Physical function, grip strength and frailty in people living with HIV in sub-Saharan Africa: systematic review

Abstract

Objective

To present the current knowledge on physical function, grip strength and frailty in HIV-infected patients living in sub-Saharan Africa, where the phenomenon is largely underestimated.

Methods

A systematic search was conducted on Medline, Scopus and African Index Medicus. We reviewed articles on sub-Saharan African people living with HIV (PLHIV) >18 years old, published until November 2016.

Results

Of 537 articles, 13 were conducted in six African countries and included in this review. Five articles reported information on functional limitation and one on disability. Two of these 5 articles reported functional limitation (low gait speed) in PLHIV. Disability was observed in 27% and 3% of PLHIV living in rural and urban places, respectively. Two of three studies reporting grip strength reported lower grip strength (nearly 4 kg) in PLHIV in comparison to uninfected patients. One study reported that PLHIV were more likely to be frail than HIV-uninfected individuals (19.4% vs.13.3%) whereas another reported no statistical difference.

Conclusion

Decline in physical function, grip strength and frailty are now part of the burden of PLHIV living in SSA countries but current data are insufficient to characterize the real public health dimension of these impairments. Further studies are needed to depict this major public health challenge. As this is likely to contribute to a significant burden on the African healthcare systems and human resources in the near future, a holistic care approach should be developed to inform guidelines.