Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence

Mouton, Johannes P.; Jobanputra, Nicole; Njuguna, Christine; Gunter, Hannah; Stewart, Alexander; Mehta, Ushma; Lahri, Saʼad; Court, Richard; Igumbor, Ehimario; Maartens, Gary; Cohen, Karen

doi:10.1016/j.afjem.2020.10.010

Cited by 4 publications

(14 citation statements)

References 22 publications

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“…The pooled prevalence of diabetes in medical settings was 11.9% (95% CI: 9.9–14.3; 15 studies; Table 2 ). 39 , 49 , 50 , 52 , 53 , 62 , 64 , 66 , 69 – 71 , 79 , 84 , 85 , 92 In emergency departments, we found an overlapping prevalence estimate of 9.3% (95% CI: 5.1–16.2; three studies). 58 , 75 , 80 A high degree of heterogeneity of estimates in both settings is noted (medical wards 95% PI: 5.4–24.3; I 2 : 97.6% and emergency departments I 2 : 98.5%; < 5 studies).…”

Section: Resultsmentioning

confidence: 75%

“…HIV prevalence was reported in 32 studies ( Table 2 ). The pooled prevalence of HIV in medical wards was 36.4% (95% CI: 31.3–41.8; 25 studies) 39 , 40 , 43 , 45 , 47 – 49 , 51 , 52 , 55 , 56 , 60 , 61 , 64 , 69 – 71 , 79 , 81 , 84 – 87 , 89 higher than the prevalence in emergency departments (21.9%; 95% CI: 14.5–31.7; seven studies). 37 , 44 , 65 , 72 , 80 , 82 , 96 HIV infection was reported using laboratory or point-of-care diagnostics in 18 studies, 37 , 40 , 43 – 45 , 47 – 51 , 56 , 65 , 68 , 72 , 82 , 84 , 89 , 96 and by medical records or clinical history in the remaining studies ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…We estimated the prevalence of hypertension from 16 studies. Pooled prevalence was 24.4% (95% CI: 16.7–34.2; 14 studies) 39 , 49 , 50 , 52 , 55 , 64 , 66 , 67 , 69 – 71 , 79 , 84 , 85 in medical wards, and 31.5% (95% CI: 26.4–37.1; two studies) 58 , 80 in emergency departments. A high degree of heterogeneity in prevalence estimates was observed in the medical setting (95% PI: 4.1–71.1; I 2 : 99.7%).…”

Section: Resultsmentioning

confidence: 99%

“…Heart failure presentations affected 8.2% (95% CI: 5.6–11.9; 13 studies) 39 , 47 – 49 , 53 , 55 , 59 , 69 , 73 , 81 , 84 – 86 of medical patients, and 4.0% (95% CI: 0.9–16.1; three studies) 75 , 83 , 98 of emergency department patients ( Fig. 3 ).…”

Section: Resultsmentioning

confidence: 99%

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Un miembro del personal de la Building Foundation for Development ayuda a preparar suministros para su entrega a instalaciones sanitarias y campos de desplazados en Al Jazirah (Sudán), que actualmente acoge a desplazados internos que huyen del conflicto en Jartum (Sudán).

Spencer,

Rylance,

Quint

et al. 2023

Bull World Health Org

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Objective To estimate the prevalence of individual chronic conditions and multimorbidity among adults admitted to hospital in countries in sub–Saharan Africa. Methods We systematically searched MEDLINE®, Embase®, Global Index Medicus, Global Health and SciELO for publications reporting on patient cohorts recruited between 1 January 2010 and 12 May 2023. We included articles reporting prevalence of pre-specified chronic diseases within unselected acute care services (emergency departments or medical inpatient settings). No language restrictions were applied. We generated prevalence estimates using random-effects meta-analysis alongside 95% confidence intervals, 95% prediction intervals and I 2 statistics for heterogeneity. To explore associations with age, sex, country-level income status, geographical region and risk of bias, we conducted pre-specified meta-regression, sub-group and sensitivity analyses. Findings Of 6976 identified studies, 61 met the inclusion criteria, comprising data from 20 countries and 376 676 people. None directly reported multimorbidity, but instead reported prevalence for individual conditions. Among medical admissions, the highest prevalence was human immunodeficiency virus infection (36.4%; 95% CI: 31.3–41.8); hypertension (24.4%; 95% CI: 16.7–34.2); diabetes (11.9%; 95% CI: 9.9–14.3); heart failure (8.2%; 95% CI: 5.6–11.9); chronic kidney disease (7.7%; 95% CI: 3.9–14.7); and stroke (6.8%; 95% CI: 4.7–9.6). Conclusion Among patients seeking hospital care in sub-Saharan Africa, multimorbidity remains poorly described despite high burdens of individual chronic diseases. Prospective public health studies of multimorbidity burden are needed to generate integrated and context-specific health system interventions that act to maximize patient survival and well-being.

