Abstract
Background:
The aim of this study was to describe the clinical presentation and predictors of death in a HIV population hospitalized in Ouagadougou, Burkina Faso.
Materials and Methods:
Baseline demographics, viro-immunological status, clinical presentations, and outcome have been analyzed by univariate analysis and a multivariate model.
Results:
A total of 1,071 hospitalizations of HIV-positive patients was recorded between 1 January, 2004 and 31 August, 2006, the majority of whom were female (64.1%). The baseline CD4 cell count/μl was higher in the female patients than in the male ones (166.1 vs 110.9). Gastroenteric symptoms were the first cause of hospitalization (61.7%). The crude mortality rate was higher in males than females (38% vs 25.3%). Baseline World Health Organization clinical stage IV (OR 9.22), neurological syndrome (OR 3.04) or wasting syndrome at admission (OR 2.9), positive malaria film (OR 2.17), and an older age independently predicted death. Weight at admission > 40 kg and a higher platelet count at admission were independently associated with a better outcome.
Conclusions:
Females are admitted to hospital earlier than males, probably as an indirect result of the Prevention of Mother-to-Child Transmission (PMTCT) public health initiative. An active search of HIV status in other members of the family (PMTCT-plus) may result in the detection of asymptomatic HIV-infected patients as well. A Plasmodium falciparum-positive smear during admission significantly impacted on outcome as well as low platelet count.
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References
WHO, UNICEF, UNAIDS: Epidemiological fact sheets on HIV/AIDS and sexually transmitted infections. December 2006 update. http://www.who.int/GlobalAtlas/predefinedReports/EFS2006/EFS_PDFs/EFS2006_BF.pdf (accessed 26 January 2008).
UNAIDS: 2007 AIDS epidemic update. Available at: http://www.unaids.org. Accessed 26 January 2008.
WHO/HIV/2005.02 Interim WHO clinical staging of HIV/AIDS and HIV/AIDS case definitions for surveillance African region. http://www.who.int/hiv/pub/guidelines/casedefinitions/en/index.html (accessed 26 January 2008).
Tuberculosis Coalition for Technical Assistance. International Standards for Tuberculosis Care (ISTC). Tuberculosis Coalition for Technical Assistance, The Hague, 2006. http://who.int/tb/publications/2006/istc_report.pdf (accessed 26 January 2008).
WHO (2003) Revision. Scaling up antiretroviral therapy in resource-limited settings: treatment guidelines for a public health approach. http://who.int/3by5/publications/documents/arv_guidelines/en/ (accessed 26 January 2008).
Furber AS, Hodgson IJ, Desclaux A, Mukasa DS: Barriers to better care for people with AIDS in developing countries. Br Med J 2004; 329: 1281–1283.
Sungkanuparph S, Kiertiburanakul S, Manosuthi W, Kiatatchasai W, Vibhagool A: Initiation of highly active antiretroviral therapy in advanced AIDS with CD4 <50 cells/mm3 in a resource limited setting: efficacy and tolerability. Int J STD AIDS 2005; 16: 243–246.
WHO-UNAIDS May 2007. Guidance on provider-initiated HIV testing and counseling in health facilities. http://whqlibdoc.who.int/publications/2007/9789241595568_eng.pdf (accessed 26 January 2008).
Grant AD, Djomand G, Smets P, Kadio A, Coulibaly M, Kakou A, Maurice C, Whitaker JP, Sylla-Koko F, Bonard D, Wiktor SZ, Hayes RJ, De Cock KM, Greenberg AE: Profound immunosuppression across the spectrum of opportunistic disease among hospitalised HIV-infected adults in Abidjan, Côte d’Ivoire. AIDS 1997; 11: 1357–1364.
Louie JK, Chi NH, Thao le TT, Quang VM, Campbell J, Chau NV, Rutherford GW, Farrar JJ, Parry CM: Opportunistic infections in hospitalised HIV-infected adults in Ho Chi Minh City, Vietnam: a cross-sectional study. Int J STD AIDS 2004; 15: 758–761.
