2000年博茨瓦纳玛丽娜公主医院与艾滋病毒相关的入院负担和死亡率:抗逆转录病毒前联合治疗时代

艾滋病(英文) Pub Date : 2017-01-16 DOI:10.4236/WJA.2017.71007

M. Molefi, J. Tshikuka, Tuduetso Monagen, M. G. M. D. Magafu, T. Masupe, Bontle Mbongwe, P. Rheeder

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引用次数: 0

摘要

背景:人类免疫病毒和获得性免疫缺陷综合症(艾滋病毒/艾滋病)在过去三十年中已在博茨瓦纳得到确认，然而，抗逆转录病毒联合疗法(cART)在2000年之后才开始采用。迄今为止，还没有对cart前基于设施的艾滋病毒/艾滋病相关疾病负担的历史数据进行分析。目的:分析2000年玛丽娜公主医院(PMH)艾滋病毒相关入院负担和艾滋病毒相关死亡，并确定与艾滋病毒/艾滋病死亡相关的社会人口因素。方法:对2014年5 - 6月的医疗档案进行回顾性分析。对2000年的九千七百四十六(9746)条记录进行了分析。根据医疗记录和/或《国际疾病分类》(ICD 10 B20-B24)第B20-B24节所列任何病症的文件，确定病例为有记录的艾滋病毒/艾滋病。结果是艾滋病毒相关入院和艾滋病毒相关死亡占所有入院和死亡的百分比。同时计算住院病死率(CFR)。使用对数二项回归模型确定与hiv相关入院和死亡相关的最显著因素。结果:该院hiv相关住院率为4.1% (403/9746)，hiv相关死亡率为11.3%(80/707)。院内HIV-CFR为19.9%(80/403)。经调整的对数二项模型发现，女性性别和cART使用是hiv相关入院最显著的保护因素，而年龄在10 - 15岁之间是最显著的危险因素。cART水平是hiv相关死亡的重要保护因素，而年龄大于15岁是最重要的危险因素。结论:在博茨瓦纳大规模使用cART之前，PMH中hiv相关入院和死亡的负担很大。这项研究强调艾滋病毒阳性患者入院的风险增加，并强调需要cART来预防死亡。需要进一步的研究来评估大规模推广cART的影响。

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The Burden of HIV-Related Admissions and Mortality at Princess Marina Hospital, Botswana in 2000: A Pre-Combination Antiretroviral Therapy Era

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.

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艾滋病(英文)

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