Prevalence of metabolic syndrome among HIV-positive and HIV-negative populations in sub-Saharan Africa-a systematic review and meta-analysis

BACKGROUND: Metabolic syndrome (MetS) is a constellation of conditions that increase the risk of cardiovascular diseases. It is an emerging concern in sub-Saharan African (SSA) countries, particularly because of an increasingly aging population and lifestyle changes. There is an increased risk of MetS and its components among people living with Human immune deficiency syndrome (HIV) individuals; however, the prevalence of metabolic syndrome in the SSA population and its differential contribution by HIV status is not yet established. This systematic review and meta-analysis were conducted to estimate the pooled prevalence of metabolic syndrome in people living with HIV and uninfected populations, its variation by sub-components. METHODS: We performed a comprehensive search on major databases-MEDLINE (PubMed), EBSCOhost, and Cochrane Database of Systematic Reviews and Web of sciences for original epidemiological research articles that compared proportions of the MetS and its subcomponents between people living with HIV and uninfected patients and published between January 1990-December 2017. The inclusion criteria were adults aged ≥ 18 years, with confirmed HIV status. We assessed the risk of bias using a prevalence studies tool, and random effect meta-analyses were used to compute the pooled overall prevalence. RESULTS: A total of four cross-sectional studies comprising 496 HIV uninfected and 731 infected participants were included in the meta-analysis. The overall prevalence of MetS among people living with HIV was 21.5% (95% CI 15.09-26.86) versus uninfected 12.0% (95% CI 5.00-21.00%), with substantial heterogeneity. The reported relative risk estimate for MetS among the two groups was twofold (RR 1.83, 95% CI 0.98-3.41), with an estimated predictive interval of 0.15 to 22.43 and P = 0.055 higher for the infected population. Hypertension was the most prevalent MetS sub-components, with diverse proportions of people living with HIV (5.2-50.0%) and uninfected (10.0-59.0%) populations. CONCLUSIONS: The high range of MetS prevalence in the HIV-infected population compared to the uninfected population highlights the possible presence of HIV related drivers of MetS. Also, the reported high rate of MetS, irrespective of HIV status, indicates a major metabolic disorder epidemic that requires urgent prevention and management programs in SSA. Similarly, in the era of universal test and treat strategy among people living with HIV cohorts, routine check-up of MetS sub-components is required in HIV management as biomarkers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016045727

Prevalence and risk factors of HIV infection among people who inject drugs in Cambodia:findings from a national survey

BACKGROUND: Globally, people who inject drugs (PWID) continue to be among the most vulnerable populations to acquire infection of human immunodeficiency virus (HIV). The most recent national survey found that nearly a quarter of PWID in Cambodia were infected with HIV in 2012. The aim of this study is to estimate the current prevalence of and factors associated with HIV infection among PWID in Cambodia. METHODS: This national integrated biological and behavioral survey was conducted from June to December 2017. Participants were recruited from the capital city and 11 major provinces using the respondent driven sampling method. Face-to-face interviews were conducted using a structured questionnaire, and blood samples were collected for HIV, syphilis, and hepatitis C virus (HCV) testing. Multiple logistic regression analysis was conducted to identify risk factors for HIV infection. All analyses were estimated with sampling weights that corrected for non-response and sample design. RESULTS: A total of 310 PWID participated in the study, and the mean age was 31.8 years (SD = 7.8). The prevalence of HIV was 15.2%. More than half (57.4%) of the HIV-positive participants were co-infected with HCV, and 44.7% were not aware of their HIV status prior to this study. After adjustment for other covariates, HIV infection remained positively associated with being female (AOR = 1.88, 95% CI = 1.03-4.04), being in the older age group of ≥35 (AOR = 2.99, 95% CI 1.33-9.22), being widowed, divorced or separated (AOR = 2.57, 95% CI = 1.04-6.67), living on the streets (AOR = 2.86, 95% CI 1.24-4.37), and HCV infection (AOR = 3.89, 95% CI 1.86-1.15). The HIV infection remained negatively associated with having higher level of formal education of ≥10 years (AOR = 0.44, 95% CI 0.13-0.83) and higher average income of ≥US$200 per month (AOR = 0.20, 95% CI = 0.05-0.74). CONCLUSIONS: The prevalence of HIV among PWID in Cambodia remains high, but is reducing compared with the 24.8% reported in the 2012 national survey. Findings from this study provide critical information for tailoring interventions based on identified vulnerabilities and risk factors for HIV. Our findings underline the importance of socio-structural factors in HIV epidemiology among PWID in Cambodia, which require mitigation

Setting road safety targets in Cambodia : a methodological demonstration using the latent risk time series model.

