Skip to main content
Top
Published in: BMC Infectious Diseases 1/2020

01-12-2020 | Insomnia | Research article

Burden of fatigue among adults living with HIV/AIDS attending antiretroviral therapy in Ethiopia

Authors: Tsiwaye Gebreyesus, Addisalem Belay, Gebretsadik Berhe, Gebremedhin Haile

Published in: BMC Infectious Diseases | Issue 1/2020

Login to get access

Abstract

Background

Fatigue is one of the most common and devastating Human Immuno-deficiency Virus (HIV) - related symptoms, with a varying prevalence in different study areas. In Ethiopia, there is a paucity of information on the magnitude and factors associated with fatigue among HIV/Acquired Immune Deficiency Syndrome (AIDS) patients. This may lead to under-diagnosis and eventually under-management of the symptom.

Methods

Institution based cross-sectional study design was conducted among 609 HIV/AIDS patients who were selected by using a systematic random sampling method. Data were collected by using interviewer administered structured questionnaire. Level of fatigue was measured by Fatigue Severity Scale.

Results

The prevalence of fatigue was found to be 51.7%. The factors associated with fatigue were: Parity [AOR = 2.01; 95% CI: 1.09–3.71], CD4 count 200–499 cells/mm3 [AOR = 2.81; 95% CI: 1.58–4.99], anemia [AOR = 4.90 95% CI: 2.40–9.97], co-morbidities [AOR = 3.65; 95% CI: 1.71–7.78], depression [AOR = 3.68 95% CI: 1.99–6.79], not being physically active [AOR = 3.20 95% CI: 1.50–6.81], clinical stage II or IV HIV [AOR = 3.11; 95% CI: 1.51–6.40] and [AOR = 4.08; 95% CI: 1.37–12.14], respectively.

