................................................................................................................22

5.2 PREVALENCE OF OPPORTUNISTIC INFECTIONS AMONG PATIENTS ATTENDING ART

CLINIC AT RUHIIRA HEALTH CENTER III, ISINGIRO DISTRICT. .......................................................22

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5.2.1 Frequency of opportunistic infections among study participants attending ART clinic at Ruhiira HC III,

Isingiro District. ....................................................................................................................................................22

5.3 ASSOCIATED RISK FACTORS FOR THE DEVELOPMENT OF OPPORTUNISTIC INFECTIONS

AMONG HIV PATIENTS ATTENDING ART AT RUHIIRA HEALTH CENTRE III. ..............................23

5.3.1 Selected Socio-Demographic characteristics of study participants attending ART clinic at Ruhiira HC

III, Isingiro District. ..............................................................................................................................................23

5.3.2 Distribution of OIs with selected clinical variables of participants attending ART clinic at Ruhiira HC

III, Isingiro District. ..............................................................................................................................................24

5.4 ASSOCIATION OF HIGH RISK BEHAVIOR WITH HIV & OI POSITIVE STATUS ........................25

5.4.1 Distribution of OIs with different high risk behaviors exhibited by the study participants. ..................25

CONCLUSION.....................................................................................................................................................25

STRENGTHS AND WEAKNESSES.................................................................................................................26

RECOMMENDATIONS .....................................................................................................................................26

References.........................................................................................................................................................27

Appendix 1: Consent Form..............................................................................................................................30

Appendix 2: Questionnaire. Instructions; Tick the right option and fill in where necessary. .....................31

Appendix 3: DATA COLLECTION SHEET .....................................................................................................34

Appendix 5: Work Plan....................................................................................................................................35

Appendix 6: MAPS ..........................................................................................................................................36

Map of Uganda showing Isingiro District at position # 26 ................................................................................36

MAP OF ISINGIRO SHOWING SUB-COUNTIES.....................................................................................37

LETTER OF PERMISSION............................................................................................................................38