<p><strong>Background.</strong> In order to gauge the impact of the HIV epidemic on psychotic disorders, the magnitude and causal direction of the association between HIV infection and psychosis need to be examined closely.</p><p><strong>Objective.</strong> To determine the HIV seropositivity rate among adult patients presenting with first-episode psychosis (FEP) to Town Hill Hospital in Pietermaritzburg, KwaZulu-Natal.</p><p><strong>Design.</strong> A cross-sectional, point-prevalence study was done over a 6-month period.</p><p><strong>Results.</strong> Of the 63 FEP patients in the study, 48 tested HIV- negative and 15 tested positive, giving a seroprevalence rate of 23.8%.</p><p><strong>Conclusion.</strong> The prevalence of HIV seropositivity is high among patients with FEP.</p>

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<div style="left: 81.7503px; top: 420.56px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.907951);" data-canvas-width="78.795"><strong>Background:</strong></div><div style="left: 160.545px; top: 420.56px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.932665);" data-canvas-width="311.7900000000001">Following allegations of human rights abuses at</div><div style="left: 81.7503px; top: 443.889px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.916508);" data-canvas-width="390.57000000000005">a psychiatric hospital in Pietermaritzburg, KwaZulu-Natal, that</div><div style="left: 81.7503px; top: 467.219px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.887322);" data-canvas-width="390.52500000000003">were reported in one of the local newspapers, the national</div><div style="left: 81.7503px; top: 490.548px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.90354);" data-canvas-width="390.51000000000005">and provincial Ministers of Health visited the hospital. Because</div><div style="left: 81.7503px; top: 513.878px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.90347);" data-canvas-width="390.59999999999997">of the seriousness of the allegations, the national Minister</div><div style="left: 81.7503px; top: 537.207px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.879068);" data-canvas-width="390.57">of Health established a Committee of Enquiry to investigate</div><div style="left: 81.7503px; top: 560.537px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.880785);" data-canvas-width="390.53999999999996">the allegations. The 7 committee members included experts</div><div style="left: 81.7503px; top: 583.866px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.872622);" data-canvas-width="390.6000000000001">in mental health care services, legal services, public service</div><div style="left: 81.7503px; top: 607.196px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.93681);" data-canvas-width="390.52500000000003">sector, a hospital board member, and a representative of the</div><div style="left: 81.7503px; top: 630.525px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.89069);" data-canvas-width="73.185">community.</div><div style="left: 81.7503px; top: 630.525px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.89069);" data-canvas-width="73.185"> </div><div style="left: 81.7503px; top: 668.038px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.914141);" data-canvas-width="65.94"><strong>Objectives:</strong></div><div style="left: 147.69px; top: 668.038px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.888951);" data-canvas-width="324.645">. The terms of reference of the Committee of Enquiry</div><div style="left: 81.7503px; top: 691.367px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.912476);" data-canvas-width="390.55499999999995">were to investigate allegations of human rights abuses of</div><div style="left: 81.7503px; top: 714.697px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.919925);" data-canvas-width="390.585">psychiatric patients at the hospital, and to report their findings</div><div style="left: 81.7503px; top: 738.026px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.906079);" data-canvas-width="277.215">to the Minister, in line with the media reports.</div><div style="left: 81.7503px; top: 738.026px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.906079);" data-canvas-width="277.215"> </div><div style="left: 81.7503px; top: 775.539px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.919581);" data-canvas-width="58.470000000000006"><strong>Methods.</strong></div><div style="left: 140.22px; top: 775.539px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.860663);" data-canvas-width="332.12999999999994">The public was invited through notices in the print</div><div style="left: 81.7503px; top: 798.869px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.912723);" data-canvas-width="390.5999999999999">and electronic media to make submissions relating to the</div><div style="left: 81.7503px; top: 822.198px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.887693);" data-canvas-width="390.57000000000005">allegations. Interviews and site inspections were conducted.</div><div style="left: 81.7503px; top: 845.528px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.913401);" data-canvas-width="390.5550000000001">Written submissions were received. Legislative and regulatory</div><div style="left: 81.7503px; top: 868.857px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.902183);" data-canvas-width="390.56999999999994">frameworks were studied. Reports of previous commissions as</div><div style="left: 81.7503px; top: 892.187px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.911323);" data-canvas-width="245.07">well as hospital records were analysed.