The Burden of HIV-Related Admissions and Mortality at Princess Marina Hospital, Botswana in 2000: A Pre-Combination Antiretroviral Therapy Era ()
Affiliation(s)
1Department of Family Medicine & Public Health Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
2School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
3Department of Health Science, National Pedagogic University, Kinshasa, Democratic Republic of Congo.
4School of Public Health, Faculty of Health Sciences, Gaborone, Botswana.
5Department of Internal Medicine, Steve-Biko Academic Hospital, Pretoria, South Africa.
ABSTRACT
Background: human immune virus and acquired immunodeficiency syndrome (HIV/AIDS) have been recognized in Botswana for the last three decades, however, combination anti-retroviral therapy (cART) was only introduced after 2000. Facility-based historical data of the burden of HIV/AIDS- related conditions pre-cART have so far not been analyzed. Objective: To analyze the burden of HIV-related admissions and HIV-related deaths, and identify the socio-demographic factors associated with HIV/AIDS deaths at Princess Marina Hospital (PMH) in the year 2000. Methods: A retrospective review of medical files was carried out between May and June 2014. Nine thousand seven hundred and forty-six (9746) records were analyzed for the year for 2000. Cases were identified as documented HIV/AIDS as per medical notes and/or documentation of any of the conditions listed in sections B20-B24 of the International Classification of Diseases (ICD 10 B20-B24). Outcomes were the percentages of HIV-related admissions and HIV-related deaths out of all admissions and deaths. The in-hospital case fatality rate (CFR) was also calculated. Log-binomial regression models were used to determine the most significant factors associated with HIV-related admission and death. Results: The percentages of HIV-related admissions and HIV-related deaths were 4.1% (403/9746) and 11.3% (80/707), respectively. The in-hospital HIV-CFR was 19.9% (80/403). Adjusted log-binomial models identified the most significant protective factors for HIV-related admission were female sex and cART use while age >15 years old was the most significant risk factor. The se of cART was significant protective factor for HIV-associated death while age older than 15 years was the most significant risk factor. Conclusion: There was a significant burden of HIV-related admissions and deaths in PMH before wide-scale cART use in Botswana. This study highlights the increased risk of hospital admission for HIV-positive patients and underlines the need for cART to prevent deaths. Further studies evaluating the impact of wide-scale cART roll out are needed.
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Molefi, M. , Tshikuka, J. , Monagen, T. , Magafu, M. , Masupe, T. , Mbongwe, B. and Rheeder, P. (2017) The Burden of HIV-Related Admissions and Mortality at Princess Marina Hospital, Botswana in 2000: A Pre-Combination Antiretroviral Therapy Era.
World Journal of AIDS,
7, 67-75. doi:
10.4236/wja.2017.71007.
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