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dc.contributor.authorLumu, Bukenya Lameck
dc.date.accessioned2021-08-23T12:22:18Z
dc.date.available2021-08-23T12:22:18Z
dc.date.issued2021-04
dc.identifier.citationLumu, B. L. (2021). Determinants of time to onset of HIV associated neurocognitive disorders among HIV patients in Uganda. Unpublished master's dissertation. Makerere University, Kampalaen_US
dc.identifier.urihttp://hdl.handle.net/10570/8836
dc.descriptionA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfillment of the requirements for the award of the degree of Master of Statistics of Makerere Universityen_US
dc.description.abstractThe main objective of this study was to assess the factors associated with time to onset of HIV associated neurocognitive disorders (HAND) among HIV patients. The study utilized data from the Mildmay Uganda HIV clinic which constituted of 10797 HIV infected patients. The assessment was done using socio-demographic and clinical factors. The analysis was done using time to event approach (time to onset of HAND) involving log-rank comparison of survival curves and Cox proportional hazard model. The median time to onset of HAND was 1624 days (4 and half years). At multivariate analysis, the following factors were significantly associated with time to onset of HAND after enrolment into HIV care; having a history of smoking increases the risk of HAND diagnosis among HIV patients. The smokers had an increased risk (HR=1.983; p-value=0.028) of HAND diagnosis when compared to non-smokers. A history of alcohol abuse had a reduced risk (HR=0.642; p-value=0.000) of diagnosis of HAND compared to those with no history which contradicted the previous researches that suggested otherwise. This is mainly attributed to the difference in research approaches and methodology used as this was mainly a predictive association study while the latter involved micro-biology study of the participants. An increase in CD4 cells count at enrollment into care had a reduced risk (HR=0.999; p-value=0.000) of HAND diagnosis. A history of meningitis diagnosis more than doubled the risk (HR=2.689; p-value=0.000) of HAND diagnosis compared to those who had never had a meningitis diagnosis. An increase in the duration on ART by 1-month reduced the risk (HR=0.929; p-value=0.001) of HAND diagnosis. The key conclusions from this study are that an HIV patient with a history of smoking and meningitis diagnosis had an increased risk of diagnosis of HAND while having a higher CD4 at enrollment in HIV care and staying on ART for long reduced the risk of HAND diagnosis. Basing on the findings of the study, the researcher recommends that health education messages against smoking be strongly emphasized during health worker(s) interaction or counselling sessions for all HIV patients to curb the vice. The other recommendation is that routine screening for meningitis should be integrated into care for all HIV patients for early diagnosis and management, and anti-retroviral therapy (ART) should be provided for all patients diagnosed with HIV and routinely monitored to ensure no dropouts are recorded to improve the health status of the patients and minimize chances of acquiring neuro-cognitive disorderen_US
dc.language.isoenen_US
dc.publisherMakerere Universityen_US
dc.subjectHIV/AIDSen_US
dc.subjectHIV neurocognitive disordersen_US
dc.subjectHIV patientsen_US
dc.subjectUgandaen_US
dc.titleDeterminants of time to onset of HIV associated neurocognitive disorders among HIV patients in Ugandaen_US
dc.typeThesisen_US


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