Author(s)

Mooketsi Molefi^1,2, Jose-Gaby Tshikuka^1,3, Tuduetso Leka Monagen¹, Mgaywa Gilbert Mjungu Damas Magafu¹, Tiny Masupe¹, Bontle Mbongwe⁴, Paul Rheeder^2,5

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.

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.

Disease Burden, HIV-Related Admissions, HIV-Related Deaths, Princess Marina Hospital and Retrospective Analysis

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.