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Irene Tamí-Maury, Yaya Ibrahim Coulibaly, Souare Salimata Cissoko, Sounkalo Dao, Sibylle Kristensen. First report of HIV-related oral manifestations in Mali. The Pan African Medical Journal. 2012;11:18 Key words: Oral manifestations, HIV, CD4 count, prevalence, ART Permanent link: http://www.panafrican-med-journal.com/content/article/11/18/full Received: 06/10/2011 - Accepted: 17/01/2012 - Published: 31/01/2012 © Irene Tamí-Maury et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
First report of HIV-related oral manifestations in Mali
Irene Tamí-Maury1,&, Yaya Ibrahim Coulibaly2, Souare Salimata Cissoko3, Sounkalo Dao4, Sibylle Kristensen5
1University of Alabama at Birmingham, Department of Epidemiology, Birmingham, United States (Currently at The University of Texas MD Anderson Cancer Center, Houston, United States), 2Faculté de Médecine, de Pharmacie et d’Odonto-Stomatologie, Bamako, Mali, 3Pharmacie/Centre Hospitalier Universitaire Gabriel Touré, Bamako, Mali, 4Maladies Infectieuses et Tropicales/Centre Hospitalier Universitaire Point G, Bamako, Mali, 5One Heart World-Wide, San Francisco, United States
&Corresponding author
Irene Tamí-Maury, University of Alabama at Birmingham, Department of Epidemiology, Birmingham, United States
In 2004, the sudden availability of free antiretroviral therapy (ART in Mali, within the context of an already overburdened health care system created gaps in individual patient quality of care. The objective of this study was to determine the prevalence of HIV-related oral manifestations (OM) during the first month of ART therapy in a Malian health facility.
Medical records of adult patients who initiated ART regimens at the Gabriel Touré Hospital, Mali (2001 to 2008) were randomly identified. Multiple logistic regression models were used to evaluate the relationship between the presence of OM during the first month of ART and selected variables, including CD4 counts and WHO clinical staging at ART initiation.
Out of 205 patients on ART (mean age 39 ± 10 years), 71.0% were females and 36.1% had no formal education. 40.6% were in WHO clinical stage III. OM prevalence during the first month of HIV care was 31.4%, being oral candidiasis the commonest lesion. 73.2% and 82.5% of the patients with OM had CD4 count < 200 cells/mm3 and were classified as WHO clinical stage III or IV. WHO clinical stage III and VI patients had 5.4-fold increased odds of having any OM (both p< 0.01) when controlling for age, ethnicity, gender, marital status, and CD4 counts.
OM detected in people with low CD4 count and WHO clinical stage III and IV at ART initiation suggested that they were very immune-compromised when initiating HIV care. Early identification of OM could improve the quality of care and guarantee the benefits of ART.