</div><div style="left: 81.7503px; top: 929.699px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.885889);" data-canvas-width="55.56"><strong>Findings:</strong></div><div style="left: 137.31px; top: 929.699px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.864354);" data-canvas-width="334.995">The findings of the Committee confirmed all media</div><div style="left: 81.7503px; top: 953.029px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.925522);" data-canvas-width="390.55499999999995">allegations of human rights abuses as appearing in the terms</div><div style="left: 81.7503px; top: 976.358px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.903296);" data-canvas-width="390.54">of reference. In addition, the Committee identified the following</div><div style="left: 81.7503px; top: 999.688px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.857488);" data-canvas-width="117.09">systemic defects: (</div><div style="left: 198.855px; top: 999.688px; font-size: 15.45px; font-family: sans-serif;">i</div><div style="left: 202.365px; top: 999.688px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.90508);" data-canvas-width="269.92499999999995">) weak management over a long period</div><div style="left: 81.7503px; top: 1023.02px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.938404);" data-canvas-width="56.445">of time; (</div><div style="left: 153.555px; top: 1023.02px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(1.02233);" data-canvas-width="7.0200000000000005">ii</div><div style="left: 160.575px; top: 1023.02px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.952916);" data-canvas-width="203.12999999999997">) absence of a hospital board; (</div><div style="left: 348.33px; top: 1023.02px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(1.02233);" data-canvas-width="10.53">iii</div><div style="left: 358.86px; top: 1023.02px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.936267);" data-canvas-width="113.46000000000001">) inadequacies in</div><div style="left: 81.7503px; top: 1046.35px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.947004);" data-canvas-width="280.755">the physical layout and quality of facilities; (</div><div style="left: 362.49px; top: 1046.35px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.897309);" data-canvas-width="10.004999999999999">iv</div><div style="left: 372.495px; top: 1046.35px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.939087);" data-canvas-width="99.825">) abuse of staff</div><div style="left: 81.7503px; top: 1069.68px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.862468);" data-canvas-width="83.75999999999999">by patients; (</div><div style="left: 195.15px; top: 1069.68px; font-size: 15.45px; font-family: sans-serif;">v</div><div style="left: 201.645px; top: 1069.68px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.8569);" data-canvas-width="300.31499999999994">) staff reporting on duty under the influence of</div><div style="left: 81.7503px; top: 1093.01px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.894182);" data-canvas-width="59.93999999999999">alcohol; (</div><div style="left: 155.73px; top: 1093.01px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.897309);" data-canvas-width="10.004999999999999">vi</div><div style="left: 165.735px; top: 1093.01px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.848626);" data-canvas-width="181.61999999999998">) high rate of absenteeism; (</div><div style="left: 333.36px; top: 1093.01px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.944958);" data-canvas-width="17.025">viii</div><div style="left: 350.385px; top: 1093.01px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.861321);" data-canvas-width="121.91999999999999">) shortage of staff;</div><div style="left: 81.7503px; top: 1116.34px; font-size: 15.45px; font-family: sans-serif;">(</div><div style="left: 85.3503px; top: 1116.34px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.944958);" data-canvas-width="17.025">viii</div><div style="left: 102.375px; top: 1116.34px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.962439);" data-canvas-width="130.63500000000002">) lack of discipline; (</div><div style="left: 233.025px; top: 1116.34px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.910762);" data-canvas-width="10.155">ix</div><div style="left: 243.18px; top: 1116.34px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.938973);" data-canvas-width="229.12500000000003">) evidence of racism, nepotism and</div><div style="left: 81.7503px; top: 1139.66px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.885451);" data-canvas-width="104.98500000000001">favouritism; and (</div><div style="left: 176.175px; top: 1139.66px; font-size: 15.45px; font-family: sans-serif;">x</div><div style="left: 182.82px; top: 1139.66px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.886648);" data-canvas-width="278.91">) strained relations between the management</div><div style="left: 81.7503px; top: 1162.99px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.90469);" data-canvas-width="72.33000000000001">and unions.</div><div style="left: 81.7503px; top: 1162.99px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.90469);" data-canvas-width="72.33000000000001"> </div><div style="left: 193.455px; top: 1200.51px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.884255);" data-canvas-width="278.83500000000004"><strong>Recommendations</strong>: The Committee recommended that remedial</div><div style="left: 81.7503px; top: 1223.84px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.889275);" data-canvas-width="390.525">and preventive measures be undertaken as a matter of urgency</div><div style="left: 81.7503px; top: 1247.17px; font-size: 15.45px; font-family: sans-serif; transform: scaleX(0.894605);" data-canvas-width="390.53999999999996">to combat human rights abuses and address deficiencies in the system.</div>