The authors present the methodology used for estimating forecasts for the number of road traffic fatalities in 2011—2020 in Cambodia based on observed developments in Cambodian road traffic fatalities and motor vehicle ownership in the years 1995—2009. Using the latent risk time series model baseline forecasts for the fatality risk were estimated for the years 2010—2020. These baseline forecasts were then used to obtain estimates for the future number of fatalities based on three scenarios for the future Cambodian growth in motor vehicle ownership: a low, a middle, and a high growth scenario. The middle growth scenario results in an expected death toll of approximately 3,200 in 2020. In 2010, it was therefore decided in Cambodia to set the target at a 50% reduction of this number or 1,600 fatalities in 2020. If it is possible to achieve this target by taking additional actions to improve road safety, then a total of 7,350 lives could be saved in Cambodia over the whole 2011—2020 period. (Author/publisher

Prevalence and correlates of HIV infection among people who use drugs in Cambodia:A cross-sectional survey using respondent driven sampling method

Background: Most of studies on the relationship between drug use and HIV have focused largely on people who inject drugs. Non-injecting drug use is much more common than injecting drug use, and although it can also predispose people to HIV infection, it is not widely explored. We therefore conducted this study to explore the prevalence of HIV and identify risk factors for HIV infection among people who use non-injecting drugs (PWUD) in Cambodia. Methods: This cross-sectional study was conducted in 2017. The Respondent Driven Sampling method was used to recruit the study participants who were interviewed face-to-face using a structured questionnaire. Blood samples were collected for HIV and syphilis testing. A multivariable logistic regression analysis was conducted to identify risk factors associated with HIV infection. Results: In total, 1367 PWUD were included in this study, whose mean age was 28.0 (SD = 7.7) years. The majority (95.1%) of the participants used methamphetamine. The prevalence of HIV was 5.7, and 35.2% of the identified HIV-positive PWUD were not aware of their status prior to the survey. After adjustment for other covariates, HIV infection remained significantly associated with being in the age group of ≥35 (AOR = 2.34, 95% CI = 1.04-6.11), having lower level of formal education of ≤ 6 years (AOR = 2.26, 95% CI = 1.04-5.15), living on the streets (AOR = 2.82, 95% CI = 1.10-7.23), perception that their HIV risk was higher as compared to that of the general population (AOR = 3.18, 95% CI = 1.27-8.62), having used injecting drugs in lifetime (AOR = 3.8, 95% CI = 1.36-4.56), and having cuts or sores around the genital area in the past 12 months (AOR = 3.42, 95% CI = 1.09-6.33). Conclusions: The prevalence of HIV among PWUD in this study was more than 10 times higher than the prevalence in the general adult population. The findings reveal a higher vulnerability to HIV infection among specific sub-populations of PWUD, such as those who are homeless, who may benefit from tailored interventions that respond to their specific needs. To enhance HIV case finding, stratification of PWUD to facilitate HIV risk profiling based on socio-economic profiles and drug injection history is recommended. © 2019 The Author(s)

Correction to: Mobile Link - A theory-based messaging intervention for improving sexual and reproductive health of female entertainment workers in Cambodia: Study protocol of a randomized controlled trial (Trials DOI: 10.1186/s13063-018-2614-7)

10.1186/s13063-018-3090-9Trials191686

HIV risks and recent HIV testing among transgender women in Cambodia: Findings from a national survey

10.1371/journal.pone.0238314PLoS ONE159-Sepe023831

Access to community-based HIV services among transgender women in Cambodia: Findings from a national survey

10.1186/s12939-019-0974-6International Journal for Equity in Health1817

Lead Contamination and Its Human Health Effects in India, Vietnam and Cambodia

In the present study, lead concentrations were determined in human blood collected from cities, dumping sites and reference sites in South India, North Vietnam and Cambodia. To evaluate human health effect of lead exposure, the δ-aminolevulinic acid dehydratase (ALAD) activities were also measured. Concentrations of lead in human blood ranged from 2.33 μg/dl to 27.4 μg/dl. Especially, concentrations in blood of residents from Perungudi (waste dumping site) and Palaverkadu (farming village) in South India were higher than those from other regions or those reported previously. Concentrations of lead in blood of some residents exceeded the threshold levels which can induce hypertension in adult and inhibit development of intelligence in fetus. Furthermore, significant negative correlations between blood lead levels and ALAD activities were observed in the residents from all the three countries, indicating possible suppression of that heme biosynthesis by lead in these residents.ArticleBiomedical Research on Trace Elements.17(4):413-416(2007)journal articl