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BMC Public Health
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Prevalence of peripheral neuropathy and its associated demographic and health status characteristics, among people on antiretroviral therapy in Rwanda

Authors: David Kabagema Tumusiime, Francois Venter, Eustasius Musenge, Aimee Stewart

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

The introduction of antiretroviral therapy (ART) has dramatically reduced the mortality rate of people living with HIV (PLHIV). However, complications of both HIV and ART, such as peripheral neuropathy currently affect PLHIV. The purpose of this study was to establish the prevalence of peripheral neuropathy of the lower extremity and, its association with demographic and health status, characteristics among people on ART in Rwanda.

Methods

A cross sectional study was conducted among 507 women and men aged between 18 and 60 years, on ART, randomly selected from eight selected ART clinics in Rwanda. Brief Peripheral Neuropathy Screen was used to assess peripheral neuropathy.

Results

Peripheral neuropathy prevalence was 59% overall, mean age of the participants was 39.7 (±9.2) and a slightly older age was associated with peripheral neuropathy; [42(±9.2) vs 37 (±8.8) (p < 0.001)]. 78% of participants living in urban settings compared to 40% in rural settings reported peripheral neuropathy, 69% of participants with higher levels of education (secondary level and above) reported lower extremity neuropathy.
The three factors were significantly associated with peripheral neuropathy in multivariable model analysis: older age [aOR = 1.1, 95% CI (1.0, 1.2), p < 0.001], primary education level [aOR = 0.6 95% Cl (0.3, 1.0), p = 0.04] and urban setting [aOR = 0.1, 95% CI (0.06, 0.3), p < 0.001], after adjusting for other factors. None of the health status characteristics namely; the level of CD4 cell count, duration of HIV infection and duration on ART, was independently associated with peripheral neuropathy.

