Patterns and trends in mortality among HIV-infected and HIV-uninfected patients in a major Internal Medicine Unit in Yaoundé, Cameroon: a retrospective cohort study.

Autor:	Mbuagbaw J; Faculty of Health Sciences, University of Buea, PO Box 63, Buea, Cameroon; Internal Medicine Unit, Buea Regional Hospital, PO Box 32, Buea, Cameroon., Jingi AM; Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon., Noubiap JJ; Department of Medicine, Groote Schuur Hospital and University of Cape Town, 7925 Cape Town, South Africa; Medical Diagnostic Center, PO Box 6230, Yaoundé, Cameroon., Kaze AD; Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA., Nansseu JR; Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon., Bigna JJ; Department of Epidemiology and Public Health, Pasteur Center of Cameroon, PO Box 1274, Yaoundé, Cameroon., Wawo Yonta E; Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon; Internal Medicine Unit, Yaoundé University Hospital Centre, PO Box 4806, Yaoundé, Cameroon., Ngu Blackett K; Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon; Internal Medicine Unit, Yaoundé University Hospital Centre, PO Box 4806, Yaoundé, Cameroon.
Jazyk:	angličtina
Zdroj:	JRSM open [JRSM Open] 2016 Sep 01; Vol. 7 (9), pp. 2054270416654859. Date of Electronic Publication: 2016 Sep 01 (Print Publication: 2016).
DOI:	10.1177/2054270416654859
Abstrakt:	Objective: To describe the trends in mortality and the spectrum of disease in HIV-infected and -uninfected inpatients in a population in Yaoundé. Design: A retrospective study. Setting: Internal Medicine Unit, University Hospital Centre, Yaoundé, Cameroon. Participants: All deaths registered between January 2000 and May 2007 in the unit. Main Outcomes Measures: Sociodemographic characteristics, clinical features and results of all investigations done, cause of death. Results: During the study period, 362 deaths were registered, consisting of 281 (77.6%) in HIV-infected patients, 54.4% of which were women. HIV-infected patients were younger (mean age: 40.2 (SD: 11.6) vs. 55.5 (SD: 18.3) years, p < 0.001) and economically active (60.3% vs. 24.4%, p < 0.001). Most HIV-infected patients (77.6%) were classified as WHO stage IV, with the rest being WHO stage III. Most HIV-infected patients (87.8%) had evidence of profound immunosuppression (CD4 < 200 cells/mm(3)). The mortality trend appeared to be declining with appropriate interventions. The most frequent causes of death in HIV-infected patients were pleural/pulmonary tuberculosis (34.2%), undefined meningoencephalitis (20.3%), other pneumonias (18.2%), toxoplasmosis (16.4%), cryptococcal meningitis (14.2%) and Kaposi sarcoma (15.7%). HIV-uninfected patients died mostly as a result of chronic diseases including liver diseases (17.3%), kidney failure (13.6%), congestive heart failure (11.1%) and stroke (9.9%). Conclusion: There was a declining mortality due to HIV with appropriate interventions such as subsidised tests for HIV-infected patients, increased availability of HAART and other medications for prevention and treatment of opportunistic infections. The spectrum of HIV disease was wide and preventable.
Databáze:	MEDLINE
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