Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Dec;41(4):163-70.
doi: 10.2149/tmh.2013-12. Epub 2013 Nov 30.

Prevalence of HIV and Disease Outcomes on the Medical and Surgical Wards at Kamuzu Central Hospital, Lilongwe, Malawi

Claire E Kendig  1 , Denise J McCulloch  1 , Nora E Rosenberg  1 , Jonathan C Samuel  2 , Charles Mabedi  3 , Carol G Shores  4 , Mina C Hosseinipour  5 , Mitch Matoga  6 , Anthony G Charles  2
Affiliations

Prevalence of HIV and Disease Outcomes on the Medical and Surgical Wards at Kamuzu Central Hospital, Lilongwe, Malawi

Claire E Kendig et al. Trop Med Health. 2013 Dec.

Abstract

Introduction: The World Health Organization (WHO) recommends HIV Counseling and Testing (HCT) in a range of clinical settings. We describe the characteristics of patients diagnosed with HIV on the medical and surgical wards at a tertiary care hospital in Malawi.

Methods: Under the universal opt-out HCT protocol we characterized the number of new HIV/AIDS infections and associated clinical features among hospitalized surgical and medical patients diagnosed during the course of admission.

Results: All 2985 and 3959 medical and surgical patients, respectively, admitted between April 2012 and January 2013 were screened for HCT. 62% and 89% of medical and surgical patients, respectively, had an unknown status on admission and qualified for testing. Of the patients with an unknown status, a new HIV diagnosis was made in 20% and 7% of medical and surgical patients, respectively. Of the newly diagnosed patients with a CD4 count recorded, 91% and 67% of medical and surgical patients, respectively, had a count less than 350, qualifying for ART by Malawi ART guidelines. Newly HIV-diagnosed medical and surgical patients had an inpatient mortality of 20% and 2%, respectively.

Discussion: While newly diagnosed HIV-positive medical patients had high inpatient mortality and higher rates of WHO stage 3 or 4 conditions, surgical patients presented with less advanced HIV, though still meeting ART initiation guidelines. The medical inpatient wards are an obvious choice for implementing voluntary counseling and testing (VCT), but surgical patients present with less advanced disease and starting treatment in this group could result in more years of life gained.

Keywords: HIV counseling and testing; inpatient; medicine; sub-Saharan Africa; surgery.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
CD4 counts in medicine and surgery patients with a new HIV diagnosis at KCH
See this image and copyright information in PMC

References

    1. UNAIDS world AIDS day report 2012 fact sheet: Sub-saharan africa [Internet]. Geneva: Joint United Nations Program on HIV/AIDS (UNAIDS); 2012; cited March 6, 2013]. Available from: http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiolo....
    1. Bunnell R, Cherutich P. Universal HIV testing and counselling in Africa. Lancet 2008; 371: 2148–2150 - PubMed
    1. Wanyenze RK, Nawavvu C, Namale AS, Mayanja B, Bunnell R, Abang B, Amanyire G, Sewankambo NK, Kamya MR. Acceptability of routine HIV counselling and testing, and HIV seroprevalence in Ugandan hospitals. Bull World Health Organ 2008; 86(4): 302–309 - PMC - PubMed
    1. Marum E. Innovations, issues and debates in HIV testing and counselling. HIV/AIDS Implementers Conference, Windhoek, Namibia, June 13, 2009
    1. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: Implications for HIV prevention programs. J Acquir Immune Defic Syndr 2005; 39(4): 446–453 - PubMed

LinkOut - more resources