Conclusion

The finding of this study revealed that fatigue is a common health problem among adult People Living with HIV (PLHIV). Factors associated with fatigue included: Parity, CD4 count 200–499 cells/mm3, Clinical Stage II or IV HIV, anemia, co-morbidities, depression, and not being physically active. The health care service needs to address the predisposing factors by provision integrated care including timely detection and treatment of comorbidities, mental health problems, and promote physical activity to slow down disease progression and then reduce exposure to fatigue.
Literature
1.
go back to reference HIV/AIDS. J.U.N.P.o., UNAIDS data 2017. Geneva: Switzerland: UNAIDS 2017; 2018. HIV/AIDS. J.U.N.P.o., UNAIDS data 2017. Geneva: Switzerland: UNAIDS 2017; 2018.
2.
go back to reference Unaids J. Fact sheet—latest global and regional statistics on the status of the AIDS epidemic. Geneva: UNAIDS; 2017. Unaids J. Fact sheet—latest global and regional statistics on the status of the AIDS epidemic. Geneva: UNAIDS; 2017.
3.
go back to reference Girum T, Wasie A, Worku A. Trend of HIV/AIDS for the last 26 years and predicting achievement of the 90–90-90 HIV prevention targets by 2020 in Ethiopia: a time series analysis. BMC Infect Dis. 2018;18(1):320.CrossRef Girum T, Wasie A, Worku A. Trend of HIV/AIDS for the last 26 years and predicting achievement of the 90–90-90 HIV prevention targets by 2020 in Ethiopia: a time series analysis. BMC Infect Dis. 2018;18(1):320.CrossRef
4.
go back to reference Lakew Y, Benedict S, Haile D. Social determinants of HIV infection, hotspot areas and subpopulation groups in Ethiopia: evidence from the National Demographic and health survey in 2011. BMJ Open. 2015;5(11):e008669.CrossRef Lakew Y, Benedict S, Haile D. Social determinants of HIV infection, hotspot areas and subpopulation groups in Ethiopia: evidence from the National Demographic and health survey in 2011. BMJ Open. 2015;5(11):e008669.CrossRef
5.
go back to reference Wu J, et al. Self-reported sleep disturbances in HIV-infected people: a meta-analysis of prevalence and moderators. Sleep Med. 2015;16(8):901–7.CrossRef Wu J, et al. Self-reported sleep disturbances in HIV-infected people: a meta-analysis of prevalence and moderators. Sleep Med. 2015;16(8):901–7.CrossRef
6.
go back to reference Bernard C, Dabis F, de Rekeneire N. Prevalence and factors associated with depression in people living with HIV in sub-Saharan Africa: a systematic review and meta-analysis. PLoS One. 2017;12(8):e0181960.CrossRef Bernard C, Dabis F, de Rekeneire N. Prevalence and factors associated with depression in people living with HIV in sub-Saharan Africa: a systematic review and meta-analysis. PLoS One. 2017;12(8):e0181960.CrossRef
7.
go back to reference Biraguma J, Mutimura E, Frantz JM. Health-related quality of life and associated factors in adults living with HIV in Rwanda. SAHARA-J: J Social Aspects HIV/AIDS. 2018;15(1):110–20.CrossRef Biraguma J, Mutimura E, Frantz JM. Health-related quality of life and associated factors in adults living with HIV in Rwanda. SAHARA-J: J Social Aspects HIV/AIDS. 2018;15(1):110–20.CrossRef
8.
go back to reference Voss JG, et al. Symptom burden of fatigue in men and women living with HIV/AIDS in southern Africa. J Assoc Nurses AIDS Care. 2007;18(4):22–31.CrossRef Voss JG, et al. Symptom burden of fatigue in men and women living with HIV/AIDS in southern Africa. J Assoc Nurses AIDS Care. 2007;18(4):22–31.CrossRef
9.
go back to reference Peltzer K, Phaswana-Mafuya N. The symptom experience of people living with HIV and AIDS in the eastern cape, South Africa. BMC Health Serv Res. 2008;8(1):271.CrossRef Peltzer K, Phaswana-Mafuya N. The symptom experience of people living with HIV and AIDS in the eastern cape, South Africa. BMC Health Serv Res. 2008;8(1):271.CrossRef
10.
go back to reference Kluger BM, Krupp LB, Enoka RM. Fatigue and fatigability in neurologic illnesses: proposal for a unified taxonomy. Neurology. 2013;80(4):409–16.CrossRef Kluger BM, Krupp LB, Enoka RM. Fatigue and fatigability in neurologic illnesses: proposal for a unified taxonomy. Neurology. 2013;80(4):409–16.CrossRef
11.
go back to reference Jong E, et al. Predictors and treatment strategies of HIV-related fatigue in the combined antiretroviral therapy era. Aids. 2010;24(10):1387–405.CrossRef Jong E, et al. Predictors and treatment strategies of HIV-related fatigue in the combined antiretroviral therapy era. Aids. 2010;24(10):1387–405.CrossRef
12.
go back to reference Phillips KD, et al. Physiological and psychological correlates of fatigue in HIV disease. Biol Res Nurs. 2004;6(1):59–74.CrossRef Phillips KD, et al. Physiological and psychological correlates of fatigue in HIV disease. Biol Res Nurs. 2004;6(1):59–74.CrossRef
13.
