Prevalence and clinical presentation of HIV infection among newly hospitalised surgical patients at Muhimbili National Hospital, Dar es Salaam, Tanzania

East Afr Med J. 2003 Dec;80(12):640-5. doi: 10.4314/eamj.v80i12.8781.

Abstract

Background: In Tanzania information is lacking on the prevalence of HIV infection in surgical patients in tertiary care facilities, in whom there are many points of special interest.

Objective: To determine the prevalence of HIV infection and associated clinical and demographic features among hospitalised surgical patients at Muhimbili National Hospital (MNH).

Setting: Muhimbili National Hospital.

Materials and methods: Consecutive newly admitted patients were tested for HIV antibodies after pre-test counselling. Sera were tested using a dual ELISA algorithm. The data were analysed to determine the prevalence of HIV infection and relationships of serostatus with clinical and socio-demographic characteristics.

Results: Of 1,534 patients admitted during the study, 1,031(67.2%) consented to HIV testing following pre-test counselling. The prevalence of AIDS-related clinical features in patients who declined to be HIV tested was similar to that of seronegative patients, but significantly lower than that of seropositive patients. The overall age-adjusted HIV prevalence was 10.5% (95% CI = 9.9-14.0). The highest age-specific HIV prevalence was in the age group 35-44 years at 27.9%. No one was infected in the age group 0-4 years (n = 111). Differences in prevalence between age groups were statistically significant (p < 0.0001). Patients with granulomatous and suppurative infections had HIV prevalence of 28.3%. Twenty of 124 seropositive patients (16.1%) died in hospital compared to 58 of 907(6.4%) of seronegative patients (p = 0.0001).

Conclusion: At Muhumbili National Hospital overall HIV prevalence in hospitalised surgical patients were 10.5%, compared to an overall national prevalence of 6.7%. Patients in the age groups 25 to 34 and 35 to 44 years had HIV seroprevalence of 26.8% and 27.9% respectively. Patients with infective conditions had the highest HIV prevalence. HIV seropositive patients were associated with higher hospital mortality than seronegative patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS Serodiagnosis
  • Adolescent
  • Adult
  • Age Distribution
  • Child
  • Child, Preschool
  • Comorbidity
  • Counseling
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • HIV Infections / complications
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology*
  • HIV Seroprevalence*
  • Hospital Mortality
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Population Surveillance
  • Risk Factors
  • Sex Distribution
  • Socioeconomic Factors
  • Surgical Procedures, Operative / statistics & numerical data*
  • Tanzania / epidemiology