Felix Bongomin, Winnie Kibone, Ritah Nantale, Byron Awekonimungu, Nixson Oyoo, Joseph Baruch Baluku, Francis Okongo, Megan Genevieve Latoya, David W Denning, Davidson H Hamer, Conrad Muzoora
{"title":"乌干达北部艾滋病毒感染者及其护理人员对医院尸检的认识和可接受性评估","authors":"Felix Bongomin, Winnie Kibone, Ritah Nantale, Byron Awekonimungu, Nixson Oyoo, Joseph Baruch Baluku, Francis Okongo, Megan Genevieve Latoya, David W Denning, Davidson H Hamer, Conrad Muzoora","doi":"10.2147/HIV.S521230","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Autopsy is a valuable diagnostic tool utilized to identify causes of death and to confirm ante-mortem diagnoses of opportunistic infections among people living with HIV (PLHIV). We assessed acceptance of full or minimally invasive hospital (non-medicolegal) autopsies.</p><p><strong>Methods: </strong>We conducted a multicentre, observational, cross-sectional study between October 2023 and January 2024 in four large HIV clinics in Northern Uganda among adult PLHIV and their caregivers, using a structured questionnaire. We conducted multivariable logistic regression to assess for association between acceptance of autopsy and selected exposures among PLHIV and caregivers with results expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 310 participants, including 232 PLHIV and 78 caregivers were enrolled. Most participants (77.4%, n=240) had heard of autopsy. Overall, 132 (42.6%) participants reported that they would accept autopsy; 38/78 (48.7%) of the caregivers versus 94/232 (40.5%) of PLHIV. Most (81.3%, n=252) cited desire for accurate cause of death as their reason for accepting autopsy. However, 133 (42.9%) reported fear of body disfigurement, 77 (24.8%) lack of perceived benefit, 35 (11.3%) religiously unacceptable, and 52 (16.8%) culturally/traditionally forbidden as reasons for autopsy refusal. Autopsy acceptance among PLHIV was associated with being an inpatient (aOR: 4.6; 95% CI: 2.04-10.4), autopsy awareness (aOR: 5.1; 95% CI: 1.2-22.0), and inversely with having a primary education level (aOR: 0.44; 95% CI: 1.61-3.18). Among caregivers, no education was associated with acceptance of autopsy (aOR: 0.09; 95% CI: 0.02-0.55).</p><p><strong>Conclusion: </strong>In Uganda, less than half of PLHIV or their caregivers would accept having an autopsy when they die. There is need for public sensitization about the relevance of autopsies in this population, with emphasis that the clinical diagnosis may not necessarily be the cause of death.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":"17 ","pages":"143-152"},"PeriodicalIF":1.5000,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164845/pdf/","citationCount":"0","resultStr":"{\"title\":\"Assessment of Awareness and Acceptability of Hospital Autopsy Among People Living with HIV and Their Caregivers in Northern Uganda.\",\"authors\":\"Felix Bongomin, Winnie Kibone, Ritah Nantale, Byron Awekonimungu, Nixson Oyoo, Joseph Baruch Baluku, Francis Okongo, Megan Genevieve Latoya, David W Denning, Davidson H Hamer, Conrad Muzoora\",\"doi\":\"10.2147/HIV.S521230\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Autopsy is a valuable diagnostic tool utilized to identify causes of death and to confirm ante-mortem diagnoses of opportunistic infections among people living with HIV (PLHIV). We assessed acceptance of full or minimally invasive hospital (non-medicolegal) autopsies.</p><p><strong>Methods: </strong>We conducted a multicentre, observational, cross-sectional study between October 2023 and January 2024 in four large HIV clinics in Northern Uganda among adult PLHIV and their caregivers, using a structured questionnaire. We conducted multivariable logistic regression to assess for association between acceptance of autopsy and selected exposures among PLHIV and caregivers with results expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 310 participants, including 232 PLHIV and 78 caregivers were enrolled. Most participants (77.4%, n=240) had heard of autopsy. Overall, 132 (42.6%) participants reported that they would accept autopsy; 38/78 (48.7%) of the caregivers versus 94/232 (40.5%) of PLHIV. Most (81.3%, n=252) cited desire for accurate cause of death as their reason for accepting autopsy. However, 133 (42.9%) reported fear of body disfigurement, 77 (24.8%) lack of perceived benefit, 35 (11.3%) religiously unacceptable, and 52 (16.8%) culturally/traditionally forbidden as reasons for autopsy refusal. Autopsy acceptance among PLHIV was associated with being an inpatient (aOR: 4.6; 95% CI: 2.04-10.4), autopsy awareness (aOR: 5.1; 95% CI: 1.2-22.0), and inversely with having a primary education level (aOR: 0.44; 95% CI: 1.61-3.18). Among caregivers, no education was associated with acceptance of autopsy (aOR: 0.09; 95% CI: 0.02-0.55).