Prevalence, characteristics and correlates of a positive-dementia screen in patients on antiretroviral therapy in Bamenda, Cameroon: a cross-sectional study

• Published in: BMC neurology Vol. 13; no. 1; p. 86
• Main Authors: Atashili, Julius, Gaynes, Bradley N, Pence, Brian W, Tayong, Gladys, Kats, Dmitry, O’donnell, Julie K, Ndumbe, Peter M, Njamnshi, Alfred K
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.07.2013; BioMed Central
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Age Factors; AIDS; AIDS Dementia Complex - diagnosis; AIDS Dementia Complex - drug therapy; AIDS Dementia Complex - epidemiology; Antiretroviral drugs; Antiretroviral Therapy, Highly Active - methods; Cameroon - epidemiology; Cross-Sectional Studies; Dementia; Diagnosis; Drug therapy; Epidemiology; Female; Health aspects; Highly active antiretroviral therapy; HIV; HIV (Viruses); HIV patients; HIV testing; Human immunodeficiency virus; Humans; Male; Mass Screening; Middle Aged; Multivariate Analysis; Neuropsychological Tests; Prevalence; Psychiatric Status Rating Scales; Psychological aspects; Risk factors; Statistics as Topic; Studies; Surveys; Young Adult; Cameroon
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/1471-2377-13-86

In this study we assess the prevalence, characteristics as well as socio-demographic and clinical correlates of a positive screen for HIV-associated dementia in a group of patients on antiretroviral therapy (ART) in Bamenda, Cameroon. In a cross-sectional study, a structured questionnaire was used to collect data on 400 patients attending the Bamenda Regional Hospital AIDS-treatment Centre. Patients were assessed for neurocognitive function using the International HIV Dementia Scale (IHDS) to assess finger-tapping (FT), alternating hand sequence (AHS) and a 4-word recall (4WR), each scored on a maximum of four. A total of 297 (74%) participants were females. The total IHDS score ranged from 6-12 with a mean of 9.02 and 85% of subjects screened positive for dementia (≤10 on IHDS). Participants performed worst in the AHS assessment with a mean of 2.25 (IQR: 2-3). In multivariable analyses, screening positive for dementia was significantly associated with having primary education or less (aOR: 8.33, 95%CI: 3.85, 16.67), and having HIV symptoms (aOR: 12.16, 95%CI: 3.08, 48.05). A very high proportion of patients on ART screened positive for dementia using the IHDS. This could potentially be an indication of a high prevalence of HIV-associated neurocognitive disorders in this population and or a poor performance of the IHDS in patients on ART. Future studies will need to assess the validity of the IHDS in this population of patients on ART and also evaluate long term outcomes in patients with positive dementia screens.