Prevalence of HIV-Related Neuropathies, Disability Patterns, and Quality of Life Outcomes among Persons on Haart in Selected Public Health Facilities in Busia County, Kenya

Abstract

Prevalence of peripheral neuropathies and disability among seroreactive persons is increasing globally with deteriorating quality of life (QOL).The objective was to determine the prevalence of HIV-related neuropathies, patterns of disabilities and the QOL outcomes of this population that were attending Comprehensive Care Clinics (CCCs) in Busia County, Kenya. A descriptive cross-sectional research design was used. A time-constrained method was used to sample 289 adults living with HIV/AIDS and attending care in CCCs in Busia County, Kenya. The screening tools used to collect data were CHANT, EQ 5D and the Washingtong group long Questionarre. Data was analyzed using the Statistical Package for Social Sciences (SPSS) and used to calculate the descriptive and inferential statistics. The results indicated a prevalence of 61.19% (male), 70.27% (female) and 68.1% as the overall of peripheral neuropathy (PN) in the respondents. Female were 76.8% (n=222) as compared to male 23.2% (n=67). Correlation analysis indicated that there was strong positive (r=0.621, p-value=.000) relationship between foot vibration and illness. Regression analysis revealed that there was statistically significant influence of peripheral neuropathy domain on demographic characteristics on person on HAART as they accounted for 98.5 % of the variation in (R2=.985). Mobility had the highest prevalence rate of 51.90% (n=150). Regression analysis indicated that there was statistically significant relationship between demographic characteristics and disability core-activity domain at 95.8 % variation in (R2=.958). The QoL in the physical, psychological, social relationship and environmental domains was affected.In conclusion, peripheral neuropathy (PN) is prevalent amongst persons on HAART and is predominantly characterized by pain, numbness, absent or diminished ankle tendon reflexes and loss of vibration sense of the big toe. While diagnosis of PN remains generally clinical, other illnesses that complicate distal neuropathies should be excluded. Peripheral neuropathy is prevalent and is influenced by socio-demographic characteristics of persons on HAART-PN. However, early diagnosis and treatment / exercise guided by physiotherapists have a higher likelihood of success in forestalling severe symptoms, impaired function, disability, and poor quality of life. This call for interventions to screen for neuropathy symptoms, to minimize disabling outcomes and that way optimize the Quality of Life. Theimplication is to screen persons living with HIV on HAART for PN to establish their medical, physiotherapy and rehabilitation needs, ensuring early interventions to prevent progression of impairment, onset of disability and deterioration in quality of life. Therefore, adaptation of PN screening tools and physiotherapeutic interventions should be considered.