HIV/AIDS related mortality among adult medical patients in a tertiary health institution in South–South, Nigeria

An, Gary; Bassey, IE; Udonwa, Ndifreke E; Okokon, IB; Philip-Ephraim, E. E.

doi:10.1016/s1995-7645(10)60054-5

Cited by 8 publications

(9 citation statements)

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“…All included studies were aimed at assessing either cause of death or the most frequent diagnoses among PLHIV during the antiretroviral therapy era. In all included studies the commonest cause of hospitalization was tuberculosis [18–24,26,27,29] except in 1 [28] and the most common cause of death was tuberculosis in all the included studies [18–24,26–29] except in 2 [29,30] . We summarized the characteristics of all included studies in Table 1, and from this list, we extracted data related to the causes of hospitalization and death in the modern ART era in Sub-Saharan Africa.…”

Section: Resultsmentioning

confidence: 99%

“…All 12 studies included were published between 2008 and 2018 in English and they were conducted in Sub-Saharan Africa. Of these, 3 [18][19][20] were conducted in Nigeria, 2 [21,22] were conducted in Uganda, 3 were conducted in South Africa, [23][24][25] 1 in Gabon, [26] 1 in Ethiopia, [27] 1 in Ghana, [28] and 1 in Burkina Faso. [29] The total sample size of 12 studies was 14,619 participants, predominantly women.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Cause of hospitalization and death in the antiretroviral era in Sub-Saharan Africa published 2008–2018

2021

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Background: Worldwide despite the availability of antiretroviral therapy, human immunodeficiency virus/acquired immunodeficiency syndrome still causes morbidity and mortality among patients. In Sub-Saharan Africa, human immunodeficiency virus/ acquired immunodeficiency syndrome remains a major public health concern. The aim of this study was to identify the causes of morbidity and mortality in the modern antiretroviral therapy era in Sub-Saharan Africa.Methods: We conducted a systematic review according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. We searched relevant studies from 3 databases which are Google Scholar, PubMed, and CINAHL. Two review authors independently screened titles, abstracts, and full-text articles in duplicate, extracted data, and assessed bias. Discrepancies were resolved by discussion or arbitration of a third review author. R software version 3.6.2 was used to analyze the data. Maximum values were used in order to show which disease was mostly spread out by looking at the highest prevalence reported. This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO).Results: A total of 409 articles were obtained from the database search, finally 12 articles met the inclusion criteria and were eligible for data extraction. Among them, 3 were conducted in Nigeria, 2 were conducted in Uganda, 3 were conducted in South Africa, 1 in Gabon, 1 in Ethiopia, 1 in Ghana, and 1 in Burkina Faso. In most of the included studies, tuberculosis was the leading cause of hospitalization which accounted for between 18% and 40.7% and it was also the leading cause of death and accounted for between 16% and 44.3%, except in 1 which reported anemia as the leading cause of hospitalization and in 2 which reported wasting syndrome and meningitis respectively as the leading causes of death. Opportunistic malignancies accounted between for 1.8% to 5% of hospitalization and 1.2% to 9.8% of deaths.Conclusions: Tuberculosis is the commonest cause of hospitalization and death in Sub-Saharan Africa, but it is always followed by other infectious disease and other non-AIDS related causes.Abbreviations: ART = antiretroviral therapy, CD4 = cluster of differentiation 4, HIV/AIDS = human immunodeficiency virus/ acquired immunodeficiency syndrome, Q2 = median, PICO = population, intervention, comparator and outcome, PLHIV = patients living with HIV, PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses, UKZN = University of KwaZulu-Natal.

