Causes of Death in Hospitalized HIV Patients in the Early Anti-Retroviral Therapy Era
Identifieur interne : 000385 ( Main/Exploration ); précédent : 000384; suivant : 000386Causes of Death in Hospitalized HIV Patients in the Early Anti-Retroviral Therapy Era
Auteurs : M. Lartey [Ghana] ; A. Asante-Quashie [Ghana] ; A. Essel ; E. Kenu [Ghana] ; V. Ganu [Ghana] ; A. Neequaye [Ghana]Source :
- Ghana Medical Journal [ 0016-9560 ] ; 2015.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Cause de décès, Femelle, Ghana (épidémiologie), Hospitalisation (), Humains, Infections à VIH (mortalité), Infections à VIH (traitement médicamenteux), Jeune adulte, Mortalité hospitalière, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Thérapie antirétrovirale hautement active (mortalité), Tuberculose pulmonaire (mortalité), Études rétrospectives.
- MESH :
- mortalité : Infections à VIH, Thérapie antirétrovirale hautement active, Tuberculose pulmonaire.
- traitement médicamenteux : Infections à VIH.
- épidémiologie : Ghana.
- Adolescent, Adulte, Adulte d'âge moyen, Cause de décès, Femelle, Hospitalisation, Humains, Jeune adulte, Mortalité hospitalière, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Études rétrospectives.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Antiretroviral Therapy, Highly Active (mortality), Cause of Death, Female, Ghana (epidemiology), HIV Infections (drug therapy), HIV Infections (mortality), Hospital Mortality, Hospitalization (statistics & numerical data), Humans, Male, Middle Aged, Retrospective Studies, Tuberculosis, Pulmonary (mortality), Young Adult.
- MESH :
- geographic , epidemiology : Ghana.
- drug therapy : HIV Infections.
- mortality : Antiretroviral Therapy, Highly Active, HIV Infections, Tuberculosis, Pulmonary.
- statistics & numerical data : Hospitalization.
- Adolescent, Adult, Aged, Aged, 80 and over, Cause of Death, Female, Hospital Mortality, Humans, Male, Middle Aged, Retrospective Studies, Young Adult.
Abstract
To establish the cause(s) of death among persons with HIV and AIDS admitted to the Fevers Unit of the Korle-Bu Teaching Hospital (KBTH) in 2007 and to determine whether they were AIDS-related in the era of availability of HAART
Retrospective chart review of all deaths that occurred in the year 2007 among inpatients with HIV infection. Cause of Death (COD) was established with post mortem diagnosis, where not available ICD-10 was reviewed independently by two physicians experienced in HIV medicine and a consensus reached as to the most likely COD.
In the year under review, 215 (97%) of the 221 adult deaths studied were caused by AIDS and HIV-associated illnesses. Of these, 123 (55.7%) were due to an AIDS-defining illness as described in CDC Category 3 or WHO stage 4. Infections accounted for most of the deaths 158 (71.5%), many of them opportunistic 82 (51.8%). Tuberculosis was the commonest COD. Clinical diagnosis of TB was accurate in 54% of deaths, but was not validated by autopsy in 36% of deaths. There were few deaths (14.5%) in patients on HAART.
In a developing country like Ghana where HAART was still not fully accessible, AIDS-related events remained the major causes of death in persons living with HIV. Total scale-up of the ART programme with continuous availability of antiretrovirals is therefore imperative to reduce deaths from AIDS and HIV associated illnesses. There is need for interventions for early diagnosis as well as reduction in late presentation and also better diagnostic tools for tuberculosis.
