scholarly journals Causes of hospitalization and predictors of HIV-associated mortality at the main referral hospital in Sierra Leone: a prospective study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sulaiman Lakoh ◽  
Darlinda F. Jiba ◽  
Joseph E. Kanu ◽  
Eva Poveda ◽  
Angel Salgado-Barreira ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Prospective Study ◽  
Sierra Leone ◽  
Hospital Admissions ◽  
Public Health Problem ◽  
Referral Hospital ◽  
High Morbidity ◽  
Treatment Access ◽  
Diarrheal Illness ◽  
A Prospective Study

Abstract Background HIV infection is a growing public health problem in Sierra Leone and the wider West Africa region. The countrywide HIV prevalence was estimated at 1.7% (67,000 people), with less than 30% receiving life-saving ART in 2016. Thus, HIV-infected patients tend to present to health facilities late, with high mortality risk. Methods We conducted a prospective study of HIV inpatients aged ≥15 years at Connaught Hospital in Freetown—the main referral hospital in Sierra Leone—from July through September 2017, to assess associated factors and predictors of HIV-related mortality. Results One hundred seventy-three HIV inpatients were included, accounting for 14.2% (173/1221) of all hospital admissions during the study period. The majority were female (59.5%, 70/173), median age was 34 years, with 51.4% (89/173) of them diagnosed with HIV infection for the first time during the current hospitalization. The most common admitting diagnoses were anemia (48%, 84/173), tuberculosis (24.3%, 42/173), pneumonia (17.3%, 30/173) and diarrheal illness (15.0%, 26/173). CD4 count was obtained in 64.7% (112/173) of patients, with median value of 87 cells/μL (IQR 25–266), and was further staged as severe immunosuppression: CD4 < 100 cells/μL (50%, 56/112); AIDS: CD4 < 200 cells/μL (69.6%, 78/112); and late-stage HIV disease: CD4 < 350 cells/μL (83%, 93/112). Fifty-two patients (30.1%, 52/173) died during hospitalization, 23% (12/52) of them within the first week. The leading causes of death were anemia (23.1%, 12/52), pneumonia (19.2%, 10/52), diarrheal illness (15.4%, 8/52) and tuberculosis (13.6%, 7/52). Neurological symptoms, i.e., loss of consciousness (p = 0.04) and focal limb weakness (p = 0.04); alcohol use (p = 0.01); jaundice (p = 0.02); cerebral toxoplasmosis (p = 0.01); and tuberculosis (p = 0.04) were significantly associated with mortality; however, only jaundice (AOR 0.11, 95% CI [0.02–0.65]; p = 0.01) emerged as an independent predictor of mortality. Conclusion HIV-infected patients account for a substantial proportion of admissions at Connaught Hospital, with a high morbidity and in-hospital mortality burden. These findings necessitate the implementation of specific measures to enhance early HIV diagnosis and expand treatment access to all HIV-infected patients in Sierra Leone.

scholarly journals A Prospective Study of Etiological Agents Among Febrile Patients in Sierra Leone

2021 ◽  
Author(s):  
Han Wang ◽  
Jing Zhao ◽  
Na Xie ◽  
Wanxue Wang ◽  
Ruping Qi ◽  
...  
Keyword(s):  
Prospective Study ◽  
Sierra Leone ◽  
Etiological Agents ◽  
A Prospective Study

A Prospective Study of the Efficacy of Local Application of Gentamicin versus Mupirocin in the Prevention of Peritoneal Dialysis Catheter-Related Infections

2008 ◽  
Vol 28 (5) ◽  
pp. 505-508 ◽  
Author(s):  
Kwok Hong Chu ◽  
Wai Yee Choy ◽  
Chi Chung William Cheung ◽  
Ka Shun Fung ◽  
Hon Lok Tang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Prospective Study ◽  
Hospital Admissions ◽  
Local Application ◽  
Peritoneal Dialysis Catheter ◽  
Exit Site ◽  
Gram Positive ◽  
Gram Negative ◽  
A Prospective Study