go back to reference Evans WJ, Lambert CP. Physiological basis of fatigue. Am J Physical Med Rehabil. 2007;86(1):S29–46.CrossRef Evans WJ, Lambert CP. Physiological basis of fatigue. Am J Physical Med Rehabil. 2007;86(1):S29–46.CrossRef
14.
go back to reference Barroso J, Carlson JR, Meynell J. Physiological and psychological markers associated with HIV-related fatigue. Clin Nurs Res. 2003;12(1):49–68.CrossRef Barroso J, Carlson JR, Meynell J. Physiological and psychological markers associated with HIV-related fatigue. Clin Nurs Res. 2003;12(1):49–68.CrossRef
15.
go back to reference Barroso J, et al. Physiological and psychosocial factors that predict HIV-related fatigue. AIDS Behav. 2010;14(6):1415–27.CrossRef Barroso J, et al. Physiological and psychosocial factors that predict HIV-related fatigue. AIDS Behav. 2010;14(6):1415–27.CrossRef
16.
go back to reference Sullivan PS, Dworkin MS. And a.S.o.H.D. investigators, prevalence and correlates of fatigue among persons with HIV infection. J Pain Symptom Manag. 2003;25(4):329–33.CrossRef Sullivan PS, Dworkin MS. And a.S.o.H.D. investigators, prevalence and correlates of fatigue among persons with HIV infection. J Pain Symptom Manag. 2003;25(4):329–33.CrossRef
17.
go back to reference Henderson M, et al. Fatigue among HIV-infected patients in the era of highly active antiretroviral therapy. HIV medicine. 2005;6(5):347–52.CrossRef Henderson M, et al. Fatigue among HIV-infected patients in the era of highly active antiretroviral therapy. HIV medicine. 2005;6(5):347–52.CrossRef
18.
go back to reference Salahuddin N, et al. Daytime sleepiness, nighttime sleep quality, stressful life events, and HIV-related fatigue. J Assoc Nurses AIDS Care. 2009;20(1):6–13.CrossRef Salahuddin N, et al. Daytime sleepiness, nighttime sleep quality, stressful life events, and HIV-related fatigue. J Assoc Nurses AIDS Care. 2009;20(1):6–13.CrossRef
19.
go back to reference Webel AR, et al. Physical activity is associated with reduced fatigue in adults living with HIV/AIDS. J Adv Nurs. 2016;72(12):3104–12.CrossRef Webel AR, et al. Physical activity is associated with reduced fatigue in adults living with HIV/AIDS. J Adv Nurs. 2016;72(12):3104–12.CrossRef
20.
go back to reference Barroso J, et al. Fatigue in HIV-infected people: a three-year observational study. J Pain Symptom Manag. 2015;50(1):69–79.CrossRef Barroso J, et al. Fatigue in HIV-infected people: a three-year observational study. J Pain Symptom Manag. 2015;50(1):69–79.CrossRef
21.
go back to reference Barroso J, et al. Intensity, chronicity, circumstances, and consequences of HIV-related fatigue: a longitudinal study. Clin Nurs Res. 2014;23(5):514–28.CrossRef Barroso J, et al. Intensity, chronicity, circumstances, and consequences of HIV-related fatigue: a longitudinal study. Clin Nurs Res. 2014;23(5):514–28.CrossRef
22.
go back to reference George Dalmida S, et al. Depressive symptoms and fatigue as mediators of relationship between poor sleep factors and medication adherence in HIV-positive women. J Res Nurs. 2015;20(6):499–514.CrossRef George Dalmida S, et al. Depressive symptoms and fatigue as mediators of relationship between poor sleep factors and medication adherence in HIV-positive women. J Res Nurs. 2015;20(6):499–514.CrossRef
23.
go back to reference Pence BW, et al. Chronicity and remission of fatigue in patients with established HIV infection. AIDS Patient Care STDs. 2009;23(4):239–44.CrossRef Pence BW, et al. Chronicity and remission of fatigue in patients with established HIV infection. AIDS Patient Care STDs. 2009;23(4):239–44.CrossRef
24.
go back to reference Wagener M, et al. Employment-related concerns of HIV-positive people in the Netherlands: input for a multidisciplinary guideline. J Occup Rehabil. 2014;24(4):790–7.CrossRef Wagener M, et al. Employment-related concerns of HIV-positive people in the Netherlands: input for a multidisciplinary guideline. J Occup Rehabil. 2014;24(4):790–7.CrossRef
25.
go back to reference Dalmida SG, M.M.H, Fox R, Delaney AM. Depressive symptoms and fatigue as mediators of relationship between poor sleep factors and medication adherence in HIV-positive women. Res Nurs. 2015;20(6):499–514.CrossRef Dalmida SG, M.M.H, Fox R, Delaney AM. Depressive symptoms and fatigue as mediators of relationship between poor sleep factors and medication adherence in HIV-positive women. Res Nurs. 2015;20(6):499–514.CrossRef
26.
go back to reference Camlin, et al. C.e, Patient-reported factors associated with reengagement among HIV-infected patients disengaged from care in East Africa. HHS Public Access. 2016;30(3):495–502. Camlin, et al. C.e, Patient-reported factors associated with reengagement among HIV-infected patients disengaged from care in East Africa. HHS Public Access. 2016;30(3):495–502.
27.
go back to reference Jenkin P, et al. P.J.e., The experience of fatigue for adults living with HIV. J Clin Nurs. 2006;15:1123–31.CrossRef Jenkin P, et al. P.J.e., The experience of fatigue for adults living with HIV. J Clin Nurs. 2006;15:1123–31.CrossRef
