A Study on the Assessment of Hiv Related Emergency Visit During the Haart Era in Six Public Hospitals of Addis Ababa
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Date
2015-06
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Addis Ababa University
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
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.
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%.
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Keywords
Public Hospitals