Sensory neuropathy and associated factors among patients living with human immuno-deficiency virus in Africa: a systematic review and meta-analysis.
Background: Despite high prevalence of sensory neuropathy among individuals living with HIV, there is no comprehensive information regarding variables that determine sensory neuropathy onset among the patients who attended health care facilities. In conditions where there is a high number of patients with sensory neuropathy, clinicians confront challenges in managing the problem, and increase the burden of health care expenditures. This study aimed to determine the prevalence of peripheral neuropathy and associated factors among people living with HIV in Africa.
Methods: To ensure the transparency, accuracy, and thoroughness of this systematic review and meta-analysis, we adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Systematic electronic searches were conducted across several databases, including African Journal Online, Google Scholar, PubMed, Scopus, and the Wiley Online Library. Articles found during the searching were imported into EndNote software version X7, where duplicates were removed. The extracted data were then imported to Microsoft Excel and analyzed using STATA version 11 for analysis. The Q statistic and I2 test were employed to evaluate heterogeneity between studies.
Results: The initial search identified 1,821 articles, which were organized using citation management software. The current meta-analysis found that 36.46% (95% CI: 26.48-46.44, I2 = 87.1%) patients living with HIV/AIDS experience peripheral sensory neuropathy. Factors associated with peripheral neuropathy included being older than 40 years (OR = 2.40; 95% CI: 01.24, 4.64), having viral load greater than 1,000 copies (OR = 2.46; 95% CI: 1.03, 5.88) and having a CD4 count below 200 cells (OR = 4.30; 95% CI: 1.24, 14.98).
Conclusions: This study found that peripheral sensory neuropathy is highly prevalent among HIV-infected individuals in Africa. Advanced age, elevated viral load, and low CD4 count were identified as independent predictors of HIV-related peripheral neuropathy. It is recommended that simple, established neurological screening methods be regularly used to identify early signs of HIV-SN or individuals at risk, across all patients.