Causes of early mortality in HIV-infected TB suspects in an East African referral hospital.
Causes of early mortality in HIV-infected TB suspects in an East African referral hospital.
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DOI：
10.1097/qai.0b013e3181eb611a
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发表时间：
2010-12
期刊：
影响因子：
--
通讯作者：
Huang L
中科院分区：
文献类型：
--
作者：
Kyeyune R;den Boon S;Cattamanchi A;Davis JL;Worodria W;Yoo SD;Huang L
呼吸道感染是非洲死亡的主要原因，特别是在艾滋病毒感染者中。关于致命呼吸道疾病病因的数据主要基于尸检研究。我们评估了乌干达坎帕拉住院的HIV感染患者中与早期死亡率相关的肺炎原因。对坎帕拉Mulago医院收治的咳嗽至少2周的HIV感染患者进行的前瞻性队列研究。连续入组的Ziehl Neelsen痰涂片抗酸杆菌阴性的患者接受支气管镜检查和支气管肺泡灌洗，并检查分枝杆菌（涂片，固体培养）、耶氏肺孢子虫（Giemsa染色）和真菌（KOH涂片，印度墨水染色，Sabouraud培养）。早期死亡率定义为2个月随访访视前死亡。407例入组患者中有353例（87%）的随访数据可用。在有随访数据的参与者中，112人（32%）在2个月内死亡。在早期死亡的患者中，74例（66%）确诊，包括结核病（TB）（56%）、隐球菌肺炎（1%）、肺孢子虫肺炎（3%）、肺卡波西肉瘤（4%）和2种或2种以上疾病引起的肺炎（3%）。感染艾滋病毒的结核病嫌疑人的死亡率很高，其中结核病与死亡的最大比例有关。很大一部分患者在没有确诊的情况下死亡。
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. 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. 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%). 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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影响因子：
3.8
作者：
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10.1016/j.trstmh.2008.10.001
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