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HIV-associated morbidity, mortality and diagnostic testing opportunities among inpatients at a referral hospital in northern Tanzania.

Publication ,  Journal Article
Ole-Nguyaine, S; Crump, JA; Kibiki, GS; Kiang, K; Taylor, J; Schimana, W; Bartlett, JA; Shao, JF; Hamilton, JD; Thielman, NM
Published in: Ann Trop Med Parasitol
March 2004

Hospitalized patients with HIV infection are among the most likely to benefit from the expanding availability of anti-retroviral therapy in sub-Saharan Africa. Between 1990 and 2000, 3667 people known to be HIV-infected were admitted to Kilimanjaro Christian Medical Centre (KCMC) in Moshi, northen Tanzania. The level of inpatient mortality among these patients varied from 15%-21%, and the proportion of the HIV-infected patients admitted who were female increased significantly, from 45% at the start of the study period to 52% at the end (P <0.001). When the medical records for 1683 of the HIV-infected patients who had been admitted between 1996 and 2001 were reviewed, the most prevalent diagnoses on admission were found to be pulmonary tuberculosis (21%), malaria (14%) and gastro-enteritis/diarrhoea (12%) among the adults, and non-tubercular pulmonary infection (21%), pulmonary tuberculosis (19%) and gastro-enteritis/diarrhoea (12%) among the children. The crude odds ratios (OR) for inpatient death were greatest for adults presenting with meningitis [OR=3.7; 95% confidence interval (CI)=2.1-6.7], septicaemia (OR=2.9; CI=1.2-7.3) or renal disease (OR=2.6; CI=1.2-5.7), and mortality was higher for men than for women (OR=1.4; CI=1.1-1.8). A single-day, point-prevalence survey in September 2001, among the KCMC's inpatients, identified HIV infection in 21% of those surveyed, many (44%) of the patients found positive being previously unaware of their infection. HIV infection remains a major cause of hospitalization and mortality in Moshi. A policy of routine testing would increase the number of HIV infections detected, allowing improvements in case management and in the prevention of infection.

Duke Scholars

Published In

Ann Trop Med Parasitol

DOI

ISSN

0003-4983

Publication Date

March 2004

Volume

98

Issue

2

Start / End Page

171 / 179

Location

England

Related Subject Headings

  • Tropical Medicine
  • Tanzania
  • Sex Distribution
  • Prevalence
  • Morbidity
  • Middle Aged
  • Male
  • Malaria
  • Lung Diseases
  • Infant
 

Citation

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Ole-Nguyaine, S., Crump, J. A., Kibiki, G. S., Kiang, K., Taylor, J., Schimana, W., … Thielman, N. M. (2004). HIV-associated morbidity, mortality and diagnostic testing opportunities among inpatients at a referral hospital in northern Tanzania. Ann Trop Med Parasitol, 98(2), 171–179. https://doi.org/10.1179/000349804225003163
Ole-Nguyaine, S., J. A. Crump, G. S. Kibiki, K. Kiang, J. Taylor, W. Schimana, J. A. Bartlett, J. F. Shao, J. D. Hamilton, and N. M. Thielman. “HIV-associated morbidity, mortality and diagnostic testing opportunities among inpatients at a referral hospital in northern Tanzania.Ann Trop Med Parasitol 98, no. 2 (March 2004): 171–79. https://doi.org/10.1179/000349804225003163.
Ole-Nguyaine S, Crump JA, Kibiki GS, Kiang K, Taylor J, Schimana W, et al. HIV-associated morbidity, mortality and diagnostic testing opportunities among inpatients at a referral hospital in northern Tanzania. Ann Trop Med Parasitol. 2004 Mar;98(2):171–9.
Ole-Nguyaine, S., et al. “HIV-associated morbidity, mortality and diagnostic testing opportunities among inpatients at a referral hospital in northern Tanzania.Ann Trop Med Parasitol, vol. 98, no. 2, Mar. 2004, pp. 171–79. Pubmed, doi:10.1179/000349804225003163.
Ole-Nguyaine S, Crump JA, Kibiki GS, Kiang K, Taylor J, Schimana W, Bartlett JA, Shao JF, Hamilton JD, Thielman NM. HIV-associated morbidity, mortality and diagnostic testing opportunities among inpatients at a referral hospital in northern Tanzania. Ann Trop Med Parasitol. 2004 Mar;98(2):171–179.

Published In

Ann Trop Med Parasitol

DOI

ISSN

0003-4983

Publication Date

March 2004

Volume

98

Issue

2

Start / End Page

171 / 179

Location

England

Related Subject Headings

  • Tropical Medicine
  • Tanzania
  • Sex Distribution
  • Prevalence
  • Morbidity
  • Middle Aged
  • Male
  • Malaria
  • Lung Diseases
  • Infant