HIV-Neuropathy In Rwanda

Today's post from 7thspace.com (see link below) is another article concerning the prevalence of neuropathy in an African country, where older HIV medications are still being used. This time it's Rwanda and the article tends to lay blame on social and lifestyle factors when it's clear that if you are still distributing old-fashioned and cheap HIV drugs, then neuropathy cases will always rise. It's a question of political will on the part of governments and a social conscience on the part of the pharmaceutical companies, whose prices remain obscenely high for countries whose health budgets can't sustain using modern drugs. Patients living with resulting neuropathy become double victims in a commercial world.

Prevalence of peripheral neuropathy and its associated demographic and health status characteristics, among people on antiretroviral therapy in Rwanda 
Author: D K TumusiimeF VenterE MusengeA Stewart
Credits/Source: BMC Public Health 2014, 14:1306 Published on: 2014-12-19
 
The introduction of antiretroviral therapy (ART) has dramatically reduced the mortality rate of people living with HIV (PLHIV). However, complications of both HIV and ART, such as peripheral neuropathy currently affect PLHIV.

The purpose of this study was to establish the prevalence of peripheral neuropathy of the lower extremity and, its association with demographic and health status, characteristics among people on ART in Rwanda.

Methods: A cross sectional study was conducted among 507 women and men aged between 18 and 60 years, on ART, randomly selected from eight selected ART clinics in Rwanda. Brief Peripheral Neuropathy Screen was used to assess peripheral neuropathy.

Results: Peripheral neuropathy prevalence was 59% overall, mean age of the participants was 39.7 (+/-9.2) and a slightly older age was associated with peripheral neuropathy; 42(+/-9.2) vs 37 (+/-8.8) (p less than 0.001).

78% of participants living in urban settings compared to 40% in rural settings reported peripheral neuropathy, 69% of participants with higher levels of education (secondary level and above) reported lower extremity neuropathy.The three factors were significantly associated with peripheral neuropathy in multivariable model analysis: older age [aOR = 1.1, 95% CI (1.0, 1.2), p less than 0.001], primary education level (aOR = 0.6 95% Cl (0.3, 1.0), p = 0.04) and urban setting (aOR = 0.1, 95% CI (0.06, 0.3), p less than 0.001), after adjusting for other factors. None of the health status characteristics namely; the level of CD4 cell count, duration of HIV infection and duration on ART, was independently associated with peripheral neuropathy.

Conclusions: The prevalence of peripheral neuropathy among PLHIV on ART in Rwanda is high.

It is unclear why urban setting has an effect on PN levels in this cross sectional study, but does suggest that unidentified social and lifestyles factors may have a role in subjective symptoms and objective signs, of PN.

http://7thspace.com/headlines/501457/prevalence_of_peripheral_neuropathy_and_its_associated_demographic_and_
health_status_characteristics_among_people_on_antiretroviral_therapy_in_rwanda.
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