Prevalence of undiagnosed HIV, hepatitis B, and hepatitis C among patients in an Indian emergency department.

Autor: Pandiselvam S; Meenakshi Mission Hospital and Research Center Institute of Emergency Medicine Madurai Tamil Nadu India., Jena NN; Meenakshi Mission Hospital and Research Center Institute of Emergency Medicine Madurai Tamil Nadu India., Ghatak-Roy A; Department of Emergency Medicine George Washington University Washington DC USA., Dreyer N; Department of Emergency Medicine George Washington University Washington DC USA., Naik N; Department of Emergency Medicine George Washington University Washington DC USA., Blanchard J; Department of Emergency Medicine George Washington University Washington DC USA., Davey K; Department of Emergency Medicine George Washington University Washington DC USA.
Jazyk: angličtina
Zdroj: Journal of the American College of Emergency Physicians open [J Am Coll Emerg Physicians Open] 2020 Dec 07; Vol. 2 (1), pp. e12328. Date of Electronic Publication: 2020 Dec 07 (Print Publication: 2021).
DOI: 10.1002/emp2.12328
Abstrakt: Objectives: HIV, hepatitis B, and hepatitis C remain significant causes of morbidity and mortality in low resource settings. Emergency department (ED)-based screening has proven effective in decreasing the spread of undiagnosed disease, although such programs are rare in low-middle income countries.
Methods: A prospective, cross sectional study of all adult patients presenting to the ED in a 600-bed teaching hospital in Tamil Nadu, India. This study used an opt-in strategy in which patients were offered testing at the end of their ED visit. Costs of testing were paid out of pocket by patients. Patients with known HIV, hepatitis B, or hepatitis C were excluded from the study.
Results: During the study period 26,465 patients presented to the ED, and 18,286 patients consented to participate (68.9%). Among the 18,286 patients tested, 174 were positive for either HIV (39, 0.21%), hepatitis C (52, 0.28%), or hepatitis B (83, 0.45%). Three patients tested positive for both HIV and hepatitis C, and 1 patient tested positive for both HIV and hepatitis B. A total of 69.2% of patients with HIV, 61.2% of patients with hepatitis B, and 83% of patients with hepatitis C presented for reasons unrelated to their underlying diagnosis.
Conclusion: Although limited to only 1 hospital in southern India, this study represents the largest ED-based screening program for HIV, hepatitis B, and hepatitis C ever conducted in India or any other low-middle income countries. The majority of patients presented for reasons unrelated to their underlying diagnosis. Future research is needed on implementation strategies, cost feasibility, and linkage to care.
Competing Interests: The authors declare no conflicts of interest.
(© 2020 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of the American College of Emergency Physicians.)
Databáze: MEDLINE
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