An assessment of the prevalence and associated burden of symptoms in HIV patients in Swakopmund, Namibia

 

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dc.contributor.advisor Gwyther, Liz en_ZA
dc.contributor.author Brand, Maja en_ZA
dc.date.accessioned 2016-08-11T10:21:26Z
dc.date.available 2016-08-11T10:21:26Z
dc.date.issued 2016 en_ZA
dc.identifier.citation Brand, M. 2016. An assessment of the prevalence and associated burden of symptoms in HIV patients in Swakopmund, Namibia. University of Cape Town. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/21195
dc.description.abstract Background: HIV infection and AIDS are characterized by a multitude of symptoms which has not changed since the advent of HAART. Based on this reality the World Health Organisation (WHO) recommends palliative care to be provided alongside disease specific treatment for all PLWHIV. There are many barriers to patients reporting their symptoms and physicians often fail to recognise the symptom burden. Palliative medicine improves quality of life, relieves suffering, provides good end of life care and helps patients and loved ones to come to terms with a chronic progressive disease. Namibia is one of the hardest hit countries globally with respect to the HIV epidemic. No palliative care services are available in that country yet. No research has been done to assess the prevalence and burden of symptoms amongst PLWHIV. The study serves as a pilot project to address these shortcomings. Aim: The aim of this study is to assess the prevalence and associated burden of symptoms in patients attending an HIV clinic in Swakopmund and local general practitioners' awareness of the symptom burden and assessment in HIV patients. Methods: This was a cross-sectional descriptive study conducted at the HIV clinic at the State Hospital in Swakopmund, Namibia, and amongst general practitioners working in the Erongo region. The study was conducted in two parts: 1) Assessment of symptom prevalence and severity in HIV patients on HAART attending the HIV clinic at the Swakopmund State Hospital. A total of 104 adult patients were recruited using simple random sampling was used to recruit 104 adult patients who were interviewed using the MSAS-SF. Demographic data and symptoms recorded by the health care professionals during follow-up visits were extracted from the patients' records. 2) The evaluation of general practitioners' perception regarding the symptom burden and importance of symptom assessment in HIV patients receiving HAART. Based on the outcome of the above findings a questionnaire was designed to assess the awareness of general practitioners of the burden of disease in PLWHIV. Ethical Approval was obtained from the Human Research Ethics Committee of the University of Cape Town as well as from the Ethical Committee of the Ministry of Health, Namibia. Results: The median of the sample was 40 years, the median CD4 count 417, and the median number of years on HAART was 4. The majority were females (61.5 %) and 66.3% were employed. The mean number of symptoms was 5.99 (median 5, SD 4.912). The most common symptoms were of psychological nature and pain, cough and peripheral neuropathy were common physical symptoms. Median values of TMSAS, GDI and PSYCH were higher in the unemployed and in females. PHYS was significantly higher in females. There was no association with the CD4 count. Time on treatment is not significantly related to any of TMSAS, GDI, PH YS or PSYCH scores, but younger age was related to higher GDI. Patient self - report of symptoms was significantly higher than symptoms recorded by the health practitioners during follow-up. Many general practitioners (44%) assume patients on HAART to be relatively symptom free, that low CD4 counts are related to symptom burden (84%) and that patients will report symptoms if present(76%). Conclusion: Symptom prevalence and burden is high in this study population despite HAART and there seem to be barriers to the reporting of symptoms by the patients. There is evidence of poor symptom assessment and symptom control. This highlights the need for palliative care for ambulatory HIV patients. en_ZA
dc.language.iso eng en_ZA
dc.subject.other Palliative Medicine en_ZA
dc.title An assessment of the prevalence and associated burden of symptoms in HIV patients in Swakopmund, Namibia en_ZA
dc.type Master Thesis
uct.type.publication Research en_ZA
uct.type.resource Thesis en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Public Health and Family Medicine en_ZA
dc.type.qualificationlevel Masters
