The Development of a Tool to Identify Peripheral Neuropathy and HIV Associated Dementia
HIV infections in sub-Saharan Africa present a unique set of challenges. More than 22 million people in that part of the world have the virus that causes AIDS. While millions of them are taking life-saving antiretroviral drugs to control HIV, they also live where electricity is nonexistent, clinics are rare and trained doctors even rarer.
In some parts of rural Kenya, for instance, more than 15 percent of the population is infected, and many live in districts with fewer than one doctor for every 15,000 patients. Many people with HIV in western Kenya have never even seen a doctor, said UCSF neurologist Ana-Claire Meyer, MD, who spends the better part of her year there doing clinical research.
According to Meyer, the typical caregiver in the western Kenyan province of Nyanza, where her work is concentrated, is a nurse or clinical officer with lower-level training. While these caregivers provide life-saving first-line treatment for people with HIV, they may not have the expertise to recognize and deal with some of the complications that arise due to infections – particularly neurological problems.
One common complication in HIV is a set of conditions known as peripheral neuropathies, caused by nerve damage that can lead to mild pain and numbness in the hands and feet or a more severe and debilitating condition.
"A lot of these complications are under-diagnosed – if they are diagnosed at all," said Meyer.