Conclusions

The prevalence of peripheral neuropathy among PLHIV on ART in Rwanda is high. It is unclear why urban setting has an effect on PN levels in this cross sectional study, but does suggest that unidentified social and lifestyles factors may have a role in subjective symptoms and objective signs, of PN.
Literature
1.
Joint United Nations Programme on HIV/AIDS: How to get to Zero. WorldAIDSday_report_2011_en.pdf
2.
O’Brien K, Nixon S, Tynan A-M, Glazier R: Aerobic exercise interventions for adults living with HIV/AIDS. Cochrane Database Syst Rev. 2010, 8: CD001796-PubMed
3.
Scanlon ML, Vreeman RC: Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings. Hivaids Auckl Nz. 2013, 5: 1-17.
4.
Harrison TB, Smith B: Neuromuscular manifestations of HIV/AIDS. J Clin Neuromuscul Dis. 2011, 13 (2): 68-84. 10.1097/CND.0b013e318221256f.CrossRefPubMed
5.
Mehta SA, Ahmed A, Kariuki BW, Said S, Omasete F, Mendillo M, Laverty M, Holzman R, Valentine F, Sivapalasinga MS: Implementation of a validated peripheral neuropathy screening tool in patients receiving antiretroviral therapy in Mombasa, Kenya. Am J Trop Med Hyg. 2010, 83 (3): 565-570. 10.4269/ajtmh.2010.09-0629.CrossRefPubMedPubMedCentral
6.
Evans SR, Ellis RJ, Chen H, Yeh T, Lee AJ, Schifitto G, Wu K, Bosch RJ, McArthur JC, Simpson DM, Clifford DB: Peripheral neuropathy in HIV: prevalence and risk factors. Aids Lond Engl. 2011, 25 (7): 919-928. 10.1097/QAD.0b013e328345889d.CrossRef
7.
Tumusiime DK, Stewart A, Venter F, Musenge E: The reliability of modified lower extremity functional scale among adult people living with HIV on Antiretroviral Therapy, in Rwanda. SAHARA J. 2014, In press
8.
Black K: Business Statistics for Contemporary Decision Making. 4th Edition (Wiley Student Edition for India). 2004, India: Wiley, ISBN 978-81-265-0809-9
9.
Cherry CL, Wesselingh SL, Lal L, McArthur JC: Evaluation of a clinical screening tool for HIV-associated sensory neuropathies. Neurology. 2005, 65 (11): 1778-1781. 10.1212/01.wnl.0000187119.33075.41.CrossRefPubMed
10.
Tumusiime DK, Stewart A, Venter FWD, Musenge E: The reliability of the modified lower extremity functional scale among adults living with HIV on antiretroviral therapy, in Rwanda, Africa. SAHARA J. 2014, 11 (1): 178-186. 10.1080/17290376.2014.976249. 10.1080/17290376.2014.976249CrossRefPubMedPubMedCentral
11.
Theroux N, Phipps M, Zimmerman L, Relf MV: Neurological complications associated with HIV and AIDS: clinical implications for nursing. J Neurosci Nurs. 2013, 45 (1): 5-13. 10.1097/JNN.0b013e318275b1b2.CrossRefPubMed
12.
13.
Ellis RJ, Rosario D, Clifford DB, McArthur JC, Simpson D, Alexander T, Gelman BB, Vaida F, Collier A, Marra CM, Ances B, Atkinson JH, Dworkin RH, Morgello S, Grant I: Continued high prevalence and adverse clinical impact of human immunodeficiency virus-associated sensory neuropathy in the era of combination antiretroviral therapy: the CHARTER Study. Arch Neurol. 2010, 67 (5): 552-558. 10.1001/archneurol.2010.76.CrossRefPubMedPubMedCentral
14.
Luma HN, Tchaleu BCN, Doualla MS, Temfack E, Sopouassi VNK, Mapoure YN, Djientcheu VD: HIV-associated sensory neuropathy in HIV-1 infected patients at the Douala General Hospital in Cameroon: a cross-sectional study. Aids Res Ther. 2012, 9 (1): 35-10.1186/1742-6405-9-35.CrossRefPubMedPubMedCentral
15.
Biraguma J, Rhoda A: Peripheral neuropathy and quality of life of adults living with HIV/AIDS in the Rulindo district of Rwanda. Sahara J. 2012, 9 (2): 88-94.PubMed
16.
Venkataramana AB, Skolasky RL, Creighton JA, McArthur JC: Diagnostic utility of the subjective peripheral neuropathy screen in HIV-infected persons with peripheral sensory polyneuropathy. Aids Read. 2005, 15 (7): 341-344. 348–9, 354PubMed
17.
Zanetti C, Manzano GM, Gabbai AA: The frequency of peripheral neuropathy in a group of HIV positive patients in Brazil. Arq Neuropsiquiatr. 2004, 62 (2A): 253-256. 10.1590/S0004-282X2004000200012.CrossRefPubMed
18.
Kamerman PR, Wadley AL, Cherry CL: HIV-associated sensory neuropathy: risk factors and genetics. Curr Pain Headache Rep. 2012, 16 (3): 226-236. 10.1007/s11916-012-0257-z.CrossRefPubMed
19.
Cherry CL, Affandi JS, Imran D, Yunihastuti E, Smyth K, Vanar S, Kamarulzaman A, Price P: Age and height predict neuropathy risk in patients with HIV prescribed stavudine. Neurology. 2009, 73 (4): 315-320. 10.1212/WNL.0b013e3181af7a22.CrossRefPubMed
20.
Haanpää ML, Backonja M-M, Bennett MI, Bouhassira D, Cruccu G, Hansson PT, Jensen TS, Kauppila T, Rice AS, Smith BH, Treede RD, Baron R: Assessment of neuropathic pain in primary care. Am J Med. 2009, 122 (10 Suppl): S13-S21.CrossRefPubMed
