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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
High rates of HIV in surgical patients in Soweto, South Africa: impact on resource utilisation and recommendations for HIV testing
Transactions of the Royal Society of Tropical Medicine and Hygiene, Volume 101, No. 2, Year 2007
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Description
Interactions between HIV and surgical diseases are relatively poorly described in high HIV prevalence settings. We report HIV prevalence and its associations in a prospective study of adults admitted to surgical units in Soweto, South Africa. Voluntary counselling and testing (VCT) for HIV was offered to surgical inpatients. Research nurses interviewed participants at enrolment and doctors reviewed records after discharge. In HIV-infected participants, CD4 counts and viral loads were ascertained. Of 1000 participants, 537 consented to VCT, of whom 176 (32.8%, 95% CI 28.8-36.9%) tested HIV positive. A history of tuberculosis (adjusted odds ratio (AOR) 3.0, 95% CI 1.5-6.2) or sexually transmitted infection (AOR 2.7, 95% CI 1.8-4.2) was associated with HIV infection. Diagnoses of cutaneous abscesses (OR 3.4, 95% CI 1.4-8.1) and anorectal sepsis (OR 3.1, 95% CI 1.1-9.0) were associated with HIV and indicated advanced disease. There were no differences in rates of operative procedures, wound sepsis, investigations or length of stay by HIV status. Hospital-acquired pneumonia was more common in HIV-infected participants (P = 0.028). In conclusion, in this high HIV prevalence setting, resource utilisation is similar between HIV-infected and uninfected patients in surgical wards where high rates of HIV in young adults support routine HIV testing. WHO clinical staging of HIV should include anal sepsis as an indicator of advanced HIV disease. © 2006 Royal Society of Tropical Medicine and Hygiene.
Authors & Co-Authors
Martinson, Neil Alexander
South Africa, Johannesburg
University of the Witwatersrand
United States, Baltimore
Johns Hopkins University
Omar, Tanvier
South Africa, Johannesburg
University of the Witwatersrand
Gray, Glenda E.
South Africa, Johannesburg
University of the Witwatersrand
Vermaak, Jacobus S.
South Africa, Johannesburg
University of the Witwatersrand
Badicel, Maria
South Africa, Johannesburg
University of the Witwatersrand
Degiannis, Elias D.
South Africa, Johannesburg
University of the Witwatersrand
Steyn, Jan G.
South Africa, Johannesburg
University of the Witwatersrand
McIntyre, James Alasdair
South Africa, Johannesburg
University of the Witwatersrand
Smith, Martin Derrick
South Africa, Johannesburg
University of the Witwatersrand
Statistics
Citations: 18
Authors: 9
Affiliations: 2
Identifiers
Doi:
10.1016/j.trstmh.2006.04.002
ISSN:
00359203
Research Areas
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Study Locations
South Africa