The prevalence and in-hospital mortality of patients with HIV and tuberculosis admitted to resuscitation area of an urban district-level hospital in Cape Town
Date
2020-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY : 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 prevalence and in-hospital mortality of 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 was used. Trauma and paediatric (< 13 years) cases were excluded. Patient demographics, HIV and tuberculosis status, disease presentation, investigations and procedures 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 comparisons for categorical data were done using the χ2-test.
Results: A total of 370 patients were included. HIV prevalence was 38.4% (n=142; unknown status n=78, 21.1%) and tuberculosis prevalence 13.5% (n=50; unknown status n=233, 63%). The HIV/tuberculosis coinfection rate was 10.8%. Age (mean 42.5 years) and gender distribution (male 40.3%) were similar amongst HIV and tuberculosis groups. Intentional overdose presentations were more frequent in the HIV positive group (14.8% vs 8.7%, p<0.01). HIV-negative patients were less likely to receive an abdominal ultrasound examination (p<0.01) to aid in excluding extra-pulmonary tuberculosis and received less intravenous antibiotics (p<0.01). In-hospital mortality was 17% and was not influenced by HIV status (p=0.27) or tuberculosis status (p=0.27).
Conclusion: This study highlights the influence of both HIV and tuberculosis on the resuscitation area of a district level hospital. Neither HIV nor tuberculosis status were associated with in-hospital
mortality. The high prevalence of intentional overdose may reflect underlying social concerns that need to be addressed.
AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.
Description
Thesis (MFamMed)--Stellenbosch University, 2020.
Keywords
HIV-positive persons -- Mortality -- Khayelitsha (Cape Town, South Africa), Tuberculosis -- Patients -- Mortality -- Khayelitsha (Cape Town, South Africa), Trauma centers -- Khayelitsha (Cape Town, South Africa), Resuscitation, UCTD