Browsing by Author "Biraguma, Juvenal"

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    Health policy brief: Towards prevention of risk factors for non-communicable diseases among people living with HIV infection in Rwanda
    (University of the Western Cape, 2017) Biraguma, Juvenal; Frantz, Jose
    People living with the HIV infection (PLWHI) can now live longer due to the availability and effective use of combination antiretroviral therapy (cART). Eastern and Southern Africa remains the region affected by HIV. Rwanda is one the Eastern Africa that has achieved high rates of antiretroviral therapy (ART) coverage, accounting 164,262 (78%) of all PLWHI in 2016. However, both HIV infection and continued use of life-long cART medications have been associated with a constellation of non-communicable diseases (NCDs). Additionally, HIVinfected (HIV+) persons are at increased risk of NCDs, especially cardiometabolic diseases (CMD), compared to HIV-uninfected (HIV-) counterparts. People living with HIV infection are at an increased risk for NCDs due to their HIV status and their resultant reduced immunity, the use of some cART, and contextual and sociodemographic factors. Fortunately, lifestyle factors including regular physical activity participation, diet modification, and smoking cessation could play a major role in preventing CMD, and in improving life expectancy for HIV+ individuals. However, these interventions are not always integrated in routine African clinical settings, particularly in Rwanda. Currently, health-related benefits of people living with HIV infection on established ART, has shifted from survival to a health-related quality of life outcome (HRQOL).
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    Health-related quality of life and associated factors in adults living with HIV in Rwanda
    (Taylor & Francis, 2018) Biraguma, Juvenal; Mutimura, Eugene; Frantz, Jose M.
    In Rwanda, as in other sub-Saharan African (SSA) countries, life expectancy of people living with HIV (PLWH) has increased dramatically as a result of combined antiretroviral therapy (cART). People living with HIV can now live longer but with increasing rates of non-communicable diseases (NCDs). Thus, prevention of NCD comorbidities in PWLHI is crucial to maintain and gain health-related benefits and to maximise the health-related quality of life (HRQOL) in the long-term management of PLWH. This study determines the association between physical and mental health-related dimensions of quality of life (QOL) with behavioural and biological risk factors, after controlling socio-demographic and HIV-related factors in adults living with HIV in Rwanda. A cross-sectional study using the WHO STEPwise approach and Kinyarwanda version of the MOS-HIV Health Survey, risk factors for NCDs and HRQOL were analysed for 794 PLWH, both HIV+ on ART and ART-naïve. Multiple regression analysis was used to examine the relationship between CMD risk factors and physical health and mental health summary scores. A total of 794 participants were interviewed. The mean age of the sample was 37.9 (±10.8) years and the majority of the participants were women (n = 513; 64.6%). About 16.2% reported daily smoking, 31.4% reported harmful alcohol use and 95% reported insufficient consumption of vegetables and fruits while 26.1% reported being physically inactive. 18.4% were overweight 43.4% had abdominal obesity, i.e. waist-hip-ratio (WHR) ≥0.95 in males and 0.85 in females. High blood pressure (HBP), i.e. systolic blood pressure (SBP) of ≥140 mmHg, or diastolic blood pressure (DBP) ≥90 mmHg was 24.4%. The results reveal that mean physical health summary and mental health summary score values were 63.96 ± 11.68 and 53.43 ± 10.89, respectively. While participants indicated that tobacco users and those who had abdominal obesity reported poor mental HRQOL, physical inactivity and hypertension have a negative impact on physical HRQOL. In addition, certain sociodemographic and HIV-related variables – specifically being unmarried, lack of HIV disclosure and low CD4 count (less 350 cell counts /mm3) – were associated with significantly lower mental and physical dimensions of quality of life. The results of this study reveal that behavioural and biological risk factors for NCDs were significantly associated with a lower HRQOL. These research findings also suggest that the assessment of the association between behavioural and biological risk factors for NCDs and a HRQOL provides opportunities for targeted counselling and secondary prevention efforts, so that health care providers can implement strategies that have a significant impact on the HRQOL.
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    Knowledge about modifiable risk factors for non-communicable diseases adults living with HIV in Rwanda
    (African health science, 2019) Biraguma, Juvenal
    Non-communicable diseases (NCD) are of international public health concern. Of more concern are people living with HIV (PLHIV), who have the increased risk of developing NCDs, such as hypertension, stroke and diabetes. Research has revealed that there is a relationship between knowledge of NCD risk factors and risk perceptions in the general population.
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    Knowledge about modifiable risk factors for non-communicable diseases adults living with HIV in Rwanda
    (African journals online (AJOL), 2019) Biraguma, Juvenal
    Non-communicable diseases (NCD) are of international public health concern. Of more concern are people living with HIV (PLHIV), who have the increased risk of developing NCDs, such as hypertension, stroke and diabetes.
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    Peripheral neuropathy and quality of life of adults living with HIV/AIDS in the Rulindo district of Rwanda
    (Taylor & Francis, 2012) Biraguma, Juvenal; Rhoda, Anthea
    Although the life expectancy of people living with HIV/AIDS (PLWH) has increased in the past years, they could experience secondary illness such as peripheral neuropathy (PN). Therefore, they need to adapt to chronic disablement which could affect their quality of life (QoL). The research that informed this article aimed at determining the prevalence of PN among adults living with HIV/AIDS and attending the outpatients’ clinic at Rutongo Hospital in the Rulindo district of Rwanda. Another aim was to determine these patients’ QoL. A cross-sectional descriptive quantitative research design was used. A time-constrained method was used to sample 185 adults living with HIV/AIDS and attending the outpatients’ clinic at Rutongo Hospital. The subjective PN screen and the World Health Organization Quality of Life Scale Brief Version were used to collect the data. Data were analysed using the Statistical Package for the Social Sciences. Student’s t-test and one-way analysis of variance were performed to determine if significant differences existed between QoL scores in participants with and without PN symptoms. The results indicated that 40.5% of respondents experienced PN. QoL in participants with PN showed significantly lower scores in the physical (p ¼ 0.013) and psychological (p ¼ 0.020) domains when compared with those who did not have PN. These results indicate a high prevalence of neuropathy among PLWH attending the outpatients’ clinic at Rutongo Hospital. In addition, patients with neuropathy had lower QoL scores in the physical and psychological domains than those without neuropathy symptoms. The management of PLWH should therefore include interventions to optimise QoL as well as screening for neuropathy symptoms so that sufferers can liaise with their medical providers to find medical and supportive therapies that could assist them.