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. 2010 Dec;55(4):446-50.
doi: 10.1097/qai.0b013e3181eb611a.

Causes of early mortality in HIV-infected TB suspects in an East African referral hospital

Rachel Kyeyune  1 , Saskia den Boon, Adithya Cattamanchi, J Lucian Davis, William Worodria, Samuel D Yoo, Laurence Huang
Affiliations

Causes of early mortality in HIV-infected TB suspects in an East African referral hospital

Rachel Kyeyune et al. J Acquir Immune Defic Syndr. 2010 Dec.

Abstract

Background: Respiratory infections are a leading cause of death in Africa, especially among HIV-infected patients. Data on the etiology of fatal respiratory diseases are largely based on autopsy studies. We evaluated causes of pneumonia associated with early mortality among hospitalized HIV-infected patients in Kampala, Uganda.

Methods: Prospective cohort study of HIV-infected patients admitted to Mulago Hospital, Kampala, with at least 2 weeks of cough. Consecutively enrolled patients with negative Ziehl Neelsen sputum smears for acid-fast bacilli underwent bronchoscopy with bronchoalveolar lavage and examination for mycobacteria (smear, solid culture), Pneumocystis jirovecii (Giemsa stain), and fungi (KOH mount, India ink stain, Sabouraud culture). Early mortality was defined as death before the 2-month follow-up visit.

Results: Follow-up data were available for 353 (87%) of 407 patients enrolled. Of participants with follow-up data, 112 (32%) died within 2 months. Among patients with early mortality, a diagnosis was confirmed in 74 (66%), including tuberculosis (TB) (56%), cryptococcal pneumonia (1%), Pneumocystis pneumonia (3%), pulmonary Kaposi sarcoma (4%), and pneumonia caused by 2 or more disease processes (3%).

Conclusions: Mortality in HIV-infected TB suspects is high, with TB associated with the largest proportion of deaths. A significant proportion of patients die without a confirmed diagnosis.

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Figures

FIGURE 1
FIGURE 1
Study population. All percentages presented as a proportion of the total number of patients enrolled. Percentages may not sum to 100% because of rounding.
FIGURE 2
FIGURE 2
Survival time in days in patients who died.
See this image and copyright information in PMC

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