Management of patients presenting with diarrhoea to a regional emergency department in KwaZulu-Natal: Call for clearer, more relevant guidance
Background. HIV is prevalent throughout South Africa, and diarrhoea is a common presentation to the emergency department (ED) among both HIV-infected and -uninfected individuals. Method. We audited the management of diarrhoea against standard guidelines in the ED of a regional hospital in KwaZulu-...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
AOSIS
2014-09-01
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| Series: | Southern African Journal of HIV Medicine |
| Subjects: | |
| Online Access: | https://sajhivmed.org.za/index.php/hivmed/article/view/9 |
| _version_ | 1818008272889708544 |
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| author | Soren Kudsk-Iversen John Paul Gilbert Anneshree Azarath |
| author_facet | Soren Kudsk-Iversen John Paul Gilbert Anneshree Azarath |
| author_sort | Soren Kudsk-Iversen |
| collection | DOAJ |
| description | Background. HIV is prevalent throughout South Africa, and diarrhoea is a common presentation to the emergency department (ED) among both HIV-infected and -uninfected individuals.
Method. We audited the management of diarrhoea against standard guidelines in the ED of a regional hospital in KwaZulu-Natal. Patients presenting with diarrhoea as their chief complaint were eligible and data were collected prospectively.
Results. A total of 72 patients were included: 58 (81%) of patients were HIV-positive with an average CD4+ count of 180 cells/µl. A total of 34 stool samples were sent for standard microscopy and culture (M&C), among which 26 were positive (76%). Forty-three patients (60%) received antibiotics, 15 of whom had positive stool M&C. In all cases, the final diagnosis was listed as acute gastroenteritis without further specification, and antibiotic use according to guidelines appeared inconsistent.
Conclusion. Based on this audit, we suggest that current guidelines are not clear concerning management of acute diarrhoea in HIV-infected individuals, and that the lack of clear management strategies is likely to affect patient safety and increase antibiotic resistance. |
| first_indexed | 2024-04-14T05:27:01Z |
| format | Article |
| id | doaj.art-5a5905e5b825439f8eeb193da151d5db |
| institution | Directory Open Access Journal |
| issn | 1608-9693 2078-6751 |
| language | English |
| last_indexed | 2024-04-14T05:27:01Z |
| publishDate | 2014-09-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Southern African Journal of HIV Medicine |
| spelling | doaj.art-5a5905e5b825439f8eeb193da151d5db2022-12-22T02:09:56ZengAOSISSouthern African Journal of HIV Medicine1608-96932078-67512014-09-0115310210310.4102/sajhivmed.v15i3.99Management of patients presenting with diarrhoea to a regional emergency department in KwaZulu-Natal: Call for clearer, more relevant guidanceSoren Kudsk-Iversen0John Paul Gilbert1Anneshree Azarath2Stanger Provincial Hospital, Stanger, KwaZulu-Natal, South AfricaStanger Provincial Hospital, Stanger, KwaZulu-Natal, South AfricaStanger Provincial Hospital, Stanger, KwaZulu-Natal, South AfricaBackground. HIV is prevalent throughout South Africa, and diarrhoea is a common presentation to the emergency department (ED) among both HIV-infected and -uninfected individuals. Method. We audited the management of diarrhoea against standard guidelines in the ED of a regional hospital in KwaZulu-Natal. Patients presenting with diarrhoea as their chief complaint were eligible and data were collected prospectively. Results. A total of 72 patients were included: 58 (81%) of patients were HIV-positive with an average CD4+ count of 180 cells/µl. A total of 34 stool samples were sent for standard microscopy and culture (M&C), among which 26 were positive (76%). Forty-three patients (60%) received antibiotics, 15 of whom had positive stool M&C. In all cases, the final diagnosis was listed as acute gastroenteritis without further specification, and antibiotic use according to guidelines appeared inconsistent. Conclusion. Based on this audit, we suggest that current guidelines are not clear concerning management of acute diarrhoea in HIV-infected individuals, and that the lack of clear management strategies is likely to affect patient safety and increase antibiotic resistance.https://sajhivmed.org.za/index.php/hivmed/article/view/9HIVAIDSInfectious diarrhoeaNon-infectious diarrhoeaEmergency medicine |
| spellingShingle | Soren Kudsk-Iversen John Paul Gilbert Anneshree Azarath Management of patients presenting with diarrhoea to a regional emergency department in KwaZulu-Natal: Call for clearer, more relevant guidance Southern African Journal of HIV Medicine HIV AIDS Infectious diarrhoea Non-infectious diarrhoea Emergency medicine |
| title | Management of patients presenting with diarrhoea to a regional emergency department in KwaZulu-Natal: Call for clearer, more relevant guidance |
| title_full | Management of patients presenting with diarrhoea to a regional emergency department in KwaZulu-Natal: Call for clearer, more relevant guidance |
| title_fullStr | Management of patients presenting with diarrhoea to a regional emergency department in KwaZulu-Natal: Call for clearer, more relevant guidance |
| title_full_unstemmed | Management of patients presenting with diarrhoea to a regional emergency department in KwaZulu-Natal: Call for clearer, more relevant guidance |
| title_short | Management of patients presenting with diarrhoea to a regional emergency department in KwaZulu-Natal: Call for clearer, more relevant guidance |
| title_sort | management of patients presenting with diarrhoea to a regional emergency department in kwazulu natal call for clearer more relevant guidance |
| topic | HIV AIDS Infectious diarrhoea Non-infectious diarrhoea Emergency medicine |
| url | https://sajhivmed.org.za/index.php/hivmed/article/view/9 |
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