Implementation of a Validated Peripheral Neuropathy Screening Tool in Patients Receiving Antiretroviral Therapy in Mombasa, Kenya
Limited objective data are available for the prevalence of peripheral neuropathy (PN) among antiretroviral (ART)-treated human immunodeficiency virus (HIV)-infected patients in resource-limited settings. A validated neuropathy-screening tool was integrated into routine ART visits at an HIV clinic in...
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| Veröffentlicht in: | The American journal of tropical medicine and hygiene 2010-09, Vol.83 (3), p.565-570 |
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| creator | MEHTA, Sapna A AHMED, Aabid KARIUKI, Beatrice W SAID, Swaleh OMASETE, Fanuel MENDILLO, Megan LAVERTY, Maura HOLZMAN, Robert VALENTINE, Fred SIVAPALASINGAM, Sumathi |
| description | Limited objective data are available for the prevalence of peripheral neuropathy (PN) among antiretroviral (ART)-treated human immunodeficiency virus (HIV)-infected patients in resource-limited settings. A validated neuropathy-screening tool was integrated into routine ART visits at an HIV clinic in Mombasa, Kenya. Diagnosis of PN required at least one symptom and either abnormal vibratory sensation or deep tendon reflex bilaterally. Among 102 consecutively screened patients, 63% were women, 62% were receiving ART for < or = 1 year, and 86% were receiving a stavudine (D4T)-based regimen. Thirty-seven (36%) had PN. Univariate analysis showed that current D4T use was protective against PN (P = 0.03) and older age was a marginal risk factor (P = 0.05). Multivariate analysis showed that older age was a risk factor for neuropathy (P = 0.04). Peripheral neuropathy was common, particularly among older HIV-infected adults in Kenya. The protective association with current D4T use likely represents survivor effect bias. Longitudinal studies using this screen will help further characterize PN in resource-limited settings. |
| doi_str_mv | 10.4269/ajtmh.2010.09-0629 |
| format | Article |
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A validated neuropathy-screening tool was integrated into routine ART visits at an HIV clinic in Mombasa, Kenya. Diagnosis of PN required at least one symptom and either abnormal vibratory sensation or deep tendon reflex bilaterally. Among 102 consecutively screened patients, 63% were women, 62% were receiving ART for < or = 1 year, and 86% were receiving a stavudine (D4T)-based regimen. Thirty-seven (36%) had PN. Univariate analysis showed that current D4T use was protective against PN (P = 0.03) and older age was a marginal risk factor (P = 0.05). Multivariate analysis showed that older age was a risk factor for neuropathy (P = 0.04). Peripheral neuropathy was common, particularly among older HIV-infected adults in Kenya. The protective association with current D4T use likely represents survivor effect bias. Longitudinal studies using this screen will help further characterize PN in resource-limited settings.</description><identifier>ISSN: 0002-9637</identifier><identifier>EISSN: 1476-1645</identifier><identifier>DOI: 10.4269/ajtmh.2010.09-0629</identifier><identifier>PMID: 20810821</identifier><identifier>CODEN: AJTHAB</identifier><language>eng</language><publisher>Deerfield, IL: American Society of Tropical Medecine and Hygiene</publisher><subject>Anti-HIV Agents - adverse effects ; Anti-HIV Agents - therapeutic use ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiviral agents ; Biological and medical sciences ; CD4 Lymphocyte Count ; Cross-Sectional Studies ; Female ; HIV Infections - drug therapy ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infectious diseases ; Kenya ; Male ; Medical sciences ; Multivariate Analysis ; Peripheral Nervous System Diseases - chemically induced ; Peripheral Nervous System Diseases - diagnosis ; Pharmacology. Drug treatments ; Risk Factors ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. 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A validated neuropathy-screening tool was integrated into routine ART visits at an HIV clinic in Mombasa, Kenya. Diagnosis of PN required at least one symptom and either abnormal vibratory sensation or deep tendon reflex bilaterally. Among 102 consecutively screened patients, 63% were women, 62% were receiving ART for < or = 1 year, and 86% were receiving a stavudine (D4T)-based regimen. Thirty-seven (36%) had PN. Univariate analysis showed that current D4T use was protective against PN (P = 0.03) and older age was a marginal risk factor (P = 0.05). Multivariate analysis showed that older age was a risk factor for neuropathy (P = 0.04). Peripheral neuropathy was common, particularly among older HIV-infected adults in Kenya. The protective association with current D4T use likely represents survivor effect bias. Longitudinal studies using this screen will help further characterize PN in resource-limited settings.