Prevalence and Associated Factors for Peripheral Neuropathy among Patients on Stavudine attending Meru District Hospital Comprehensive Care Centre—Kenya, 2010.

BACKGROUND: Peripheral neuropathy has been recognized as one of the undesired side effects of antiretroviral therapy particularly nucleoside transcriptase inhibitors (NRTI) .Stavudine a NRTI is used widely to manage HIV/AIDS in Kenya. Following a WHO recommendation that stavudine use be discontinued, health authorities sought information on the local magnitude of the problem to guide policy change. We determined the prevalence and associated factors for peripheral neuropathy among patients on stavudine attending Meru District Hospital Comprehensive Care Centre.

METHODS: We conducted a cross sectional study. HIV-infected patients who were ≥ 13years and older and had been on stavudine for six to thirty-six months were systematically enrolled. We excluded those with history of neurological complaints prior to commencing anti-retroviral therapy. We determined neuropathy status using a standard peripheral neuropathy screening tool. A semi-structured questionnaire was administered to elicit data on socio-demographic and potential risk factors. Record review was done to validate patients’ responses. We analyzed data using Epi-info.

RESULTS: In total, 275 HIV-infected patients were enrolled. Median age was 39 years (range 13-70 years); 162 (59%) were females. Prevalence of peripheral neuropathy was 23% (95% CI 18.1-28.3, n=63). Forty-two (67%) had grade I, 18 (29%) had grade II and 3 (4%) had grade III neuropathy. Patients on stavudine for ≥ 25 months (Odds Ratio [OR] = 2.37, 95% Confidence Interval [CI], 1.08-5.18) and those with CD4 counts less than 130 cells/mm3 were more likely to develop peripheral neuropathy (OR=2.43, 95% CI, 1.29-4.57)

CONCLUSION: The prevalence of peripheral neuropathy was high. The Ministry of Health should reconsider the use of stavudine. In the meantime, clinicians should monitor patients for peripheral neuropathy and non-neurotoxic regimes instituted in patients on stavudine for ≥2 years.

Key Words: HIV/AIDS, Peripheral Neuropathy, Prevalence,

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Author (s): 

Martin Thuranira , J. Omolo , S. Amwayi , A. Abade , J. Oundo, M. Kiptoo and Z. Ng’ang’a

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