21.
Masterson Creber RM, Smeeth L, Gilman RH, Miranda JJ: Physical activity and cardiovascular risk factors among rural and urban groups and rural-to-urban migrants in Peru: a cross-sectional study. Rev Panam Salud Pública. 2010, 28 (1): 1-8.PubMed
22.
Schuelter-Trevisol F, Wolff H, Alencastro PR, Grigoletti S, Ikeda ML, Brandao AB, Barcellos NT, Fuchs Sc: Physical activity: do patients infected with HIV practice? How much? A systematic review. Curr HIV Res. 2012, 10 (6): 487-497. 10.2174/157016212802429794.CrossRefPubMed
23.
Van Griensven J, Zachariah R, Mugabo J, Reid T: Weight loss after the first year of stavudine-containing antiretroviral therapy and its association with lipoatrophy, virological failure, adherence and CD4 counts at primary health care level in Kigali, Rwanda. Trans R Soc Trop Med Hyg. 2010, 104 (12): 751-757. 10.1016/j.trstmh.2010.08.016.CrossRefPubMed
24.
Botros D, Somarriba G, Neri D, Miller TL: Interventions to address chronic disease and HIV: strategies to promote exercise and nutrition among HIV-infected individuals. Curr HIV/AIDS Rep. 2012, 9 (4): 351-363. 10.1007/s11904-012-0135-7.CrossRefPubMedPubMedCentral
25.
Jayakumar P, Shankar EM, Karthikeyan M, Ravikannan P: Lipodystrophy and adrenal insufficiency: potential mediators of peripheral neuropathy in HIV infection?. Med Hypotheses. 2012, 78 (3): 373-376. 10.1016/j.mehy.2011.12.003.CrossRefPubMed
26.
Mutimura E, Stewart A, Rheeder P, Crowther NJ: Metabolic function and the prevalence of lipodystrophy in a population of HIV-infected African subjects receiving highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 1999, 46 (4): 451-455.CrossRef
27.
Millogo A, Lankoandé D, Yaméogo I, Yaméogo AA, Sawadogo AB: Polyneuropathies in patients treated with HAART in Bobo-Dioulasso hospital, Burkina Faso. Bull Soc Pathol Exot. 1990, 101 (1): 11-13.
28.
Ances BM, Vaida F, Rosario D, Marquie-Beck J, Ellis RJ, Simpson DM, Clifford DB, McArthur JC, Grant I, McCutchan JA: Role of metabolic syndrome components in HIV associated sensory neuropathy. Aids Lond Engl. 2009, 23 (17): 2317-2322. 10.1097/QAD.0b013e328332204e.CrossRef
29.
Morgello S, Estanislao L, Simpson D, Geraci A, DiRocco A, Gerits P, Ryan E, Yokoushina T, Khan S, Mahboch R, Naseer M, Dorfman D, Sharp V: HIV-associated distal sensory polyneuropathy in the era of highly active antiretroviral therapy: the Manhattan HIV Brain Bank. Arch Neurol. 2004, 61 (4): 546-551. 10.1001/archneur.61.4.546.CrossRefPubMed
30.
Schifitto G, McDermott MP, McArthur JC, Marder K, Sacktor N, McClernon DR, Conant K, Cohen B, Epstein LG, Kieburtz K: Markers of immune activation and viral load in HIV-associated sensory neuropathy. Neurology. 2005, 64 (5): 842-848. 10.1212/01.WNL.0000152981.32057.BB.CrossRefPubMed
31.
Forna F, Liechty CA, Solberg P, Asiimwe F, Were W, Mermin J, Behumbiize P, Tong T, Brooks JT, Weidle PJ: Clinical toxicity of highly active antiretroviral therapy in a home-based AIDS care program in rural Uganda. J Acquir Immune Defic Syndr. 1999, 44 (4): 456-462.CrossRef
32.
Mateo MG, Gutierrez MDM, Vidal F, Domingo P: Stavudine extended release (once-daily, Bristol-Myers Squibb) for the treatment of HIV/AIDS. Expert Opin Pharmacother. 2013, 14 (8): 1055-1064. 10.1517/14656566.2013.782285.CrossRefPubMed
33.
Hung CF, Gibson SA, Letendre SL, Lonergan JT, Marquie-Beck JA, Vaida F, Ellis RJ: Impact of long-term treatment with neurotoxic dideoxynucleoside antiretrovirals: implications for clinical care in resource-limited settings. Hiv Med. 2008, 9 (9): 731-737. 10.1111/j.1468-1293.2008.00615.x.CrossRefPubMedPubMedCentral
34.
Kampira E, Kumwenda J, van Oosterhout JJ, Dandara C: Mitochondrial DNA subhaplogroups L0a2 and L2a modify susceptibility to peripheral neuropathy in Malawian adults on stavudine containing highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2013, 63 (5): 647-52. 10.1097/QAI.0b013e3182968ea5.CrossRefPubMedPubMedCentral
35.
Robinson-Papp J, Gelman BB, Grant I, Singer E, Gensler G, Morgello S: Substance abuse increases the risk of neuropathy in an HIV-infected cohort. Muscle Nerve. 2012, 45 (4): 471-476. 10.1002/mus.23231.CrossRefPubMedPubMedCentral
Metadata
Title
Prevalence of peripheral neuropathy and its associated demographic and health status characteristics, among people on antiretroviral therapy in Rwanda
Authors
David Kabagema Tumusiime
Francois Venter
Eustasius Musenge
Aimee Stewart
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-1306

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