The burden of HIV and tuberculosis on the resuscitation area of an urban district-level hospital in Cape Town
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
Introduction: Many patients present to emergency centres with HIV and tuberculosis related emergencies. Little is known about the influence of HIV and tuberculosis on the resuscitation areas of district-level hospitals. The primary objective was to determine the burden of non-trauma patients with HIV and/or tuberculosis presenting to the resuscitation area of Khayelitsha Hospital, Cape Town. Methods: A retrospective analysis was performed on a prospectively collected observational database. A randomly selected 12-week sample of data from the resuscitation area was used. Trauma and paediatric (<13 years) cases were excluded. Patient demographics, HIV and tuberculosis status, disease category, investigations and pro- cedures undertaken, disposition and
in-hospital mortality were assessed. HIV and tuberculosis status were
determined by laboratory confirmation or from clinical records. Descriptive statistics
are presented and com- parisons were done using the χ2-test or independent t-test.
Results: A total of 370 patients were included. HIV prevalence was 38.4% (n = 142;
unknown n = 78, 21.1%), tuberculosis prevalence 13.5% (n = 50; unknown n = 233, 63%), and
HIV/tuberculosis co-infection 10.8% (n =
40). HIV and tuberculosis were more likely in younger patients (both p < 0.01) and
more females were HIV- positive (p < 0.01). Patients with tuberculosis spend 93 min
longer in the resuscitation area than those without (p = 0.02). The acuity of
patients did not differ by HIV or tuberculosis status.
Infectious-related diseases and diseases of the digestive system occurred significantly
more in the HIV-positive group, and endocrine-related diseases and diseases of the
nervous system in HIV-negative patients.
HIV-positive patients received more abdominal ultrasound examinations (p < 0.01), blood
cultures (p < 0.01) and intravenous antibiotics (p < 0.01). In-hospital mortality was 17% and was
not influenced by HIV status (p =
0.36) or tuberculosis status (p = 0.29). tuberculosis on
the resuscitation area of a district level nor tuberculosis status were associated with
in-hospital mortality.
Description
CITATION: Swarts, L., Lahri, S. & Van Hoving, D. J. 2021. The burden of HIV and tuberculosis on the resuscitation area of an urban district-level hospital in Cape Town. African Journal of Emergency Medicine, 11(1):165-170, doi:10.1016/j.afjem.2020.09.016.
The original publication is available at https://www.sciencedirect.com/journal/african-journal-of-emergency-medicine
The original publication is available at https://www.sciencedirect.com/journal/african-journal-of-emergency-medicine
Keywords
HIV-positive persons -- Mortality -- Cape Town (South Africa), AIDS (Disease) -- Patients -- Mortality -- Cape Town (South Africa), Tuberculosis -- Patients -- Mortality -- Cape Town (South Africa)
Citation
Swarts, L., Lahri, S. & Van Hoving, D. J. 2021. The burden of HIV and tuberculosis on the resuscitation area of an urban district-level hospital in Cape Town. African Journal of Emergency Medicine, 11(1):165-170, doi:10.1016/j.afjem.2020.09.016