</description><subject>Anti-HIV Agents - adverse effects</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>HIV Infections - drug therapy</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infectious diseases</subject><subject>Kenya</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Multivariate Analysis</subject><subject>Peripheral Nervous System Diseases - chemically induced</subject><subject>Peripheral Nervous System Diseases - diagnosis</subject><subject>Pharmacology. Drug treatments</subject><subject>Risk Factors</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>0002-9637</issn><issn>1476-1645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkU1v1DAQhi0EokvhD3BAvnAjZWwnTnxBqio-KgpUsHC1Js6k6yqJIztdaY_8cxxaCpxsa97n8UgvY88FnJRSm9d4vYy7Ewn5DaYALc0DthFlrQuhy-oh2wCALIxW9RF7ktI1gGikEI_ZkYRGQL5v2M_zcR5opGnBxYeJh54j_4GD73Chjl9S9POOIg78M93EMOOyO_BvLhJNfrri2xAG7id-mensSPwrOfL7dXQ6LT7SEsPer_h2tcyHNfwpjC0mfMU_0nTAp-xRj0OiZ3fnMfv-7u327ENx8eX9-dnpReFKJZZCdVjWbdXWxnQVOlCkSmcqoL5vatW1iFJXpFzXtEqA0AC60qJD7VotTFOqY_bm1jvftCN1Lq-b97Jz9CPGgw3o7f-Tye_sVdhbaaSBSmaBvBW4GFKK1N-zAuxaiP1diF0LsWDsWkiGXvz76z3yp4EceHkXwORw6CNOzqe_OSVFrZRUvwAOVpin</recordid><startdate>20100901</startdate><enddate>20100901</enddate><creator>MEHTA, Sapna A</creator><creator>AHMED, Aabid</creator><creator>KARIUKI, Beatrice W</creator><creator>SAID, Swaleh</creator><creator>OMASETE, Fanuel</creator><creator>MENDILLO, Megan</creator><creator>LAVERTY, Maura</creator><creator>HOLZMAN, Robert</creator><creator>VALENTINE, Fred</creator><creator>SIVAPALASINGAM, Sumathi</creator><general>American Society of Tropical Medecine and Hygiene</general><general>The American Society of Tropical Medicine and Hygiene</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20100901</creationdate><title>Implementation of a Validated Peripheral Neuropathy Screening Tool in Patients Receiving Antiretroviral Therapy in Mombasa, Kenya</title><author>MEHTA, Sapna A ; AHMED, Aabid ; KARIUKI, Beatrice W ; SAID, Swaleh ; OMASETE, Fanuel ; MENDILLO, Megan ; LAVERTY, Maura ; HOLZMAN, Robert ; VALENTINE, Fred ; SIVAPALASINGAM, Sumathi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c431t-3da47b5b799d5ac03e34c950eff873dbaa265e3cd8b31016006561da6cb619843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Anti-HIV Agents - adverse effects</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiviral agents</topic><topic>Biological and medical sciences</topic><topic>CD4 Lymphocyte Count</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>HIV Infections - drug therapy</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infectious diseases</topic><topic>Kenya</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Multivariate Analysis</topic><topic>Peripheral Nervous System Diseases - chemically induced</topic><topic>Peripheral Nervous System Diseases - diagnosis</topic><topic>Pharmacology. Drug treatments</topic><topic>Risk Factors</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MEHTA, Sapna A</creatorcontrib><creatorcontrib>AHMED, Aabid</creatorcontrib><creatorcontrib>KARIUKI, Beatrice W</creatorcontrib><creatorcontrib>SAID, Swaleh</creatorcontrib><creatorcontrib>OMASETE, Fanuel</creatorcontrib><creatorcontrib>MENDILLO, Megan</creatorcontrib><creatorcontrib>LAVERTY, Maura</creatorcontrib><creatorcontrib>HOLZMAN, Robert</creatorcontrib><creatorcontrib>VALENTINE, Fred</creatorcontrib><creatorcontrib>SIVAPALASINGAM, Sumathi</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of tropical medicine and hygiene</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MEHTA, Sapna A</au><au>AHMED, Aabid</au><au>KARIUKI, Beatrice W</au><au>SAID, Swaleh</au><au>OMASETE, Fanuel</au><au>MENDILLO, Megan</au><au>LAVERTY, Maura</au><au>HOLZMAN, Robert</au><au>VALENTINE, Fred</au><au>SIVAPALASINGAM, Sumathi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implementation of a Validated Peripheral Neuropathy Screening Tool in Patients Receiving Antiretroviral Therapy in Mombasa, Kenya</atitle><jtitle>The American journal of tropical medicine and hygiene</jtitle><addtitle>Am J Trop Med Hyg</addtitle><date>2010-09-01</date><risdate>2010</risdate><volume>83</volume><issue>3</issue><spage>565</spage><epage>570</epage><pages>565-570</pages><issn>0002-9637</issn><eissn>1476-1645</eissn><coden>AJTHAB</coden><abstract>Limited objective data are available for the prevalence of peripheral neuropathy (PN) among antiretroviral (ART)-treated human immunodeficiency virus (HIV)-infected patients in resource-limited settings. A validated neuropathy-screening tool was integrated into routine ART visits at an HIV clinic in Mombasa, Kenya. Diagnosis of PN required at least one symptom and either abnormal vibratory sensation or deep tendon reflex bilaterally. Among 102 consecutively screened patients, 63% were women, 62% were receiving ART for < or = 1 year, and 86% were receiving a stavudine (D4T)-based regimen. Thirty-seven (36%) had PN. Univariate analysis showed that current D4T use was protective against PN (P = 0.03) and older age was a marginal risk factor (P = 0.05). Multivariate analysis showed that older age was a risk factor for neuropathy (P = 0.04). Peripheral neuropathy was common, particularly among older HIV-infected adults in Kenya. The protective association with current D4T use likely represents survivor effect bias. Longitudinal studies using this screen will help further characterize PN in resource-limited settings.</abstract><cop>Deerfield, IL</cop><pub>American Society of Tropical Medecine and Hygiene</pub><pmid>20810821</pmid><doi>10.4269/ajtmh.2010.09-0629</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The American journal of tropical medicine and hygiene, 2010-09, Vol.83 (3), p.565-570 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Anti-HIV Agents - adverse effects Anti-HIV Agents - therapeutic use Antibiotics. Antiinfectious agents. Antiparasitic agents Antiviral agents Biological and medical sciences CD4 Lymphocyte Count Cross-Sectional Studies Female HIV Infections - drug therapy Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infectious diseases Kenya Male Medical sciences Multivariate Analysis Peripheral Nervous System Diseases - chemically induced Peripheral Nervous System Diseases - diagnosis Pharmacology. Drug treatments Risk Factors Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Implementation of a Validated Peripheral Neuropathy Screening Tool in Patients Receiving Antiretroviral Therapy in Mombasa, Kenya |
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