title: Late-stage disease at presentation to an HIV clinic in eastern Tanzania: A retrospective cross-sectional study.
abstract: BACKGROUND
  Late presentation and delayed treatment initiation is associated with poor outcomes in patients with HIV. Little is known about the stage at which HIV patients present at HIV clinics in Tanzania.
  
  
  OBJECTIVE
  This study aimed at determining the proportion of HIV patients presenting with WHO clinical stages 3 and 4 disease, and the level of immunity at the time of enrollment at the care and treatment center.
  
  
  METHODS
  A retrospective cross-sectional study was conducted among 366 HIV-infected adults attending HIV clinic at Mwananyamala Hospital in Dar es Salaam, Tanzania. Data were obtained from the care and treatment clinic database.
  
  
  RESULTS
  Late stage disease at the time of presentation was found in 276 (75.4%) of the patients; out of whom 153 (41.8%) presented with CD4 count <200 cells/ul and 229 (62.6%) presented with WHO clinical stage 3 or 4 at the time of clinic enrollment. Strategies to improve early diagnosis and treatment initiation should be improved.
authors.affiliation: Buguruni Health Centre, Ilala Municipal, Dar es Salaam, Tanzania.
authors.forename: H
authors.initials: H
authors.lastname: Mhozya
authors.affiliation: School of Nursing and Public health, College of Health Sciences, University of Dodoma, Dodoma, Tanzania.
authors.forename: D
authors.initials: D
authors.lastname: Bintabara
authors.affiliation: School of Nursing and Public health, College of Health Sciences, University of Dodoma, Dodoma, Tanzania.
authors.forename: S
authors.initials: S
authors.lastname: Kibusi
authors.affiliation: School of Medicine, College of Health Sciences, University of Dodoma, Dodoma, Tanzania; Peace Corps/SEED Global Health Service Partnership, Massachusetts General Hospital Center for Global Health, Boston, Massachusetts, USA.
authors.forename: E
authors.initials: E
authors.lastname: Neilson
authors.affiliation: School of Medicine, College of Health Sciences, University of Dodoma, Dodoma, Tanzania.
authors.forename: B C
authors.initials: BC
authors.lastname: Mpondo
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013636:Tanzania / Q000453:epidemiology; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents