Assessment of quality of life in HAART-treated HIV-positive subjects with body fat redistribution in Rwanda

<p>Abstract</p> <p>Background</p> <p>The introduction of HAART has initially improved the quality of life (QoL) of HIV-positive (HIV+) patients, however body fat redistribution (BFR) and metabolic disorders associated with long-term HAART use may attenuate this improvement. As access to treatment improves in sub-Saharan Africa, the disfiguring nature of BFR (peripheral atrophy and/or central adiposity) may deter treatment adherence and initiatives and decrease QoL. We examined the relationship between BFR and domains of QoL in HAART-treated HIV+ African men and women with (HIV+BFR, n = 50) and without (HIV+noBFR, n = 50) BFR in Rwanda.</p> <p>Results</p> <p>HIV+ subjects with BFR were less satisfied with their body image (4.3 ± 0.1 versus 1.5 ± 0.2; p < .001), self-esteem and social life (4.1 ± 1.4 versus 2.1 ± 0.3; p = 0.003). HIV+BFR were more ashamed in public (4.5 ± 1.2 versus 1.1 ± 1.1), reported less confident about their health (4.6 ± 1.4 versus 1.5 ± 1.2) and were frequently embarrassed due to body changes (4.1 ± 1.1 versus 1.1 ± 0.9) (p < .001) than HIV+noBFR. HIV+ Rwandan women with BFR reported more dissatisfaction with psychological (8.3 ± 2.9 versus 13.7 ± 1.9), social relationships (6.9 ± 2.3 versus 11.1 ± 4.1) and HIV HAART-specific domain of wellbeing (3.1 ± 4.8 versus 6.3 ± 3.6) (p < .001). Age was associated with independence (r²= 0.691; <it>p </it>= 0.009) and marital status was associated with psychological (r²= 0.593; <it>p </it>= 0.019) and social relationships (r²= 0.493; <it>p </it>= 0.007). CD4 count (r²= 0.648; <it>p </it>= 0.003) and treatment duration (r²= 0.453; <it>p </it>= 0.003) were associated with HIV HAART-specific domain of wellbeing. HIV+ Rwandan women with BFR were significantly more affected by abdominal adiposity (p < .001), facial and buttocks atrophy (p < .05) than HIV+ men with BFR.</p> <p>Conclusion</p> <p>Body fat alterations negatively affect psychological and social domains of quality of life. These symptoms may result in stigmatization and marginalization mainly in HAART-treated African women, adversely affecting HAART adherence and treatment initiatives. Efforts to evaluate self-perceived body fat changes may improve patients' wellbeing, HAART adherence and treatment outcomes and contribute towards stability in quality of life continuum.</p

Editorial: South African Journal of Physiotherapy 2018

No abstract available

Clinical characteristics and outcomes of patients with stroke admitted to three tertiary hospitals in Zimbabwe: A retrospective one-year study

Background: Epidemiological data on stroke in Zimbabwe are scarce and few clinical studies have been performed to date.Methods: A retrospective review of the medical records of patients admitted for stroke during the year 2012 was performed at three tertiary hospitals. Sociodemographic data were recorded alongside with comorbidities and outcomes. Scoping over a period of one year using records of patients admitted for stroke helped to quantify and qualify the stroke problem. Descriptive analysis was done using STATA version 13.0.Results: A total of 450 stroke cases, (63% women) were included in the final analysis. The proportion of stroke cases among the admissions was 0.61%. Mean age of the stroke patients was 61.6±16.8 years (95% CI=60.1; 63.2). Risk factors were hypertension (58.5%), diabetes (18%) and HIV, (14%)). Diagnosis was clinical and 39.4% had a CT scan. Mean length of hospital stay was 8.1±5.6 days with a significance difference noted among hospitals (p&lt;0.001). In-hospital mortality was 24.9%, 95% CI (20.9; 29.0%). Mortality was associated with place of admission (p&lt;0.001). Gender and side of stroke were significantly associated (p&lt;0.001).Conclusions: The sociodemographic characteristics mirrored findings from elsewhere. Mean age was higher than reported for Zimbabwe in the nineties and lately for Malawi. Majority of patients were female, elderly and hypertensive in line with findings from other countries. Presence of HIV is supported by recent studies from Malawi and South Africa. The relationship between gender and side affected needs further research. There is need to standardise acute care through proper diagnosis to reduce mortality. There is need to support caregivers post-discharge.Data-handling is poor and there is limited capacity for Sub Saharan Africa hospitals to provide optimal stroke care. This may have long term implications on the outcome of survivors and caregivers. There is need of vigilance in acute stroke care

Supporting Survivors of Stroke in Low Resource Settings

Stroke occurs suddenly and has major impact on both the survivor and their caregiver. A third of stroke victims usually die from its direct effects or complications. The survivors usually have functional deficits resulting in the need for caregiver support. The caregivers may have inadequate knowledge of how to care for their affected relatives. The result is high caregiver burden and complications among the survivors. Once a person has stroke, it becomes important that their caregivers and their needs are determined so that they get the necessary support from the health professionals. Education of both the stroke survivors and the caregivers, and follow-up to determine if their needs are being met may be the support required. This is important in low resource settings where the survivors and caregivers may not always afford to go to stroke clinics for support visits and follow-up. Furthermore, stroke will result in reduced quality of life, poor functional outcomes, and poor community reintegration, which are important areas in life. Caregivers who look after the survivor for long periods may suffer burnout and have poor quality of life. Educating both the stroke survivor and their caregiver may result in better quality of life and survival rate

Enabling Biodiversity Research with Open Source Workflow, GIS and Metadata Tools

Software developer, Informatics at the KU Biodiversity InstitutePlatinum Sponsors Coca-Cola Gold Sponsors KU Department of Geography KU Institute for Policy & Social Research KU Libraries GIS and Data Services State of Kansas Data Access and Support Center (DASC) Wilson & Company Engineers and Architects Silver Sponsors Bartlett & West Kansas Applied Remote Sensing Program KansasView Bronze Sponsors Garmin KU Biodiversity Institut

Phylogeography and Meta-Community Analysis in QGIS

Biodiversity Institute, The University of KansasPlatinum Sponsors KU School of Business Gold Sponsors Bartlett & West KU Department of Geography KU Environmental Studies Program KU Institute for Policy & Social Research KU Libraries Silver Sponsors Kansas Biological Survey KU Center for Global & International Studies Bronze Sponsors Global Information Systems State of Kansas Data Access and Support Center (DASC) KU Center for Remote Sensing of Ice Sheets (CReSIS