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Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Cause of hospitalization and death in the antiretroviral era in Sub-Saharan Africa published 2008–2018

2021

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“…The probability of dying or abandoning treatment among patients with respiratory disease was five times higher for patients with concomitant HIV infection than for patients without HIV infection. Several studies from Nigeria have described the critical role of HIV infection as a cause of morbidity and mortality in hospitalised patients [ 24 , 25 ]. Studies have also revealed that HIV/AIDS patients in Nigeria tend to present late with advanced illnesses [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

The Pattern of Respiratory Disease Morbidity and Mortality in a Tertiary Hospital in Southern-Eastern Nigeria

et al. 2013

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Background. Respiratory complaints are commonly encountered in medicine and respiratory diseases place a high burden on healthcare infrastructure. Healthcare planning should be based on adequate information: this study will help us to analyze the pattern of respiratory disease admissions in the medical wards in a developing country. Methods. The medical records of patients admitted into the medical wards over a 5-year period were retrieved and reviewed. Information obtained included demography, diagnosis, comorbid conditions, and risk factors for respiratory disease. Results. Three thousand four hundred and ninety patients were admitted into the medical wards with 325 (9.3%) of them diagnosed with a respiratory condition. There were 121 females and 204 males. The average age of the patients was 40.7 ± 14.7 years. Only 7% of the patients smoked cigarette. The commonest respiratory conditions were tuberculosis (66.8%) and pneumonia (24.9%). The commonest comorbidity was HIV infection (39.7%). Tuberculosis/HIV coinfection rate was 50.7%. HIV infection was the single most important predictor of an adverse outcome (OR 5.1, 95% CI 2.05–12.7, P < 0.001). Conclusion. Infective conditions make up a large percentage of respiratory diseases in low income countries with HIV infection constituting a significant risk factor for a poor disease outcome.

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“…Similarly, in Uganda, a study reported 18% of admissions and 24% of death due to tuberculosis. 16 Other studies conducted in Nigeria 17 , in Gabon 18 and in South Africa 41 had similar ndings. This may be as a result of lack of or poor TB preventative strategies, inadequate HIV counselling and testing services, also delays in referral and ART initiation are all potential reasons for late consultation and increase of TB.…”

Section: Discussionmentioning

confidence: 57%

Morbidity and mortality in the modern antiretroviral treatment era in a tertiary teaching hospital in Durban, South Africa.

Riziki¹

2022

Preprint

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Background Worldwide despite the availability of antiretroviral therapy, Human Immunodeficiency Virus / Acquired immunodeficiency syndrome still causes morbidity and mortality among patients. This study aimed at identifying the determinants of morbidity and mortality in the era of modern antiretroviral treatment (ART). Methods A retrospective study was conducted; data were obtained from medical records of all HIV infected patients admitted to King Edward medical wards from January to December 2018. This included demographic profile, clinical attributes and laboratory records. Data were analysed using R software where descriptive and inferential statistics were presented. The inferential statistics were five numbers summaries, box plot, Chi square, all fisher exact test and t test or rank some test. Results A total of 577 (50.6%) females and 564 (49.4%) males aged 12 years old and older infected by HIV were included in the study. The mean age of all the patients was 39.6 ± 12.2, 506 (44.3%) patients had CD4 less than 200 cells /mm3 and 273 (23.9%) had VL ˃ 1000 copies/ml. Association between CD4 cell count and Viral load (p˂ 0.05) was found. Male gender [OR 1.39(1.07–1.8) p = 0.015], Age [OR1.02 (1.01–1.03) p˂ 0.001], CD4 < 200 cells/mm3 [OR 2.14(1.37–3.45) p = 0.001], VL ˃ 1000 copies/ml [OR 1.93(1.08–3.63) p = 0.032] were associated with mortality in our cohort. Tuberculosis was the most common diagnosis on admission and the leading cause of death. Conclusion These findings illustrate that advanced HIV disease remains significant among inpatients despite the roll-out of ART. There is a need for raising the awareness of early appropriate treatment.

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HIV/AIDS related mortality among adult medical patients in a tertiary health institution in South–South, Nigeria

Cited by 8 publications

References 9 publications

Cause of hospitalization and death in the antiretroviral era in Sub-Saharan Africa published 2008–2018

Cause of hospitalization and death in the antiretroviral era in Sub-Saharan Africa published 2008–2018

The Pattern of Respiratory Disease Morbidity and Mortality in a Tertiary Hospital in Southern-Eastern Nigeria

Morbidity and mortality in the modern antiretroviral treatment era in a tertiary teaching hospital in Durban, South Africa.

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