title: Anorectal pathology amongst HIV infected patients attending the Douala General Hospital: a cross-sectional study.
abstract: While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients' files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2-5) years and median CD4 cell count was 411 (interquartile range: 234-601) cells/mm3. Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7-27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 < 350 cells/ml (OR: 2.1, 95% CI: 1.1-4.2), not on highly active antiretroviral therapy (OR: 2.2, 95% CI: 1.1-4.6), inpatient (OR: 2.3, 95% CI: 1.2-4.3), ano-rectal intercourse (OR: 5.0, 95% CI: 1.7-15.1), and more than one sexual partner (OR: 2.4, 95% CI: 1.3-4.2). Ano-rectal pathology is common amongst HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.
authors.affiliation: 1 Internal Medicine Unit, Douala General Hospital, Cameroon.|2 Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon.
authors.forename: Henry Namme
authors.initials: HN
authors.lastname: Luma
authors.affiliation: 1 Internal Medicine Unit, Douala General Hospital, Cameroon.|3 Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon.
authors.forename: Servais Albert Fiacre Bagnaka
authors.initials: SA
authors.lastname: Eloumou
authors.affiliation: 4 Faculty of Health Sciences, University of Buea, Cameroon.
authors.forename: Ellis Atemlefeh
authors.initials: EA
authors.lastname: Fualefeh-Morfaw
authors.affiliation: 1 Internal Medicine Unit, Douala General Hospital, Cameroon.
authors.forename: Agnes
authors.initials: A
authors.lastname: Malongue
authors.affiliation: 1 Internal Medicine Unit, Douala General Hospital, Cameroon.
authors.forename: Elvis
authors.initials: E
authors.lastname: Temfack
authors.affiliation: 1 Internal Medicine Unit, Douala General Hospital, Cameroon.
authors.forename: Fernando Kemta
authors.initials: FK
authors.lastname: Lekpa
authors.affiliation: 5 London School of Hygiene and Tropical Medicine, University of London, UK.
authors.forename: Olivier
authors.initials: O
authors.lastname: Donfack-Sontsa
authors.affiliation: 4 Faculty of Health Sciences, University of Buea, Cameroon.
authors.forename: Lucy
authors.initials: L
authors.lastname: Ndip
authors.affiliation: 6 Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, USA.
authors.forename: Ivo Che
authors.initials: IC
authors.lastname: Ditah
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D006769:Hospitals, General; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012002:Rectal Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D012747:Sexual Partners
keywords: Anorectal pathology; CD4 cell counts; HIV; anorectal intercourse; highly active antiretroviral therapy