Prevalence, characteristics and correlates of a positive-dementia screen in patients on antiretroviral therapy in Bamenda, Cameroon: a cross-sectional study
1 Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Rm 222 FHS building, 63 Molyko, Buea, Cameroon
2 Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
3 Department of Community and Family Medicine, Duke University, Durham, NC, USA
4 Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, USA
5 Bamenda Regional Hospital and North West Regional coordination of the National AIDS Control Committee, Bamenda, Cameroon
6 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
7 Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon
8 Department of Neurology, Central Hospital Yaoundé/Faculty of Medicine and Biomedical Sciences, The University of Yaounde I, Yaounde, Cameroon
BMC Neurology 2013, 13:86 doi:10.1186/1471-2377-13-86Published: 15 July 2013
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.