</p><p><strong>Conclusion: </strong>In Uganda, less than half of PLHIV or their caregivers would accept having an autopsy when they die. There is need for public sensitization about the relevance of autopsies in this population, with emphasis that the clinical diagnosis may not necessarily be the cause of death.</p>\",\"PeriodicalId\":46555,\"journal\":{\"name\":\"HIV AIDS-Research and Palliative Care\",\"volume\":\"17 \",\"pages\":\"143-152\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-06-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164845/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"HIV AIDS-Research and Palliative Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/HIV.S521230\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIV AIDS-Research and Palliative Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/HIV.S521230","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Assessment of Awareness and Acceptability of Hospital Autopsy Among People Living with HIV and Their Caregivers in Northern Uganda.
Background: Autopsy is a valuable diagnostic tool utilized to identify causes of death and to confirm ante-mortem diagnoses of opportunistic infections among people living with HIV (PLHIV). We assessed acceptance of full or minimally invasive hospital (non-medicolegal) autopsies.
Methods: We conducted a multicentre, observational, cross-sectional study between October 2023 and January 2024 in four large HIV clinics in Northern Uganda among adult PLHIV and their caregivers, using a structured questionnaire. We conducted multivariable logistic regression to assess for association between acceptance of autopsy and selected exposures among PLHIV and caregivers with results expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI).
Results: A total of 310 participants, including 232 PLHIV and 78 caregivers were enrolled. Most participants (77.4%, n=240) had heard of autopsy. Overall, 132 (42.6%) participants reported that they would accept autopsy; 38/78 (48.7%) of the caregivers versus 94/232 (40.5%) of PLHIV. Most (81.3%, n=252) cited desire for accurate cause of death as their reason for accepting autopsy. However, 133 (42.9%) reported fear of body disfigurement, 77 (24.8%) lack of perceived benefit, 35 (11.3%) religiously unacceptable, and 52 (16.8%) culturally/traditionally forbidden as reasons for autopsy refusal. Autopsy acceptance among PLHIV was associated with being an inpatient (aOR: 4.6; 95% CI: 2.04-10.4), autopsy awareness (aOR: 5.1; 95% CI: 1.2-22.0), and inversely with having a primary education level (aOR: 0.44; 95% CI: 1.61-3.18). Among caregivers, no education was associated with acceptance of autopsy (aOR: 0.09; 95% CI: 0.02-0.55).
Conclusion: In Uganda, less than half of PLHIV or their caregivers would accept having an autopsy when they die. There is need for public sensitization about the relevance of autopsies in this population, with emphasis that the clinical diagnosis may not necessarily be the cause of death.
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About Dove Medical Press Dove Medical Press Ltd is part of Taylor & Francis Group, the Academic Publishing Division of Informa PLC. We specialize in the publication of Open Access peer-reviewed journals across the broad spectrum of science, technology and especially medicine. Dove Medical Press was founded in 2003 with the objective of combining the highest editorial standards with the ''best of breed'' new publishing technologies. We have offices in Manchester and London in the United Kingdom, representatives in Princeton, New Jersey in the United States, and our editorial offices are in Auckland, New Zealand. Dr Scott Fraser is our Medical Director based in the UK. He has been in full time clinical practice for over 20 years as well as having an active research interest.
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