dc.type.qualificationname MPhil en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Brand, M. (2016). <i>An assessment of the prevalence and associated burden of symptoms in HIV patients in Swakopmund, Namibia</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/21195 en_ZA
dc.identifier.chicagocitation Brand, Maja. <i>"An assessment of the prevalence and associated burden of symptoms in HIV patients in Swakopmund, Namibia."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2016. http://hdl.handle.net/11427/21195 en_ZA
dc.identifier.vancouvercitation Brand M. An assessment of the prevalence and associated burden of symptoms in HIV patients in Swakopmund, Namibia. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2016 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/21195 en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Brand, Maja AB - Background: HIV infection and AIDS are characterized by a multitude of symptoms which has not changed since the advent of HAART. Based on this reality the World Health Organisation (WHO) recommends palliative care to be provided alongside disease specific treatment for all PLWHIV. There are many barriers to patients reporting their symptoms and physicians often fail to recognise the symptom burden. Palliative medicine improves quality of life, relieves suffering, provides good end of life care and helps patients and loved ones to come to terms with a chronic progressive disease. Namibia is one of the hardest hit countries globally with respect to the HIV epidemic. No palliative care services are available in that country yet. No research has been done to assess the prevalence and burden of symptoms amongst PLWHIV. The study serves as a pilot project to address these shortcomings. Aim: The aim of this study is to assess the prevalence and associated burden of symptoms in patients attending an HIV clinic in Swakopmund and local general practitioners' awareness of the symptom burden and assessment in HIV patients. Methods: This was a cross-sectional descriptive study conducted at the HIV clinic at the State Hospital in Swakopmund, Namibia, and amongst general practitioners working in the Erongo region. The study was conducted in two parts: 1) Assessment of symptom prevalence and severity in HIV patients on HAART attending the HIV clinic at the Swakopmund State Hospital. A total of 104 adult patients were recruited using simple random sampling was used to recruit 104 adult patients who were interviewed using the MSAS-SF. Demographic data and symptoms recorded by the health care professionals during follow-up visits were extracted from the patients' records. 2) The evaluation of general practitioners' perception regarding the symptom burden and importance of symptom assessment in HIV patients receiving HAART. Based on the outcome of the above findings a questionnaire was designed to assess the awareness of general practitioners of the burden of disease in PLWHIV. Ethical Approval was obtained from the Human Research Ethics Committee of the University of Cape Town as well as from the Ethical Committee of the Ministry of Health, Namibia. Results: The median of the sample was 40 years, the median CD4 count 417, and the median number of years on HAART was 4. The majority were females (61.5 %) and 66.3% were employed. The mean number of symptoms was 5.99 (median 5, SD 4.912). The most common symptoms were of psychological nature and pain, cough and peripheral neuropathy were common physical symptoms. Median values of TMSAS, GDI and PSYCH were higher in the unemployed and in females. PHYS was significantly higher in females. There was no association with the CD4 count. Time on treatment is not significantly related to any of TMSAS, GDI, PH YS or PSYCH scores, but younger age was related to higher GDI. Patient self - report of symptoms was significantly higher than symptoms recorded by the health practitioners during follow-up. Many general practitioners (44%) assume patients on HAART to be relatively symptom free, that low CD4 counts are related to symptom burden (84%) and that patients will report symptoms if present(76%). Conclusion: Symptom prevalence and burden is high in this study population despite HAART and there seem to be barriers to the reporting of symptoms by the patients. There is evidence of poor symptom assessment and symptom control. This highlights the need for palliative care for ambulatory HIV patients. DA - 2016 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 T1 - An assessment of the prevalence and associated burden of symptoms in HIV patients in Swakopmund, Namibia TI - An assessment of the prevalence and associated burden of symptoms in HIV patients in Swakopmund, Namibia UR - http://hdl.handle.net/11427/21195 ER - en_ZA


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