Prevalence of Micronutrient Deficiency among People Living with HIV in Selected Rural Districts of the Eastern Cape Province of South Africa.

Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) leads to immune suppression, and micronutrients play vital roles in human immune responses. Hence, this study aimed to evaluate the effects of viral load suppression in adult HIV-infected patients receiving antiretroviral therapy (ART) on micronutrient deficiency and its prevalence in selected rural districts in the Eastern Cape Province of South Africa. This cross-sectional study was conducted from February 2019 to February 2021 among 50 consenting HIV-infected patients attending community health centers within the three selected districts. The data were analysed with ArcGIS v.10.8 to create geospatial maps; the Global Positioning System (GPS) for analysis and presentation; and SPSS version 25 for inferential statistics involving the t-test and Fisher's exact test, with the level of significance set at p < 0.05. Of the 50 participants, a significant difference of p = 0.003 was observed in mean age among viral load-suppressed (42.9 ± 8.89 years) and unsuppressed (32 ± 6.3 years). In addition, significant differences in the mean viral load and CD4 counts (p < 0.05) were seen. Only iron micronutrient showed a statistically significant difference (p < 0.001) between the viral load-suppressed group (mean 14.8, SD 6.1) and the unsuppressed group (mean 8.1, SD 1.6). Of the 38 individuals from the OR Tambo district, overall micronutrient deficiency was 60.5% (13 (34.2%) deficient for zinc, 9 (23.7%) deficient for iron, 5 (13.2%) for folate, and 1 (2.63%) for vitamin D). In all three study districts, deficiencies in zinc, iron, and folate micronutrients exceeded 25%, particularly in those with an unsuppressed viral load. To address these micronutrient deficiencies, people living with HIV (PLHIV) require robust nutritional supplementation programs.

Prevalence of HIV and Selected Disease Burden in Outpatients of Primary Health Care (PHC) Facilities in Rural Districts of the Eastern Cape Province, South Africa.

Assessing underlying illnesses can inform health stakeholders about chronic conditions for targeted enhanced prevention and treatment strategies. Since the Eastern Cape Province has a high disease burden, this study aimed to assess the prevalence of human immunodeficiency virus (HIV) infection and selected disease burden of outpatients from primary health care (PHC) facilities in the districts. From February 2019 to February 2021, a cross-sectional study was conducted. Research Electronic Data Capture (REDCap)-enabled tablets were used to collect data from consenting outpatients over the age of 18 years using an interviewer-administered WHO core and expanded stepwise questionnaire. The statistical analysis was mainly descriptive with the use of counts, frequencies, and summary measures. The study population was predominantly female (86.5%). Prevalent diseases included HIV, hepatitis B virus (HBV) infection, and cardiometabolic diseases. HIV prevalence was 52% and highest in the age group of 30-59 years. In people living with HIV, the nonsuppressed viral load (VL 1000 copies/mL) was highest in the age group of 40-49 years (34.6%). Prevalence of diabetes was highest at the Mhlontlo subdistrict (42.3%), while the King Sabata Dalindyebo (KSD) subdistrict had the highest prevalence of HBV infections (39.1%). Based on the findings, we advocate for intermittent assessments of disease burden in certain settings, such as rural areas, to improve PHC practice and outcomes, especially in the wake of the coronavirus disease (COVID-19) pandemic.

Characterizations of Bacterial Vaginosis among HIV-Positive and HIV-Negative Women in Rural Eastern Cape Province, South Africa.

Bacterial vaginosis (BV) is extremely common among the African population and is associated with the transmission and acquisition of human immunodeficiency virus (HIV) infection. The objective of this study was to determine the prevalence and characteristics of BV among HIV-infected and -uninfected women in rural Eastern Cape province of South Africa. A descriptive cross-sectional study was conducted between September 2017 and March 2018 on women aged 18 years and above (n = 100), attending Nelson Mandela Academic Hospital and Ngangelizwe Community Health Centre with signs and symptoms suggestive of vaginal infection. High vaginal swabs were collected, and BV was diagnosed using Nugent's score. The prevalence rate of BV was 70% irrespective of HIV status. Of the 61 HIV-infected patients, 49 (80.3%) and 12 (19.7%) were BV positive and BV negative, respectively; whilst of the 39 HIV-uninfected women, 21 (53.8%) and 18 (46.2%) were BV positive and BV negative, respectively (OR = 3.5; CI: 1.4-8.5; p=0.005). Women aged above 35 years were highly likely to develop BV (p=0.049). The presence of Mobiluncus species (>25 per high microscopic field) was significantly associated with BV among HIV-infected patients (p=0.030). A recent history of antibiotic use (≤3 months) was significantly associated with BV among HIV-negative patients (p=0.044). This study shows that BV is more prevalent among HIV-positive women than their HIV-negative counterparts, and its occurrence is higher among those aged above 35 years. The predominance of Mobiluncus species in the vagina microbiota of HIV-infected women might play a significant role in the development of BV. These findings suggest that the treatment of BV could restore normal flora and reduce susceptibility to and transmission of HIV.