title: Frequency and distribution patterns of opportunistic infections associated with HIV/AIDS in Uganda.
abstract: BACKGROUND
  We conducted a study to assess the frequency and distribution patterns of selected opportunistic infections (OIs) and opportunistic cancers (OCs) in different geographical areas before and after HAART in Uganda.
  
  
  METHODS
  This was a cross-sectional serial review of observation data for adult HIV positive patients (≥15 years) enrolled with the AIDS support organization (TASO) in Uganda covering the period from January 2001 to December 2013. Both AIDS defining OIs/OCs and non-AIDS defining OIs were analyzed. The study period was structured into three time periods: "pre- HAART" (2001-2003), "early-HAART" (2004-2008) and "late-HAART" (2009-2013). Descriptive statistics were used to summarize the data by time period, age, gender and geographical location. Chi squared test used to test the significance of the differences in proportions.
  
  
  RESULTS
  A total of 108,619 HIV positive patients were included in the analysis. 64% (64,240) were female with median age of 33 years (IQR 27-40). The most frequent OIs before HAART were oral candida (34.6%) diarrhoeal infection (<1 month) (30.6%), geohelminths (26.5%), Mycobacterium tuberculosis (TB) (17.7%), malaria (15.1%) and bacterial pneumonia (11.2%). In early HAART (2004-2008), the most frequent OIs were geohelminths (32.4%), diarrhoeal infection (25.6%), TB (18.2%) and oral candida (18.1%). In late HAART (2009-2013), the most frequent OIs were geohelminths (23.5%) and diarrhoeal infection (14.3%). By gender, prevalence was consistently higher in women (p < 0.05) before and after HAART for geohelminths, candidiasis, diarrhoeal infection, bacterial pneumonia and genital ulcer disease but consistently higher in men for TB and Kaposi's sarcoma (p < 0.05). By age, prevalence was consistently higher in older age groups (>30 years) before and after HAART for oral candida and TB (p < 0.05) and higher in young age groups (<30 years) for malaria and genital ulcers (p < 0.05). By geographical location, prevalence was consistently higher in Eastern and Northern Uganda before and after HAART for diarrheal infection and geohelminths (p < 0.0001).
  
  
  CONCLUSIONS
  The frequency and pattern of OIs before and after HAART differs by gender, age and geographical location. Prevalence of geohelminths and diarrhea infection(<1 month) remains high especially in Northern and Eastern Uganda even after HAART and should therefore be given special attention in HIV/AIDS care programmes in these settings.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda. rubaihayoj@yahoo.co.uk.|Department of Public Health, School of Health Sciences, Mountains of the Moon University, P.O. Box 837, Fort Portal, Uganda. rubaihayoj@yahoo.co.uk.
authors.forename: John
authors.initials: J
authors.lastname: Rubaihayo
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Nazarius M
authors.initials: NM
authors.lastname: Tumwesigye
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Joseph
authors.initials: J
authors.lastname: Konde-Lule
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Henry
authors.initials: H
authors.lastname: Wamani
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Edith
authors.initials: E
authors.lastname: Nakku-Joloba
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Fredrick
authors.initials: F
authors.lastname: Makumbi
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002180:Candidiasis, Oral / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009369:Neoplasms / Q000453:epidemiology; D015995:Prevalence; D014376:Tuberculosis / Q000453:epidemiology; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
keywords: Antiretroviral therapy; HIV/AIDS; Opportunistic infections; Prevalence; TASO; Uganda