A Study on the Assessment of HIV Related Emergency Visit during The HAART Era in Six Public Hospitals of Addis Ababa

Marye, Shewanesesh (2015) A Study on the Assessment of HIV Related Emergency Visit during The HAART Era in Six Public Hospitals of Addis Ababa. Masters thesis, Addis Ababa University.

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Abstract

Back ground:HIV associated medical emergencies are common emergency department presentations in high-prevalence settings. Diagnosis and management of HIV infected patients who visit Emergency clinic recently require knowledge of the disease‘s pattern and the life threatening complications associated with it. Objective: The main objective of this study is assessment of HIV related emergency visit during the HAART era in six public hospitals of Addis Ababa Methods: The study is cross-sectional and was conducted from January, 2015 to March, 2015 at six A.A Public Hospitals for a total of 422 patients. Result: There were a total of 18090 emergency department visits in the study hospitals during the specified period of which 422 (2.3%) were HIV infected patients and included in this study. Over t wo-thirds of the study subjects (N=278, 65.9%) were females with a female to male ratio of 2:1. About more than half of the patients (64.7%) were on first line HAART. Significant number of the PLHIV 42.9% had a CD4 count of <200 cells/ul, and 45.7% had a CD4 count between 200-499 cells/ul. The majority (42.4%) of the HIV patients coming to the emergency department were between the ages of 35-44 years. Hypovolumic shock secondary to diarrhea and vomiting (N=70, 16.7%), Pneumonia (N= 64, 15.2%), Anemia (N=52, 12.3%), Tuberculosis, Acute gastro-enteritis (N=35, 8.3%) and drug-induced liver injury (N=28, 6.6%) were the leading causes of ED visits among HIV infected patients. Concerning age and sex distribution on the HIV infected patients coming to emergency department, we found that pneumonia is the leading cause of diseases for age groups between 35-45 years old which mostly affected the females. Most of the diseases also are mostly manifested on females comparing than male HIV patients. From the study we can also see that most 132(31.3%) of the females are found in the fourth WHO staging comparing to the males 57(13.5%). It was identified that most of the patients 80.1% were treated for at least one kind of HIV related emergency illness in the past. Majority of the people living with HIV who came to emergency departments due to hypovolumic shock secondary to diarrhea and vomiting 16.7% followed by pneumonia 15.2% and anemia 12.3% Pulmonary tuberculosis 10.1%, and Acute Gastro Enteritis 8.3%.Conclusion: The findings indicate that HIV/AIDS patients have a frequent need for emergency care and most HIV/AIDS hospitalizations are emergency-related. The acute problems of these patients are related to a hypovolumic shock secondary to diarrhea and vomiting, pneumonia and anemia. It is the middle age groups that are at high risk for emergency illness. To facilitate early HIV diagnosis and early initiation of HAART, all stakeholders in the region must make concerted effort to expand and implement voluntary counseling and testing as well as the provider-initiated testing and counseling, even as new strategies are developed to detect early infection for prompt initiation of HAART, when necessary. An HIV associated emergency should therefore be a strong consideration for any critically ill patient, especially in high prevalence regions.

Item Type: Thesis (Masters)
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Africana
Depositing User: Emmanuel Ndorimana
Date Deposited: 29 Nov 2018 10:15
Last Modified: 29 Nov 2018 10:15
URI: http://thesisbank.jhia.ac.ke/id/eprint/8004

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