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Section: Resultsmentioning

confidence: 75%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Un miembro del personal de la Building Foundation for Development ayuda a preparar suministros para su entrega a instalaciones sanitarias y campos de desplazados en Al Jazirah (Sudán), que actualmente acoge a desplazados internos que huyen del conflicto en Jartum (Sudán).

Spencer,

Rylance,

Quint

et al. 2023

Bull World Health Org

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“…Anemia was the most common ADR in TLE arm which could be attributed to bone marrow suppression due to Tenofovir. Another study conducted in South Africa, 2021, showed 8.4% (20 cases) ADRs were related to drugs used in management of HIV and 6 cases for drug induced renal impairment with TDF and/Rifamicin [36]. Recently a pro-drug formulation of Tenofovir: Tenofovir alafenamide (TAF), has been approved in several countries.…”

Section: Resultsmentioning

confidence: 99%

Nephrotoxıcıty in Patıents on Tenofovır vs Non-Tenofovır Contaınıng Art Regımen: An Observatıonal Study

Agrawal¹,

Shrivastava²,

Khare³

et al. 2022

Pharmacophore

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Treatment of Human Immunodeficiency Virus (HIV) infection has been revolutionized by the newer generation of Anti-Retroviral therapy (ART). The first-line ART comprises of NRTI (Tenofovir plus Lamivudine) and one NNRT, Efavirenz. The renal tubular dysfunction associated with Tenofovir is an adverse effect of concern. This study was undertaken to find the incidence of nephrotoxicity due to Tenofovir based regimen in comparison to non TLE regimen. A nonrandomised cross-sectional study with 50 patients between 18-60 years already on ART regimen were included in each arm-TLE and non TLE. Nephrotoxicity was diagnosed if there was: 1) increase serum creatinine 2) Decrease Serum Uric Acid 3) abnormal spot urine albumin creatinine ratio 4) decrease blood haemoglobin concentration. Statistical analysis was done using Fischer's exact test. TLE and ZLN were the two most frequently prescribed regimen. Four patients [8% (p value 0.059)] developed nephrotoxicity in the TLE regimen as compared to none from the non-TLE regimen. Longer exposure to TLE regimen was a predisposing factor for nephrotoxicity as 3 patients were on tenofovir for more than 4 years but independent of age, body weight, or CD4 count. Anaemia was observed in 48% of patients on TLE vs 18% in non TLE regimen. 26% of patients on Tenofovir based regimen had an abnormality in at least one of the four parameters. Using Tenofovir alafenamide or shifting to an alternate regimen when early signs of renal injury are visible will prevent nephrotoxicity.

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Multiple drugs

2021

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Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence

Cited by 4 publications

References 22 publications

Un miembro del personal de la Building Foundation for Development ayuda a preparar suministros para su entrega a instalaciones sanitarias y campos de desplazados en Al Jazirah (Sudán), que actualmente acoge a desplazados internos que huyen del conflicto en Jartum (Sudán).

Un miembro del personal de la Building Foundation for Development ayuda a preparar suministros para su entrega a instalaciones sanitarias y campos de desplazados en Al Jazirah (Sudán), que actualmente acoge a desplazados internos que huyen del conflicto en Jartum (Sudán).

Nephrotoxıcıty in Patıents on Tenofovır vs Non-Tenofovır Contaınıng Art Regımen: An Observatıonal Study

Multiple drugs

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