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Meta-Analysis
. 2019 Jun 17;19(1):534.
doi: 10.1186/s12879-019-4156-3.

Late presentation of HIV positive adults and its predictors to HIV/AIDS care in Ethiopia: a systematic review and meta-analysis

Getaneh Mulualem Belay  1 , Aklilu Endalamaw  2 , Amare Demsie Ayele  2
Affiliations
Meta-Analysis

Late presentation of HIV positive adults and its predictors to HIV/AIDS care in Ethiopia: a systematic review and meta-analysis

Getaneh Mulualem Belay et al. BMC Infect Dis. .

Abstract

Introduction: Late presentation to HIV/AIDS care which is attended by problems like, poor treatment outcomes, early development of opportunistic infections, increased healthcare costs, and mortality is a major problem in Ethiopia. Although evidences are available on the prevalence and associated factors of late presentation to HIV/AIDS care, discrepancies among findings are appreciated. Thus, the country has faced difficulties of having a single estimated data.

Objective: This study aimed to estimate the pooled prevalence of late presentation of HIV positive adults to HIV/AIDS care and its predictors in Ethiopia.

Method: We searched all available articles through Google Scholar, PubMed, Web of Sciences, and EMBASE databases. Additionally, we accessed articles from the Ethiopian institutional online research repositories and reference lists of included studies. We included cohort, case- control, and cross-sectional studies in our review. Besides, we utilized the weighted inverse variance random-effects model. The total percentage of variation among studies due to heterogeneity was determined by I2 statistic. Searching was limited to studies conducted in Ethiopia and published in the English language. Publication bias was checked by Egger's regression test.

Results: A total of 8 studies with 7, 568 participants were included. The pooled prevalence of late presentation to HIV/AIDS care was 52.89% (95%CI: 35.37, 70.40). The odds of late presentation to HIV/AIDS care of frequent alcohol users [3.67(95% CI = 1.52-5.83)], high fear of stigma [3.90 (95% CI = 1.51-6.28)], chronic illness [3.34(95% CI = 1.52-5.16)], and the presence of symptoms at the time of HIV diagnosis [3.06 (95% CL = 1.18-4.94)] were higher compared to participants who did not experience the preceding.

Conclusion: The prevalence of late presentation of HIV positive adults to HIV/AIDS care was high in Ethiopia. Frequent alcohol use, high fear of stigma, chronic illness, and the presence of symptoms at the time of HIV diagnosis were associated with high odds of late presentation to HIV/AIDS care.

Trial registration: Registered in PROSPERO databases with the registration number of CRD42018081840 .

Keywords: Ethiopia; HIV/AIDS care; Late presentation; Meta-analysis.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
A PRISMA flow diagram of articles screening and process of selection
Fig. 2
Fig. 2
Forest plot of the prevalence of late presentation for HIV/AIDS care with 95% Cl. The midpoint and length of each segment indicated the prevalence and 95% confidence interval. The diamond shape revealed the pooled prevalence
Fig. 3
Fig. 3
Forest plot of AOR of predictors of late presentation for HIV/AIDS care. The midpoint and the length of each segment indicated AOR and 95% CI respectively. The diamond shape showed the pooled AOR
See this image and copyright information in PMC

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