Prevalence of Metabolic Syndrome among Inmates on Haart at Embu Prison Dispensary, Comprehensive Care Clinic

Abstract

Metabolic syndrome (MS) is a combination of interrelated risk factors of metabolic origin; the components include increased insulin resistance, obesity, dyslipidemia and hypertension. WHO defines HAART (highly active antiretroviral therapy) as a form of antiretroviral therapy for treatment of persons infected with HIV and whose use has decreased mortality and morbidity. Inclusion of protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NTRIs) have been linked to development of lipodystrophy and metabolic abnormalities. Despite the success of HAART, the prevalence of dyslipidemia, insulin resistance and fat redistribution have increased after its global scaling. Prevalence of MS among HIV –infected patients globally ranges from 17.0% to 45.4%, with most reports produced in developed nations. Disese of MS using the International Diabetes Federation is a rise in triglycerides greater than 1.7mMol/l, elevated fasting blood sugar greater than 5.6mMol/l and reduced HDL cholesterol less than 1.03mMol/l. There exists no data on prevalence of MS among the prison population in Kenya. This study sought to determine; i. The serum concentration of fasting blood sugar, TC, LDL-C, HDL-C and triglyceride of patients on HAART ii. The BMI and blood pressure among patients on HAART iii. Different types of regimens to metabolic syndrome iv. Prevalence of MS in prisoners on HAART

This was a hospital based cross-sectional study of patients on HAART for at least six months. Prevalence of metabolic syndrome was at 14.3%. Of the 217 samples, 64.5% (n=140) were male and 35.5% (n=77) were female. Prevalence of MS was higher in female at 54.8% than males 45.2%. Distribution of MS by among 20-29, 30 – 39, 40 – 49 age groups was 21.6%. Of the cases, ages 50 – 59 had the highest prevalence at 24.3% which suggests an increase in the prevalence of MS with age. There was no significant difference between the type of ART used and the prevalence of metabolic syndrome among patients on HAART. Prevalence of metabolic syndrome among inmates on HAART was estimated at 14.3%. There was no significant difference between ART used and presence of metabolic syndrome among patients on HAART. There was a weak positive correlation between presence of metabolic syndrome and ART used. Using ANOVA no significant difference was demonstrated between sex on the presence of metabolic syndrome in patients on HAART.