Tansuphasawadikul S, Amornkul PN, Tanchanpong C, Limpakarnjanarat K, Kaewkungwal J, Likanonsakul S, Eampokalap B, Naiwatanakul T, Kitayaporn D, Young NL, Hu DJ, Mastro TD: Clinical presentation of hospitalised adult patients with HIV infection and AIDS in Bangkok, Thailand. J Acquir Immune Defic Syndr 1999; 21: 326–332.
Madec Y, Laureillard D, Pinogesd L, Fernandez M, Prak N, Ngeth C, Moeung S, Song S, Balkan S, Ferradini L, Quillet C, Fontanet A: Response to highly active antiretroviral therapy among severely immuno-compromised HIV-infected patients in Cambodia. AIDS 2007; 21: 351–359.
Gilks GF, Otieno LS, Brindle RJ, Newnham RS, Lule GN, Were JB, Simani PM, Bhatt SM, Okelo GB, Waiyaki PG, Warrell DA: The presentation and outcome of HIV-related disease in Nairobi. Q J Med 1992; 82: 25–32.
Morgan D, Malamba SS, Orem J, Mayanja B, Okongo M, Whitworth JA: Survival by AIDS defining condition in rural Uganda. Sex Transm Infect 2000; 76: 193–197.
Lucas SB, De Cock KM, Hounnou A, Peacock C, Diomande M, Hondé M, Beaumel A, Kestens L, Kadio A: Contributions of tuberculosis to slim disease in Africa. Br Med J 1994; 308: 1531–1534.
Corbett EL, Marston B, Churchyard GJ, De Cock KM: Tuberculosis in sub-Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment. Lancet 2006; 367: 926–937.
Nunn P, Williams B, Floyd K, Dye C, Elzinga G, Raviglione M: Tuberculosis control in the era of HIV. Nature 2005; 5: 819–826.
Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg KA: Review of human immunodeficiency virus type 1-related opportunistic infections in sub-Saharan Africa. Clin Infect Dis 2003; 36: 652–662.
Corbett EL, Steketee RW, Ter Kuile FO, Latif AS, Kamali A, Hayes RJ: HIV-1/AIDS and the control of other infectious diseases in Africa. Lancet 2002; 359: 2177–2187.
Cohen C, Karstaedt A, Frean J, Thomas J, Govender N, Prentice E, Dini L, Galpin J, Crewe-Brown H: Increased prevalence of severe malaria in HIV-infected adults in South Africa. Clin Infect Dis 2005; 41: 1631–1637.
Hoffman IF, Jere CS, Taylor TE, Munthali P, Dyer JR, Wirima JJ, Rogerson SJ, Kumwenda N, Eron JJ, Fiscus SA, Chakraborty H, Taha TE, Cohen MS, Molyneux ME: The effect of Plasmodium falciparum malaria on HIV-1 RNA blood plasma concentration. AIDS 1999; 13: 487–494.
Miguez-Burbano MJ, Jackson JJr, Hadrigan S: Thrombocytopenia in HIV disease: clinical relevance, physiopathology and management. Curr Med Chem Cardiovasc Hematol Agents 2005; 3: 365–376.
Simpore J, Savadogo A, Ilboudo D, Nadambega MC, Esposito M, Yara J, Pignatelli S, Pietra V, Musumeci S: Toxoplasma gondii, HCV and HBV seroprevalence and co-infection among HIV-positive and -negative pregnant women in Burkina Faso. J Med Virol 2006; 78: 730–733.
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Saleri, N., Capone, S., Pietra, V. et al. Outcome and Predictive Factors of Mortality in Hospitalized HIV-Patients in Burkina Faso. Infection 37, 142–147 (2009). https://doi.org/10.1007/s15010-008-7406-7
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DOI: https://doi.org/10.1007/s15010-008-7406-7