Prevalence and Risk Factors of Metabolic Syndrome among Individuals Living with HIV and Receiving Antiretroviral Treatment in Tanzania

Abstract

Aim: To estimate the prevalence and risk factors for metabolic syndrome (MetS) among HIV positive patients on antiretroviral therapy (ART) in Tanzania. Study Design: A cross sectional study was conducted among adults aged ≥18years living with HIV-infection and receiving ART. Place and Duration of Study: The study participants were recruited from 12 care and treatment clinics in Dar es Salaam (urban) and Mbeya (rural) regions between October 2011 and February 2012. Methodology: The prevalence of MetS was assessed using International Diabetes Federation’s criteria. Biochemical assays, anthropometric measurements, demographic characteristics and lifestyle behavioural data were collected. Results: Study response rate was 351/377(93.1%) and 177 (50.4%) recruited participants were from urban settings and 238 (67.8%) were females. The prevalence of MetS was 25.6% and was higher among participants from urban than those from rural areas (35.6% vs 15.5%, p<.001). The components of MetS including raised triglyceride (43.5% vs 21.3%, p<.001), low high density lipoprotein (85.9% vs 28.2%, p<.001) and raised blood fasting glucose (10.2% vs 5.2%, p=.04) were more common among participants from urban than those from rural settings. MetS Risk factors including; consumption of fruits/vegetables <5 days/week (77.0% vs 59.3%, p<.001), not participating on vigorous intensity activities (65.5% vs 29.4% p<.001) and consuming mixed cooking oil (animal/vegetable) (15.5% vs 8.5%, p=.03) were higher among participants from rural than those from urban areas. In rural, only consumption of vegetables/fruits <5 days/week (AOR=5.50, 95%CI 1.21-24.95, p=.005) predicted the prevalence of MetS. In urban; sex (female) (AOR=3.01, 95%C 1.31-6.85, p=.002), having primary/no formal education (AOR=0.32, 95%CI 0.12-0.89, p=.04) and ex- or current alcohol drinker (AOR=2.43, 95%CI 1.17-5.06, p=.02) were significant predictors of MetS. Conclusion: Prevalence, components and predictors of MetS prevailed more in urban than in rural settings. Interventions targeting prevention of MetS to reduce diabetes and cardiovascular diseases should consider settings diversification.