Oral hyperpigmentation as an adverse effect of highly active antiretroviral therapy in HIV patients: a systematic review and pooled prevalence

Human Immunodeficiency Virus (HIV) infects patients via CD4+ cells which are later be destroyed subsequently causing the deteriotation of immune system. HIV generally manifests in the oral cavity as the first indicating sign and a marker of disease progression. HAART medications are used to reduce the incidence of oral manifestations, however it can also generate adverse effects in the oral cavity including oral hyperpigmentation. This review aimed to estimate the prevalence of oral hyperpigmentation which affect individual quality of life as a side effect of HAART.This systematic review applied Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020. Literature search was performed in ScienceDirect, PubMed, and Scopus by combining terms such as highly active antiretroviral therapy, oral manifestation, epidemiology or prevalence published between January 1998 to March 2022.Of 108 articles, eleven articles were included for systematic review and meta-analysis. The pooled prevalence of oral hyperpigmentation in HAART patients was 25% (95% CI: 11%, 38%; I2: 99%). Subgroup analysis based on geographical location showed varied result may be due to the type and duration of HAART used in study population. The most widely used type of ARV was from the NRTI group (n=7) and the study with the shortest duration showed the lowest oral hyperpigmentation prevalence (n=7).There is an increased prevalence of oral hyperpigmentation by the use of HAART. Future study should investigate the correlation between HAART duration and the degree of oral hyperpigmentation

Psychometric Properties of the Suicidal Ideation Scale in the Indonesian Language

Introduction: Suicide is one of the leading cause of mortality among adolescents and young adults, especially in low to middle-income countries. Research found that screening for suicidal ideation in non-clinical populations such as schools or communities is an important step toward preventing suicide. Despite so, not all screening tools have the capabilities to accurately detect suicidal ideation among adolescents and young adults in non-clinical populations. The Suicidal Ideation Scale (SIS) is one of the most used questionnaires to measure suicidal thoughts in non-clinical populations. This study aims to investigate the psychometric properties of SIS among adolescents and young adults in Indonesia, especially in non-clinical populations. Methods: After a series of language and cultural adaptations, 1254 senior high school and university students completed the Indonesian version of SIS using 3 standard questionnaires, namely Patient Health Questionnaire-9/PHQ-9, Beck Depression Inventory-II/BDI-II, and Children’s Depression Inventory/CDI. The SIS content validity, internal consistency, test-retest reliability and concurrent, as well as internal structure validity, were investigated using content validity index (CVI), Cronbach’s Alpha, Pearson product-moment correlation, and confirmatory factor analysis (CFA), respectively. Results: The result showed that SIS has good to excellent internal consistency and test-retest reliability. Based on the validity indicators, it has satisfactory content and convergent validity, and further support the one-factor and 2-factor model for factorial validity. Both one-factor and 2 factor model are suitable to use in non-clinical settings. Conclusions: SIS is a valid and reliable tool for suicide ideation screening in adolescents and young adults in non-clinical populations. This validated questionnaire can be used in the early detection of suicidal ideation among adolescents and young adults in non-clinical populations, thus contributing to developing strategies and policies to prevent suicide among Indonesian adolescents and young adults at group and institutional levels