Prevalence of Opportunistic Infections in HIV-infected adult patients at Kenyatta National Hospital, Kenya

Francis M Malwal, Gichuru Muriuki, Shital S Maru, Evans M Mwangangi


Background: Opportunistic Infections (OIs) constitute the first manifestation of HIV infection, indicating significant immunodeficiency. OIs remain a leading cause of morbidity and mortality in HIV-infected persons. Since most of OIs are readily treatable and preventable, every effort should be made to facilitated their management. However, there is a need to establish local prevalence of OIs and evaluate their management. This would guide in prioritizing resource and support development of suitable management strategies.

Objective: The main objective of this study was to establish the prevalence of HIV-related OIs in adult patients.

Methodology: A hospital-based cross-sectional study conducted between July and August 2011 at Kenyatta National Hospital –Comprehensive Care Center (KNH-CCC). Adult patients who were HIV positive and attending outpatient clinic at KNH-CCC were included. Information was collected on patients’ demographics, clinical characteristics and presence of new or active OIs. Data was analyzed using Statistical Package for social Sciences (SPSS) version 11.5.

Results: The prevalence of opportunistic infections was 14.1 % (95% CI: 10.7-18.5).  Overall, the most commonly reported bacterial infection was pneumonia (6.4%) whereas pulmonary tuberculosis was reported in 3.6% of patients. Significant association was found between a patients’ current OI status and WHO stage when HIV was diagnosed (AOR= 3.79 [95% CI = 1.43 – 10.03], P=0.007) and duration since HIV diagnosis (AOR 3.89 [95% CI= 1.58-9.59], P=0.003.  90% of patients were prescribed Co-trimoxazole as chemoprophylaxis agent.

Conclusion: There was a high prevalence of OIs among the HIV/AIDS patients at KNH-CCC. Bacterial Pneumonia and pulmonary tuberculosis were the most commonly observed OIs.

Keyword: Prevalence, Opportunistic-Infections, HIV, Patients.


Chu KM, Mahlangeni G, Swannet S, Ford NP, Boulle A, Cutsem G (2010). AIDS-associated Kaposi's sarcoma is linked to advanced disease and high mortality in a primary care HIV programme in South Africa. J. Int. AIDS Soc. 13:23.

Croda J, Croda MG, Neves A, De Sousa dos Santos S (2006). Benefit of antiretroviral therapy on survival of human immunodeficiency virus-infected patients admitted to an intensive care unit. HIV Med. 7:193-6.

Detels R, Tarwater P, Phair JP, Margolick J, Riddler SA, Muñoz A, Multicenter AIDS Cohort Study (2001). Effectiveness of potent antiretroviral therapies on the incidence of opportunistic infections before and after AIDS diagnosis. AIDS, 15:347-355.

Gebo KA, Fleishman JA, Reilly ED, Moore RD; HIV Research Network (2005). High rates of primary Mycobacterium avium complex and Pneumocystis jiroveci prophylaxis in the United States. Med Care. 43 (Suppl: 9):23-30.

Greenberg SD, Frager D, Suster B, Walker S, Stavropoulos C, Rothpearl A (1994). Active pulmonary tuberculosis in patients with AIDS: spectrum of radiographic findings (including a normal appearance). Radiology. , 193:115-9.

Jones JL, Hanson DL, Dworkin MS, Alderton DL, Fleming PL, Kaplan JE, Ward J (1999). Surveillance for AIDS-Defining Opportunistic Illnesses, 1992-1997. MMWR. 48: (No.SS-2).

Kaplan JE, Hanson D, Dworkin MS, Frederick T, Bertolli J, Lindegren ML, Holmberg S, Jones JL (2000). Epidemiology of human immunodeficiency virus-associated opportunistic infections in the United States in the era of highly active antiretroviral therapy. Clin. Infect. Dis. 30: S5-14.

Kulkarni SV, Kairon R, Sane SS, Padmawar PS, Kale VA, Thakar MR, Mehendale SM, Risbud AR (2009). Opportunistic infection in HIV/AIDS patients presenting with diarrhea by the level of immunosuppression. Indian J. Med. Res. 130:63-66.

Mbatia SF (2011, Feb 16). Comparative cross sectional study of the georaphical differences in the prevalence of HIV related opportunistic infections in Muranga and Taita Taveta. Retrieved Feb 16, 2011, from .

Mocroft A, Ledergerber B, Katlama C, Kirk O, Reiss P, d'Arminio Monforte A, Knysz B, Dietrich M, Phillips AN, Lundgren JD; EuroSIDA study group (2003). Decline in the AIDS and death rates in the EuroSIDA study: an observational study. Lancet. 362;22-29.

Mutua SA. (2008). Prevalence and management of opportunistic infections in HIV-infected children. Nairobi: UON, Lib.

Nissapatorn V, Lee C, Fatt QK, Abdullah KA (2003). AIDS related opportunistic infections in Hospital Kula Lumpur. Jpn. J. Infect. Dis. 56:187-192.

Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holmberg SD (1998). Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection, HIV outpatient investigators. New Eng. J. Med. 338:853-60.

Perbost I, Malafronte B, Pradier C, Santo LD, Dunais B, Counillon E, Vinti H, Enel P, Fuzibet JG, Cassuto JP, Dellamonica P (2005). In the era of highly active antiretroviral therapy, why are HIV-infected patients still admitted to hospital for an inaugural opportunistic infection? HIV Med. 7:193-6.

Walensky RP, Paltiel AD, Losina E, Mercincavage LM, Schackman BR, Sax PE, Weinstein MC, Freedberg KA (2006). The survival benifits of AIDS treatment in the United States. J. Infect, Dis. 194:11-9.

WHO. (2011). Retrieved Sep 5, 2011

Wood R, Middelkoop K, Myer L, Grant AD, Whitelaw A, Lawn SD, Kaplan G, Huebner R, McIntyre J, Bekker LG (2007). Undiagnosed tuberculosis in a community with high HIV prevalence: implications for tuberculosis control. Am. J. Respir, Crit. Care Med. 175 :87-93.

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