28.
go back to reference Barroso J, Voss JG. Fatigue in HIV and AIDS: an analysis of evidence. J Assoc Nurses AIDS Care. 2013;24(1):S5–S14.CrossRef Barroso J, Voss JG. Fatigue in HIV and AIDS: an analysis of evidence. J Assoc Nurses AIDS Care. 2013;24(1):S5–S14.CrossRef
29.
go back to reference Voss JG. Predictors and correlates of fatigue in HIV/AIDS. J Pain Symptom Manag. 2005;29(2):173–84.CrossRef Voss JG. Predictors and correlates of fatigue in HIV/AIDS. J Pain Symptom Manag. 2005;29(2):173–84.CrossRef
30.
go back to reference Di Bonaventura, M.d., et al., The association of HIV/AIDS treatment side effects with health status, work productivity, and resource use. AIDS Care, 2012. 24 (6): p. 744–755.CrossRef Di Bonaventura, M.d., et al., The association of HIV/AIDS treatment side effects with health status, work productivity, and resource use. AIDS Care, 2012. 24 (6): p. 744–755.CrossRef
31.
go back to reference ZhibinLiu J, Liu H, Jin Y. Factors associated with fatigue in acquired immunodeficiency syndrome patients with antiretroviral drug adverse reactions: a retrospectivestudy. J Tradit Chin Med. 2013;33(3). ZhibinLiu J, Liu H, Jin Y. Factors associated with fatigue in acquired immunodeficiency syndrome patients with antiretroviral drug adverse reactions: a retrospectivestudy. J Tradit Chin Med. 2013;33(3).
32.
go back to reference Langseth R. Prevalence and predictors of fatigue among people living with HIV in northern and southern Norway; 2018. Langseth R. Prevalence and predictors of fatigue among people living with HIV in northern and southern Norway; 2018.
33.
go back to reference Bergamaschi A, et al. Perceived HIV-related physical fatigue, sociodemographic characteristics and physical activity: a cross-sectional study. J Clin Nurs. 2019. Bergamaschi A, et al. Perceived HIV-related physical fatigue, sociodemographic characteristics and physical activity: a cross-sectional study. J Clin Nurs. 2019.
34.
go back to reference Meynell J, Barroso J. Bioimpedance analysis and HIV-related fatigue. J Assoc Nurses AIDS Care. 2005;16(2):13–22.CrossRef Meynell J, Barroso J. Bioimpedance analysis and HIV-related fatigue. J Assoc Nurses AIDS Care. 2005;16(2):13–22.CrossRef
35.
go back to reference McMillan EM, Newhouse IJ. Exercise is an effective treatment modality for reducing cancer-related fatigue and improving physical capacity in cancer patients and survivors: a meta-analysis. Appl Physiol Nutr Metab. 2011;36(6):892–903.CrossRef McMillan EM, Newhouse IJ. Exercise is an effective treatment modality for reducing cancer-related fatigue and improving physical capacity in cancer patients and survivors: a meta-analysis. Appl Physiol Nutr Metab. 2011;36(6):892–903.CrossRef
36.
go back to reference bālaśelṭān, E.Y.s. and O. Macro, Ethiopia Demographic and Health Survey, 2005. 2006: Central Statistical Authority. bālaśelṭān, E.Y.s. and O. Macro, Ethiopia Demographic and Health Survey, 2005. 2006: Central Statistical Authority.
37.
go back to reference Valko PO, et al. Validation of the fatigue severity scale in a Swiss cohort. Sleep. 2008;31(11):1601–7.CrossRef Valko PO, et al. Validation of the fatigue severity scale in a Swiss cohort. Sleep. 2008;31(11):1601–7.CrossRef
38.
go back to reference Goswami, et al. G.e., Sleep Apnea Symptoms as a Predictor of Fatigue in an Urban HIV Clinic. AIDS Patient Care STDs. 2015:29. Goswami, et al. G.e., Sleep Apnea Symptoms as a Predictor of Fatigue in an Urban HIV Clinic. AIDS Patient Care STDs. 2015:29.
39.
go back to reference Wakeham K, et al. Symptom burden in HIV-infected adults at time of HIV diagnosis in rural Uganda. J Palliat Med. 2010;13(4):375–80.CrossRef Wakeham K, et al. Symptom burden in HIV-infected adults at time of HIV diagnosis in rural Uganda. J Palliat Med. 2010;13(4):375–80.CrossRef
40.
go back to reference Payne B, et al. HIV-associated fatigue in the era of highly active antiretroviral therapy: novel biological mechanisms? HIV Med. 2013;14(4):247–51.CrossRef Payne B, et al. HIV-associated fatigue in the era of highly active antiretroviral therapy: novel biological mechanisms? HIV Med. 2013;14(4):247–51.CrossRef
41.
go back to reference Nosrat S, Whitworth JW, Ciccolo JT. Exercise and mental health of people living with HIV: a systematic review. Chronic Illn. 2017;13(4):299–319.CrossRef Nosrat S, Whitworth JW, Ciccolo JT. Exercise and mental health of people living with HIV: a systematic review. Chronic Illn. 2017;13(4):299–319.CrossRef
Metadata
Title
Burden of fatigue among adults living with HIV/AIDS attending antiretroviral therapy in Ethiopia
Authors
Tsiwaye Gebreyesus
Addisalem Belay
Gebretsadik Berhe
Gebremedhin Haile
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2020
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-020-05008-4

Other articles of this Issue 1/2020

BMC Infectious Diseases 1/2020 Go to the issue