Admission trends in a rural south African hospital during the early years of the HIV epidemic

Floyd, Katherine, Reid, R. Alasdair, Wilkinson, David and Gilks, Charles F. (1999) Admission trends in a rural south African hospital during the early years of the HIV epidemic. Jama-journal of The American Medical Association, 282 11: 1087-1091. doi:10.1001/jama.282.11.1087


Author Floyd, Katherine
Reid, R. Alasdair
Wilkinson, David
Gilks, Charles F.
Title Admission trends in a rural south African hospital during the early years of the HIV epidemic
Journal name Jama-journal of The American Medical Association   Check publisher's open access policy
ISSN 1538-3598
0098-7484
Publication date 1999-09
Sub-type Article (original research)
DOI 10.1001/jama.282.11.1087
Volume 282
Issue 11
Start page 1087
End page 1091
Total pages 5
Place of publication Chicago, Ill. U.S.A
Publisher American Medical Association
Language eng
Subject 1103 Clinical Sciences
1108 Medical Microbiology
1117 Public Health and Health Services
Formatted abstract
Context:
Few studies have attempted to quantify the effect of the epidemic of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) on demand for health care in developing countries. More data are required to improve understanding of its impact and to guide development of appropriate response strategies.

Objective:
To assess the HIV/AIDS epidemic's impact on demand for inpatient hospital care in a rural area of South Africa.

Design:
Retrospective analysis of data from general hospital and individual ward admission registers, a tuberculosis program database, and patient case notes.

Setting and Patients:
Patients admitted between 1991 and 1998 to a 450-bed hospital that serves Hlabisa District, South Africa (population ≃200 000), where HIV seroprevalence among antenatal clinic attendees increased from 4% in 1992 to 29% in 1998.

Main Outcome Measures:
Number of admissions to 9 hospital wards, number of clinical AIDS and general medical admissions (both excluding tuberculosis), and number of tuberculosis admissions to adult medical wards during the study period.

Results:
Total hospital admissions increased by 81%, from 6562 in 1991 to 11 872 in 1998. Adult tuberculosis ward admissions increased by 360%, from 303 to 1393. In 1998, tuberculosis patients accounted for 47% and 30% of adult male and female medical ward admissions, respectively, and for 11% of total hospital admissions. Nontuberculosis clinical AIDS cases increased 43-fold, accounting for 4% of adult medical admissions in 1997 vs 0.2% in 1991. Tuberculosis and nontuberculosis clinical AIDS cases were the only types of admission to show a clear and consistent upward trend over the period studied. Patterns in other types of admissions varied more and changes were smaller.

Conclusions:
The HIV/AIDS epidemic has had an important impact on demand for adult tuberculosis and general medical care in a rural South African district hospital. If this impact is shown to extend to other rural South African areas, response strategies are urgently needed.
Keyword Resource Utilization
Drug-users
Tuberculosis
Infection
Risk
Impact
District
Nairobi
Cohort
Women
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 07 Sep 2010, 13:01:48 EST