Infectious disease consultations at a South African academic hospital: A 6-month assessment of inpatient consultations
Background: Infectious diseases (IDs) dominate the disease profile in South Africa (SA) and the ID department is increasingly valuable. There has been little evaluation of the IDs consultation services in SA hospitals. Methods: A qualitative review of ID inpatient consultations was performed over 6...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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AOSIS
2020-09-01
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| Series: | Southern African Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | https://sajid.co.za/index.php/sajid/article/view/169 |
| _version_ | 1811273528558747648 |
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| author | Lauren Richards David C. Spencer Jeremy S. Nel Prudence Ive |
| author_facet | Lauren Richards David C. Spencer Jeremy S. Nel Prudence Ive |
| author_sort | Lauren Richards |
| collection | DOAJ |
| description | Background: Infectious diseases (IDs) dominate the disease profile in South Africa (SA) and the ID department is increasingly valuable. There has been little evaluation of the IDs consultation services in SA hospitals.
Methods: A qualitative review of ID inpatient consultations was performed over 6 months at a SA tertiary hospital. Prospectively entered data from each consultation were recorded on a computerised database and retrospectively analysed.
Results: 749 ID consultations were analysed, 4.8% of hospital admissions. Most consultations included initiation of antiretroviral therapy (ART) (27.8%), lipoarabinomannan antigen testing (24.8%) and change of ART (21.6%). Of patients reviewed, 93.3% were human immunodeficiency virus (HIV) positive and the median CD4 count was 52 cells/mm3. The infectious diagnoses (excluding HIV) most frequently encountered were pulmonary and abdominal tuberculosis (TB) and acute gastroenteritis. When all subcategories of TB infection were combined, 42.9% were found to have TB. Patients had predominantly one (45.4%) or two (30.2%) infectious diagnoses in addition to HIV. Some (12%) had three infectious diagnoses during their admission. The number of diagnoses, both infectious (odds ratio [OR] 2.00; 95% confidence interval [CI] 1.11–3.60) and non-infectious (OR 2.27; 95% CI 1.25–4.11), was associated with increased odds of death.
Conclusion: The IDs department sees a high volume of patients compared to most developed countries. HIV, TB and their management dominate the workload. This study shows that HIV patients still have significant morbidity and mortality. The complexity of these patients indicates that specific expertise is required beyond that of the general physician. |
| first_indexed | 2024-04-12T23:00:50Z |
| format | Article |
| id | doaj.art-09aa5af0f1814816ad269d1d19db6880 |
| institution | Directory Open Access Journal |
| issn | 2312-0053 2313-1810 |
| language | English |
| last_indexed | 2024-04-12T23:00:50Z |
| publishDate | 2020-09-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Southern African Journal of Infectious Diseases |
| spelling | doaj.art-09aa5af0f1814816ad269d1d19db68802022-12-22T03:13:03ZengAOSISSouthern African Journal of Infectious Diseases2312-00532313-18102020-09-01351e1e610.4102/sajid.v35i1.169151Infectious disease consultations at a South African academic hospital: A 6-month assessment of inpatient consultationsLauren Richards0David C. Spencer1Jeremy S. Nel2Prudence Ive3Division of Infectious Diseases, Department of Medicine, Faculty of Health Sciences, Helen Joseph Hospital, University of the Witwatersrand, JohannesburgDivision of Infectious Diseases, Department of Medicine, Faculty of Health Sciences, Helen Joseph Hospital, University of the Witwatersrand, Johannesburg, South Africa; and Clinical HIV Research Unit (CHRU), University of the Witwatersrand, JohannesburgDivision of Infectious Diseases, Department of Medicine, Faculty of Health Sciences, Helen Joseph Hospital, University of the Witwatersrand, JohannesburgDivision of Infectious Diseases, Department of Medicine, Faculty of Health Sciences, Helen Joseph Hospital, University of the Witwatersrand, JohannesburgBackground: Infectious diseases (IDs) dominate the disease profile in South Africa (SA) and the ID department is increasingly valuable. There has been little evaluation of the IDs consultation services in SA hospitals. Methods: A qualitative review of ID inpatient consultations was performed over 6 months at a SA tertiary hospital. Prospectively entered data from each consultation were recorded on a computerised database and retrospectively analysed. Results: 749 ID consultations were analysed, 4.8% of hospital admissions. Most consultations included initiation of antiretroviral therapy (ART) (27.8%), lipoarabinomannan antigen testing (24.8%) and change of ART (21.6%). Of patients reviewed, 93.3% were human immunodeficiency virus (HIV) positive and the median CD4 count was 52 cells/mm3. The infectious diagnoses (excluding HIV) most frequently encountered were pulmonary and abdominal tuberculosis (TB) and acute gastroenteritis. When all subcategories of TB infection were combined, 42.9% were found to have TB. Patients had predominantly one (45.4%) or two (30.2%) infectious diagnoses in addition to HIV. Some (12%) had three infectious diagnoses during their admission. The number of diagnoses, both infectious (odds ratio [OR] 2.00; 95% confidence interval [CI] 1.11–3.60) and non-infectious (OR 2.27; 95% CI 1.25–4.11), was associated with increased odds of death. Conclusion: The IDs department sees a high volume of patients compared to most developed countries. HIV, TB and their management dominate the workload. This study shows that HIV patients still have significant morbidity and mortality. The complexity of these patients indicates that specific expertise is required beyond that of the general physician.https://sajid.co.za/index.php/sajid/article/view/169infectious diseasesinpatientconsultationssouth africahivtb. |
| spellingShingle | Lauren Richards David C. Spencer Jeremy S. Nel Prudence Ive Infectious disease consultations at a South African academic hospital: A 6-month assessment of inpatient consultations Southern African Journal of Infectious Diseases infectious diseases inpatient consultations south africa hiv tb. |
| title | Infectious disease consultations at a South African academic hospital: A 6-month assessment of inpatient consultations |
| title_full | Infectious disease consultations at a South African academic hospital: A 6-month assessment of inpatient consultations |
| title_fullStr | Infectious disease consultations at a South African academic hospital: A 6-month assessment of inpatient consultations |
| title_full_unstemmed | Infectious disease consultations at a South African academic hospital: A 6-month assessment of inpatient consultations |
| title_short | Infectious disease consultations at a South African academic hospital: A 6-month assessment of inpatient consultations |
| title_sort | infectious disease consultations at a south african academic hospital a 6 month assessment of inpatient consultations |
| topic | infectious diseases inpatient consultations south africa hiv tb. |
| url | https://sajid.co.za/index.php/sajid/article/view/169 |
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