Url:
PubMed: 26339078
PubMed Central: 4549815
Affiliations:
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Asante-Quashie</name><affiliation wicri:level="3"><nlm:aff id="A2">International Organization for Migration, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>International Organization for Migration, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Essel, A" sort="Essel, A" uniqKey="Essel A" first="A" last="Essel">A. Essel</name><affiliation><nlm:aff id="A3">Department of Community Health, University of Ghana Medical School, Korle Bu</nlm:aff><wicri:noCountry code="subfield">Korle Bu</wicri:noCountry></affiliation></author><author><name sortKey="Kenu, E" sort="Kenu, E" uniqKey="Kenu E" first="E" last="Kenu">E. 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Ganu</name><affiliation wicri:level="3"><nlm:aff id="A4">Department of Medicine, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine, Korle-Bu Teaching Hospital, Korle-Bu, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Neequaye, A" sort="Neequaye, A" uniqKey="Neequaye A" first="A" last="Neequaye">A. Neequaye</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Medicine, University of Ghana Medical School, College of Health Sciences, Korle Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine, University of Ghana Medical School, College of Health Sciences, Korle Bu, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="A4">Department of Medicine, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Medicine, Korle-Bu Teaching Hospital, Korle-Bu, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author></analytic><series><title level="j">Ghana Medical Journal</title><idno type="ISSN">0016-9560</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Antiretroviral Therapy, Highly Active (mortality)</term><term>Cause of Death</term><term>Female</term><term>Ghana (epidemiology)</term><term>HIV Infections (drug therapy)</term><term>HIV Infections (mortality)</term><term>Hospital Mortality</term><term>Hospitalization (statistics & numerical data)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Tuberculosis, Pulmonary (mortality)</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Cause de décès</term><term>Femelle</term><term>Ghana (épidémiologie)</term><term>Hospitalisation ()</term><term>Humains</term><term>Infections à VIH (mortalité)</term><term>Infections à VIH (traitement médicamenteux)</term><term>Jeune adulte</term><term>Mortalité hospitalière</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Thérapie antirétrovirale hautement active (mortalité)</term><term>Tuberculose pulmonaire (mortalité)</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Antiretroviral Therapy, Highly Active</term><term>HIV Infections</term><term>Tuberculosis, Pulmonary</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infections à VIH</term><term>Thérapie antirétrovirale hautement active</term><term>Tuberculose pulmonaire</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Ghana</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cause of Death</term><term>Female</term><term>Hospital Mortality</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Cause de décès</term><term>Femelle</term><term>Hospitalisation</term><term>Humains</term><term>Jeune adulte</term><term>Mortalité hospitalière</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Objective</title><p>To establish the cause(s) of death among persons with HIV and AIDS admitted to the Fevers Unit of the Korle-Bu Teaching Hospital (KBTH) in 2007 and to determine whether they were AIDS-related in the era of availability of HAART</p></sec><sec sec-type="methods"><title>Method</title><p>Retrospective chart review of all deaths that occurred in the year 2007 among inpatients with HIV infection. Cause of Death (COD) was established with post mortem diagnosis, where not available ICD-10 was reviewed independently by two physicians experienced in HIV medicine and a consensus reached as to the most likely COD.</p></sec><sec sec-type="results"><title>Results</title><p>In the year under review, 215 (97%) of the 221 adult deaths studied were caused by AIDS and HIV-associated illnesses. Of these, 123 (55.7%) were due to an AIDS-defining illness as described in CDC Category 3 or WHO stage 4. Infections accounted for most of the deaths 158 (71.5%), many of them opportunistic 82 (51.8%). Tuberculosis was the commonest COD. Clinical diagnosis of TB was accurate in 54% of deaths, but was not validated by autopsy in 36% of deaths. There were few deaths (14.5%) in patients on HAART.</p></sec><sec sec-type="conclusions"><title>Conclusion</title><p>In a developing country like Ghana where HAART was still not fully accessible, AIDS-related events remained the major causes of death in persons living with HIV. Total scale-up of the ART programme with continuous availability of antiretrovirals is therefore imperative to reduce deaths from AIDS and HIV associated illnesses. There is need for interventions for early diagnosis as well as reduction in late presentation and also better diagnostic tools for tuberculosis.</p></sec></div></front></TEI><affiliations><list><country><li>Ghana</li></country><region><li>Région du Grand Accra</li></region><settlement><li>Accra</li></settlement></list><tree><noCountry><name sortKey="Essel, A" sort="Essel, A" uniqKey="Essel A" first="A" last="Essel">A. Essel</name></noCountry><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Lartey, M" sort="Lartey, M" uniqKey="Lartey M" first="M" last="Lartey">M. Lartey</name></region><name sortKey="Asante Quashie, A" sort="Asante Quashie, A" uniqKey="Asante Quashie A" first="A" last="Asante-Quashie">A. Asante-Quashie</name><name sortKey="Ganu, V" sort="Ganu, V" uniqKey="Ganu V" first="V" last="Ganu">V. Ganu</name><name sortKey="Kenu, E" sort="Kenu, E" uniqKey="Kenu E" first="E" last="Kenu">E. Kenu</name><name sortKey="Lartey, M" sort="Lartey, M" uniqKey="Lartey M" first="M" last="Lartey">M. Lartey</name><name sortKey="Neequaye, A" sort="Neequaye, A" uniqKey="Neequaye A" first="A" last="Neequaye">A. Neequaye</name><name sortKey="Neequaye, A" sort="Neequaye, A" uniqKey="Neequaye A" first="A" last="Neequaye">A. Neequaye</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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