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Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected adults and adolescents in northern Tanzania.

Publication ,  Journal Article
Crump, JA; Ramadhani, HO; Morrissey, AB; Saganda, W; Mwako, MS; Yang, L-Y; Chow, S-C; Morpeth, SC; Reyburn, H; Njau, BN; Shaw, AV; Shao, JF ...
Published in: Clin Infect Dis
February 1, 2011

BACKGROUND: few studies describe patterns of human immunodeficiency virus (HIV) co-infections in African hospitals in the antiretroviral therapy (ART) era. METHODS: we enrolled consecutive admitted patients aged ≥ 13 years with oral temperature of ≥ 38.0°C during 1 year in Moshi, Tanzania. A standardized clinical history and physical examination was done and hospital outcome recorded. HIV antibody testing, aerobic and mycobacterial blood cultures, and malaria film were performed. HIV-infected patients also received serum cryptococcal antigen testing and CD4(+) T lymphocyte count (CD4 cell count). RESULTS: of 403 patients enrolled, the median age was 38 years (range, 14-96 years), 217 (53.8%) were female, and 157 (39.0%) were HIV-infected. Of HIV-infected patients, the median CD4 cell count was 98 cells/μL (range, 1-1,105 cells/ μL), 20 (12.7%) were receiving ART, and 29 (18.5%) were receiving trimethoprim-sulfamethoxazole prophylaxis. There were 112 (27.7%) patients who had evidence of invasive disease, including 26 (23.2%) with Salmonella serotype Typhi infection, 24 (21.4%) with Streptococcus pneumoniae infection, 17 (15.2%) with Cryptococcus neoformans infection, 12 (10.7%) with Mycobacterium tuberculosis complex infection, 8 (7.1%) with Plasmodium falciparum infection, and 7 (6.3%) with Escherichia coli infection. HIV infection was associated with M. tuberculosis and C. neoformans bloodstream infection but not with E. coli, S. pneumoniae, or P. falciparum infection. HIV infection appeared to be protective against Salmonella. Typhi bloodstream infection (odds ratio, .12; P = .001). CONCLUSIONS: while Salmonella Typhi and S. pneumoniae were the most common causes of invasive infection overall, M. tuberculosis and C. neoformans were the leading causes of bloodstream infection among HIV-infected inpatients in Tanzania in the ART era. We demonstrate a protective effect of HIV against Salmonella. Typhi bloodstream infection in this setting. HIV co-infections continue to account for a large proportion of febrile admissions in Tanzania.

Duke Scholars

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

February 1, 2011

Volume

52

Issue

3

Start / End Page

341 / 348

Location

United States

Related Subject Headings

  • Young Adult
  • Tanzania
  • Sepsis
  • Prevalence
  • Mycoses
  • Middle Aged
  • Microbiology
  • Male
  • Humans
  • Hospitalization
 

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Crump, J. A., Ramadhani, H. O., Morrissey, A. B., Saganda, W., Mwako, M. S., Yang, L.-Y., … Maro, V. P. (2011). Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected adults and adolescents in northern Tanzania. Clin Infect Dis, 52(3), 341–348. https://doi.org/10.1093/cid/ciq103
Crump, John A., Habib O. Ramadhani, Anne B. Morrissey, Wilbrod Saganda, Mtumwa S. Mwako, Lan-Yan Yang, Shein-Chung Chow, et al. “Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected adults and adolescents in northern Tanzania.Clin Infect Dis 52, no. 3 (February 1, 2011): 341–48. https://doi.org/10.1093/cid/ciq103.
Crump JA, Ramadhani HO, Morrissey AB, Saganda W, Mwako MS, Yang L-Y, et al. Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected adults and adolescents in northern Tanzania. Clin Infect Dis. 2011 Feb 1;52(3):341–8.
Crump, John A., et al. “Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected adults and adolescents in northern Tanzania.Clin Infect Dis, vol. 52, no. 3, Feb. 2011, pp. 341–48. Pubmed, doi:10.1093/cid/ciq103.
Crump JA, Ramadhani HO, Morrissey AB, Saganda W, Mwako MS, Yang L-Y, Chow S-C, Morpeth SC, Reyburn H, Njau BN, Shaw AV, Diefenthal HC, Shao JF, Bartlett JA, Maro VP. Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected adults and adolescents in northern Tanzania. Clin Infect Dis. 2011 Feb 1;52(3):341–348.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

February 1, 2011

Volume

52

Issue

3

Start / End Page

341 / 348

Location

United States

Related Subject Headings

  • Young Adult
  • Tanzania
  • Sepsis
  • Prevalence
  • Mycoses
  • Middle Aged
  • Microbiology
  • Male
  • Humans
  • Hospitalization