Evidence map›Paper›PMID 29970017›Full record

ArticleBMC infectious diseases2018

Late presentation to HIV/AIDS care at the Douala general hospital, Cameroon: its associated factors, and consequences.

Henry Namme Luma, Paulia Jua, Olivier-Tresor Donfack, Felicite Kamdem, Eveline Ngouadjeu, Hugo Bertrand Mbatchou, Marie-Solange Doualla, Yakouba Njankou Mapoure

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Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  12. Determinants of Late HIV Presentation at Ndlavela Health Center in Mozambique.International journal of environmental research and public health · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Henry Namme LumaDouala General Hospital, P.0. Box 4856, Douala, Cameroon. hnluma@yahoo.com.ORCID 0000-0003-2388-477X
Paulia JuaFaculty of Health Sciences, University of Buea, Buea, Cameroon.
Olivier-Tresor DonfackFaculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
Felicite KamdemDouala General Hospital, P.0. Box 4856, Douala, Cameroon.
Eveline NgouadjeuDouala General Hospital, P.0. Box 4856, Douala, Cameroon.
Hugo Bertrand MbatchouDouala General Hospital, P.0. Box 4856, Douala, Cameroon.
Marie-Solange DouallaDouala General Hospital, P.0. Box 4856, Douala, Cameroon.
Yakouba Njankou MapoureDouala General Hospital, P.0. Box 4856, Douala, Cameroon.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe introduction of anti-retroviral treatment (ART) has significantly reduced mortality and morbidity associated with HIV/AIDS. While treatment at early stages of the disease is related to a better prognosis, late presentation (LP) to care is harmful to the infected person, the society and is more costly. We aimed to describe late presentation to HIV care, its associated factors and consequences in patients followed up in a tertiary hospital in Cameroon.

methodsWe retrospectively assessed patients' files between 1996 and 2014 at the Douala general hospital (DGH) HIV treatment centre. Late presentation (LP) to HIV care was defined as a CD4+ T cell count< 350 cells/mm3 or advanced clinical stages of the disease (WHO stages 3/4) at first presentation for care. We used logistic regression to study factors associated with late presentation and assessed occurrence of opportunistic infections and mortality at 3, 6 and 12 months after presentation to care.

resultsOf 1866 files studied, mean age was 40 (SD: 10) years, median CD4+ T cell count was 147 (IQR: 63-270) cells/mm3, 58.2% were at HIV clinical stages 3 and 4. The prevalence of late presentation to HIV care was 89.7% (95% CI: 88.2-91.0%) and remained above 80% from 1996 to 2014. Circumstances of diagnosis: prevention of mother to child transmission program/blood donation (OR = 0.16, 95% CI 0.10-0.29), having a positive partner (OR = 0.16, 95%CI = 0.10-0.26), and routine screening (OR = 0.13, 95%CI = 0.10-0.19) reduced the odds of presenting late compared to clinical suspicion. Students had lower odds of presenting late compared to people who had an employment (OR = 0.50, 95%CI = 0.26-0.98). Calendar time OR = 1.64, 95% CI = 1.08-2.48 for ≥2010 vs. < 2005) increased the odds of late presentation. Mortality and opportunistic infections prevalence remained significantly higher in late presenters at 3, 6 and 12 months than in early presenters.

conclusionLate presentation to HIV care is very high at the DGH and is related to poor outcome. More screening and sensitization campaigns should be carried out in the population to diagnose the disease at an earlier stage.

Indexed as

Time-to-TreatmentAcquired Immunodeficiency SyndromeAdolescentAdultCameroonDelayed DiagnosisFemaleHIV InfectionsHospitals, GeneralHumansInfectious Disease Transmission, VerticalLogistic ModelsMalePrevalenceRetrospective StudiesRisk FactorsAssociated factorsCameroonHIV/AIDSLate presentationMortalityOpportunistic infections

Identifiers

PMID29970017
PMCPMC6029364

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.