A reduction in adult blood stream infection and case fatality at a large African hospital following antiretroviral therapy roll-out
| Autor: | Nicholas A, Feasey, Angela, Houston, Mavuto, Mukaka, Dan, Komrower, Thandie, Mwalukomo, Lyson, Tenthani, Andreas, Jahn, Mike, Moore, Remco P H, Peters, Melita A, Gordon, Dean B, Everett, Neil, French, Joep J, van Oosterhout, Theresa J, Allain, Robert S, Heyderman |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Bacterial Diseases Malawi Viral Diseases Anti-HIV Agents Immunology Bacteremia HIV Infections Clinical immunology Microbiology Young Adult Immunodeficiency Viruses Risk Factors Streptococcal Infections Trimethoprim Sulfamethoxazole Drug Combination Humans Prospective Studies Sex Distribution Hospitals Municipal Microbial Pathogens Medicine and health sciences Biology and life sciences Coinfection Incidence HIV Middle Aged bacterial infections and mycoses HIV immunopathogenesis Diagnostic medicine Infectious Diseases Medical Microbiology Viral Pathogens Salmonella Infections Female HIV clinical manifestations human activities Research Article |
| Zdroj: | PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Introduction Blood-stream infection (BSI) is one of the principle determinants of the morbidity and mortality associated with advanced HIV infection, especially in sub-Saharan Africa. Over the last 10 years, there has been rapid roll-out of anti-retroviral therapy (ART) and cotrimoxazole prophylactic therapy (CPT) in many high HIV prevalence African countries. Methods A prospective cohort of adults with suspected BSI presenting to Queen's Hospital, Malawi was recruited between 2009 and 2010 to describe causes of and outcomes from BSI. Comparison was made with a cohort pre-dating ART roll-out to investigate whether and how ART and CPT have affected BSI. Malawian census and Ministry of Health ART data were used to estimate minimum incidence of BSI in Blantyre district. Results 2,007 patients were recruited, 90% were HIV infected. Since 1997/8, culture-confirmed BSI has fallen from 16% of suspected cases to 10% (p |
| Databáze: | OpenAIRE |
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