Background Peritoneal dialysis (PD)-related infections are the major cause of technique failure. Exit-site infections (ESI) can be prevented by local application of antibiotics. Mupirocin (M) is the most extensively studied drug for this application. Long-term use can result in the development of resistance. Gentamicin (G) is an attractive alternative, with both gram-positive and gram-negative activities. We studied the comparative efficacy of G cream versus M ointment in the prevention of PD-related infections in a Chinese cohort. Methods This was a prospective study of adult PD patients of the Princess Margaret Hospital, Hong Kong. Patients were excluded if they had active infection, recent ESI or peritonitis, history of allergy to either drug, or were unable to apply the drug or give consent. Patients were taught to apply the drug daily to the exit site after routine exit-site care. Records were tracked prospectively during hospital admissions and clinic follow-ups. Results 95 patients were recruited; 14 discontinued the study. The ESI rates were 0.38 and 0.20 episodes/patient-year for the G group and the M group respectively ( p = 0.36). Gram-positive ESI rates were 0.18 and 0 episodes/patient-year for the G group and the M group respectively. Gram-negative ESI rates were 0.20 episodes/patient-year for both groups ( p = 0.62). The overall peritonitis rates were similar in the two groups ( p = 0.91). Discussion In addition to good perioperative care and strict exit-site care, local antibiotic application can prevent ESI. Mupirocin has been extensively studied and shown to be effective. Similar if not superior effects of G cream have been demonstrated. In this study, neither antibiotic gave significantly better results in the prevention of either ESI or peritonitis. Conclusions Both gentamicin and mupirocin were effective as prophylaxis for ESI. Longer study is required to determine the long-term efficacy and the potential beneficial effect on the prevention of peritonitis.

scholarly journals Prevalence and mortality of cryptococcal disease in adults with advanced HIV in an urban tertiary hospital in Sierra Leone: a prospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sulaiman Lakoh ◽  
Hannah Rickman ◽  
Momodu Sesay ◽  
Sartie Kenneh ◽  
Rachael Burke ◽  
...  
Keyword(s):  
Prospective Study ◽  
Sierra Leone ◽  
Tertiary Hospital ◽  
Cryptococcal Disease ◽  
A Prospective Study

Impact of HIV infection on meningitis in Harare, Zimbabwe: a prospective study of 406 predominantly adult patients

AIDS ◽  
2000 ◽  
Vol 14 (10) ◽  
pp. 1401-1407 ◽  
Author(s):  
James G. Hakim ◽  
Innocent T. Gangaidzo ◽  
Robert S. Heyderman ◽  
Jens Mielke ◽  
Ebbah Mushangi ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Prospective Study ◽  
Adult Patients ◽  
A Prospective Study

The social impact of HIV infection on women in Kigali, Rwanda: A prospective study

1994 ◽  
Vol 38 (8) ◽  
pp. 1047-1053 ◽  
Author(s):  
P. Keogh ◽  
S. Allen ◽  
C. Almedal ◽  
B. Temahagili
Keyword(s):  
Hiv Infection ◽  
Prospective Study ◽  
Social Impact ◽  
The Social ◽  
A Prospective Study

scholarly journals Hospital admissions for skin and soft tissue infections in a population with endemic scabies: A prospective study in Fiji, 2018–2019

2020 ◽  
Vol 14 (12) ◽  
pp. e0008887
Author(s):  
Li Jun Thean ◽  
Adam Jenney ◽  
Daniel Engelman ◽  
Lucia Romani ◽  
Handan Wand ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Prospective Study ◽  
Indigenous Population ◽  
Hospital Admissions ◽  
Case Fatality ◽  
Soft Tissue Infections ◽  
Predisposing Factor ◽  
A Prospective Study ◽  
Crusted Scabies ◽  
Very High

Scabies is an important predisposing factor for impetigo but its role in more serious skin and soft tissue infections (SSTIs) is not well understood. Information is limited on incidence of SSTIs in the presence of endemic scabies. We conducted a prospective study of hospital admissions for SSTIs in the Northern Division of Fiji (population: 131,914). Prospective surveillance for admissions with impetigo, abscess, cellulitis, wound infection, pyomyositis, necrotizing fasciitis, infected scabies, and crusted scabies was conducted at the Division’s referral hospital between 2018 to 2019. Information was collected on demographic characteristics, clinical features, microbiology, treatment and outcomes. Over the study period, 788 SSTI admissions were recorded corresponding to a population incidence 647 per 100,000 person-years (95%CI 571–660). Incidence was highest at the extremes of age with peak incidence in children aged <5 years (908 per 100,000) and those aged ≥65 years (1127 per 100,000). Incidence was 1.7 times higher among the Indigenous Fijian population (753 per 100,000) compared to other ethnicities (442 per 100,000). Overall case fatality rate was 3.3%, and 10.8% for those aged ≥65 years. Scabies was diagnosed concurrently in 7.6% of all patients and in 24.6% of admitted children <5 years. There is a very high burden of hospital admissions for SSTIs in Fiji compared to high-income settings especially among the youngest, oldest and indigenous population which is concordant with scabies and impetigo distribution in this population. Our findings highlight the need for strategies to reduce the burden of SSTIs in Fiji and similar settings.

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