Estimating HIV prevalence and the impact of HIV/AIDS on a Ugandan hospital by combining serosurvey data and hospital discharge records
Estimating HIV prevalence and the impact of HIV/AIDS on a Ugandan hospital by combining serosurvey data and hospital discharge records
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DOI：
10.1097/00126334-200309010-00009
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发表时间：
2003-09-01
影响因子：
3.6
通讯作者：
Declich, S
中科院分区：
文献类型：
--
作者：
Fabiani, M;Accorsi, S;Declich, S
目的：估计乌干达北方一家医院特定疾病的艾滋病毒流行率，并评估艾滋病毒/艾滋病对医院服务的影响。设计：艾滋病毒血清调查和对常规编制的医院记录的分析。方法：血清调查是在1999年3月入住拉科医院内科病房的所有352名患者中进行的（该病房由3个单元组成：全科、结核病和癌症）。使用1999年收治的所有3447名患者的出院记录，结合血清调查数据，估计了对医院服务的影响，并表示为艾滋病毒阳性患者的住院天数百分比。总体艾滋病毒感染率为42.0%（普通内科、结核科和癌症科分别为52.6%、44.6%和13.2%）。结核病、肺炎、疟疾和肠炎患者的疾病特异性患病率范围为45-65%。与HIV阴性患者相比，HIV阳性患者的住院死亡率更高（14.6%对3.0%），平均住院时间更短（41.4%对48.9天）。艾滋病病例占住院人数的5.0%，占住院天数的4.1%，占死亡人数的11.5%。当考虑到所有的HIV阳性患者，这些占37.2%的bed-days.Conclusions：特定疾病的艾滋病毒感染率和艾滋病毒相关疾病的模式的知识是至关重要的早期病例管理。艾滋病毒抗体阳性患者对医院服务的影响相当大，1999年占住院日的三分之一以上。通过住院、门诊和外展家庭护理服务提供连续的护理可能是减轻超负荷医院压力的唯一手段。
Objective: To estimate the disease-specific HIV prevalence in a northern Ugandan hospital and to evaluate the impact of HIV/AIDS on hospital services.Design: HIV serosurvey and analysis of routinely compiled hospital records.Methods: The serosurvey was conducted among all 352 patients admitted to the medical ward of the Lacor Hospital in March 1999 (this ward consists of 3 units: general medicine, tuberculosis, and cancer). The impact on hospital services was estimated using the hospital discharge records for all 3447 patients admitted in 1999, in combination with serosurvey data, and was expressed as the percentage of bed-days attributable to HIV-positive patients.Results: The overall HIV prevalence was 42.0% (52.6, 44.6, and 13.2% in the general medicine, tuberculosis, and cancer units, respectively). The disease-specific prevalence ranged from 45-65% for patients with tuberculosis, pneumonia, malaria, and enteritis. HIV-positive patients, compared with HIV-negative patients, had a higher in-hospital mortality (14.6 vs. 3.0%) and a lower average length of stay (41.4 vs. 48.9 days). AIDS cases accounted for 5.0% of hospital admissions, 4.1% of bed-days, and 11.5% of deaths. When considering all HIV-positive patients, these accounted for 37.2% of the bed-days.Conclusions: Knowledge of disease-specific HIV prevalence and of the patterns of HIV-related diseases is crucial for early case management. The impact of HIV-positive patients on hospital services is quite high, accounting for > 1/3 of the bed-days in 1999. Providing a continuum of care through inpatient, outpatient, and outreach home care services probably represents the only means of relieving the pressure on overloaded hospitals.