The burden of HIV and tuberculosis on the resuscitation area of an urban district-level hospital in Cape Town

Swarts, Lynne; Lahri, Saʼad; Hoving, D.J. van

doi:10.1016/j.afjem.2020.09.016

Cited by 6 publications

(8 citation statements)

References 18 publications

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“…The prevalence of comorbidities in those with an initial negative SARS-CoV-2 test was rather high (HIV-positive 41.4%, hypertension 26.4%, previous or current tuberculosis 24.1%, diabetes mellitus 19.2%). The prevalence of HIV is similar to a previous study which described a prevalence of 38.4% in patients managed in the resuscitation area of Khayelitsha Hospital's emergency centre [30] . On the other hand, the prevalence of hypertension is less than previously recorded in the urban black population of Cape Town (26.4% versus 35.6%) [31] , whereas the diabetes prevalence is higher (19.2% versus 13.1%) [32] .…”

Section: Discussionsupporting

confidence: 89%

“…It is not surprising that 17% of the patients in our study had a new diagnosis of tuberculosis ( Table 3 ). This is somewhat higher than a recent study in Khayelitsha where 13.5% of patients managed in the resuscitation area had tuberculosis [30] .…”

Section: Discussioncontrasting

confidence: 59%

“…It is also higher than the mortality (5%) in patients with diabetic emergencies managed in Khayelitsha Hospital (personal communication: N Lotter), and the mortality rate in HIV-positive patients investigated for tuberculosis at Khayelitsha Hospital (7%) [37] . However, the mortality rate is similar than non-trauma adults (17%) from the same hospital [30] . Death was not associated with the primary diagnosis or HIV-positive status, but rather with older age and comorbidities including chronic renal insufficiency.…”

Section: Discussionmentioning

confidence: 69%

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Demographics and clinical characteristics of hospitalised patients under investigation for COVID-19 with an initial negative SARS-CoV-2 PCR test result

Hoving

Hattingh

Pillay

et al. 2021

African Journal of Emergency Medicine

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Background The COVID-19 pandemic is placing abnormally high and ongoing demands on healthcare systems. Little is known about the full effect of the COVID-19 pandemic on diseases other than COVID-19 in the South African setting. Objective To describe a cohort of hospitalised patients under investigation for SARS-CoV-2 that initially tested negative. Methods Consecutive patients hospitalised at Khayelitsha Hospital from April to June 2020, whose initial polymerase chain reaction test for SARS-CoV-2 was negative were included. Patient demographics, clinical characteristics, ICD-10 (International Statistical Classification of Diseases and Related Health Problems 10th Revision) diagnosis, referral to tertiary level facilities and ICU, and all-cause in-hospital mortality were collected. The 90-day re-test rate was determined and comparisons were made using the χ 2 -test and the independent samples median test. Results Overall, 261 patients were included: median age 39.8 years, 55.6% female ( n = 145). Frequent comorbidities included HIV (41.4%), hypertension (26.4%), and previous or current tuberculosis (24.1%). Nine (3.7%) patients were admitted to ICU and 38 (15.6%) patients died. Ninety-three patients (35.6%) were re-tested and 21 (22.6%) were positive for SARS-CoV-2. The top primary diagnoses related to respiratory diseases ( n = 82, 33.6%), and infectious and parasitic diseases ( n = 62, 25.4%). Thirty-five (14.3%) had a COVID-19 diagnostic code assigned (26 without microbiological confirmation) and 43 (16.5%) had tuberculosis. Older age ( p = 0.001), chronic renal impairment ( p = 0.03) and referral to higher level of care (all p < 0.001; ICU p = 0.03) were more frequent in those that died. Conclusion Patients with tuberculosis and other diseases are still presenting to emergency centres with symptoms that may be attributable to SARS-CoV-2 and requiring admission. Extreme vigilance will be necessary to diagnosis and treat tuberculosis and other diseases as we emerge from the COVID-19 pandemic.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 69%

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Demographics and clinical characteristics of hospitalised patients under investigation for COVID-19 with an initial negative SARS-CoV-2 PCR test result

Hoving

Hattingh

Pillay

et al. 2021

African Journal of Emergency Medicine

View full text Add to dashboard Cite

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“…The finding that laboratory testing was higher among PLWH is consistent with the literature and demonstrated across high and low-income settings as well as setting with a both high and low prevalence of HIV. [ 8 , 27 , 28 ]. A study from South Africa showed that HIV-positive were twice as like to receive abdominal ultrasounds and blood cultures [28] .…”

Section: Discussionmentioning

confidence: 99%

“…[ 8 , 27 , 28 ]. A study from South Africa showed that HIV-positive were twice as like to receive abdominal ultrasounds and blood cultures [28] . This could be explained by the varying and subtle presenting symptoms and signs in both early and advanced HIV infection.…”

Section: Discussionmentioning

confidence: 99%

Performance of the South African triage score among HIV positive individuals presenting to an emergency department

Maharaj

Jeena²,

Hahn³

et al. 2022

African Journal of Emergency Medicine

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The prevalence of Tuberculosis in HIV patients and their correlation with CD4+ count in a tertiary care hospital in Rishikesh, gateway to the Himalayas

Sahoo,

Kamboj,

Anand

et al. 2024

Indian Journal of Tuberculosis

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The burden of HIV and tuberculosis on the resuscitation area of an urban district-level hospital in Cape Town

Cited by 6 publications

References 18 publications

Demographics and clinical characteristics of hospitalised patients under investigation for COVID-19 with an initial negative SARS-CoV-2 PCR test result

Demographics and clinical characteristics of hospitalised patients under investigation for COVID-19 with an initial negative SARS-CoV-2 PCR test result

Performance of the South African triage score among HIV positive individuals presenting to an emergency department

The prevalence of Tuberculosis in HIV patients and their correlation with CD4+ count in a tertiary care hospital in Rishikesh, gateway to the Himalayas

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