title: Implementation of a validated peripheral neuropathy screening tool in patients receiving antiretroviral therapy in Mombasa, Kenya.
abstract: Limited objective data are available for the prevalence of peripheral neuropathy (PN) among antiretroviral (ART)-treated human immunodeficiency virus (HIV)-infected patients in resource-limited settings. A validated neuropathy-screening tool was integrated into routine ART visits at an HIV clinic in Mombasa, Kenya. Diagnosis of PN required at least one symptom and either abnormal vibratory sensation or deep tendon reflex bilaterally. Among 102 consecutively screened patients, 63% were women, 62% were receiving ART for < or = 1 year, and 86% were receiving a stavudine (D4T)-based regimen. Thirty-seven (36%) had PN. Univariate analysis showed that current D4T use was protective against PN (P = 0.03) and older age was a marginal risk factor (P = 0.05). Multivariate analysis showed that older age was a risk factor for neuropathy (P = 0.04). Peripheral neuropathy was common, particularly among older HIV-infected adults in Kenya. The protective association with current D4T use likely represents survivor effect bias. Longitudinal studies using this screen will help further characterize PN in resource-limited settings.
authors.affiliation: Division of Infectious Diseases, and Center for AIDS Research, Department of Medicine, New York University School of Medicine, New York, New York, USA. sapna.mehta@nyumc.org
authors.forename: Sapna A
authors.initials: SA
authors.lastname: Mehta
authors.forename: Aabid
authors.initials: A
authors.lastname: Ahmed
authors.forename: Beatrice W
authors.initials: BW
authors.lastname: Kariuki
authors.forename: Swaleh
authors.initials: S
authors.lastname: Said
authors.forename: Fanuel
authors.initials: F
authors.lastname: Omasete
authors.forename: Megan
authors.initials: M
authors.lastname: Mendillo
authors.forename: Maura
authors.initials: M
authors.lastname: Laverty
authors.forename: Robert
authors.initials: R
authors.lastname: Holzman
authors.forename: Fred
authors.initials: F
authors.lastname: Valentine
authors.forename: Sumathi
authors.initials: S
authors.lastname: Sivapalasingam
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007630:Kenya; D008297:Male; D015999:Multivariate Analysis; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000175:diagnosis*; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents
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