An autopsy study describing causes of death and comparing clinico-pathological findings among hospitalized patients in Kampala, Uganda.
An autopsy study describing causes of death and comparing clinico-pathological findings among hospitalized patients in Kampala, Uganda.
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DOI：
10.1371/journal.pone.0033685
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Manabe YC
中科院分区：
文献类型：
--
作者：
Cox JA;Lukande RL;Nelson AM;Mayanja-Kizza H;Colebunders R;Van Marck E;Manabe YC
关于撒哈拉以南非洲艾滋病毒感染者死亡原因的信息主要来自观察性队列研究和死因推断研究。尸检是确定死因的黄金标准。我们进行了一项尸检研究，以描述和比较临床和尸检的死亡原因和贡献的结果在住院的艾滋病毒感染和艾滋病毒未感染的患者在乌干达。2009年5月至9月，对乌干达坎帕拉Mulago医院传染病胃肠病综合病房死亡的病人进行了全面尸检。尸检死因和相关发现基于宏观和微观尸检结果以及临床信息。临床诊断由病房医生报告，并根据从病历中获得的信息分为确诊、高度怀疑、考虑或不考虑。根据HIV血清状态报告结果。在66%的HIV阳性、21%的HIV阴性和13%的HIV血清学状态未知的患者中进行了53次完整的尸检。感染性疾病导致83%的艾滋病毒阳性患者死亡，其中传播性结核病是导致37%死亡的主要诊断。艾滋病毒阳性患者和艾滋病毒阴性患者的疾病谱和死亡原因有很大不同。在艾滋病毒阳性患者中，12%的尸检诊断得到临床证实，27%高度怀疑，16%考虑，45%未考虑。在HIV阴性患者中，17%的尸检诊断被临床高度怀疑，42%被考虑，42%未被考虑。尸检仍然是确定死亡原因的一个重要工具，特别是在生命期间获得诊断检测的机会有限的情况下。艾滋病毒阳性患者继续死于可治疗和临床上未确诊的传染病。在快速护理点检测可用于确认常见感染之前，应进一步研究经验性治疗。
Information on causes of death in HIV-infected patients in Sub-Saharan Africa is mainly derived from observational cohort and verbal autopsy studies. Autopsy is the gold standard to ascertain cause of death. We conducted an autopsy study to describe and compare the clinical and autopsy causes of death and contributory findings in hospitalized HIV-infected and HIV-uninfected patients in Uganda. Between May and September 2009 a complete autopsy was performed on patients that died on a combined infectious diseases gastroenterology ward in Mulago Hospital in Kampala, Uganda. Autopsy cause of death and contributing findings were based on the macro- and microscopic post-mortem findings combined with clinical information. Clinical diagnoses were reported by the ward doctor and classified as confirmed, highly suspected, considered or not considered, based on information derived from the medical chart. Results are reported according to HIV serostatus. Fifty-three complete autopsies were performed in 66% HIV-positive, 21% HIV-negative and 13% patients with an unknown HIV serological status. Infectious diseases caused death in 83% of HIV-positive patients, with disseminated TB as the main diagnosis causing 37% of deaths. The spectrum of illness and causes of death were substantially different between HIV-positive and HIV-negative patients. In HIV-positive patients 12% of postmortem diagnoses were clinically confirmed, 27% highly suspected, 16% considered and 45% not considered. In HIV-negative patients 17% of postmortem diagnoses were clinically highly suspected, 42% considered and 42% not considered. Autopsy examination remains an important tool to ascertain causes of death particularly in settings with limited access to diagnostic testing during life. HIV-positive patients continue to die from treatable and clinically undiagnosed infectious diseases. Until rapid-point of care testing is available to confirm common infections, empiric treatment should be further investigated.
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影响因子：
3.8
作者：
Murray, Jill;Sonnenberg, Pam;Glynn, Judith R.
通讯作者：
Glynn, Judith R.
影响因子：
3.8
作者：
Martinson, Neil A.;Karstaedt, Alan;Hale, Martin
通讯作者：
Hale, Martin
DOI：
10.1097/qai.0b013e3181eb611a
发表时间：
2010-12
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Kyeyune R;den Boon S;Cattamanchi A;Davis JL;Worodria W;Yoo SD;Huang L
通讯作者：
Huang L
影响因子：
9.4
作者：
Ioannidis, Panayotis;Papaventsis, Dimitrios;Kanavaki, Sofia
通讯作者：
Kanavaki, Sofia
DOI：
10.1093/cid/cir379
发表时间：
2011-08
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Lindsley MD;Mekha N;Baggett HC;Surinthong Y;Autthateinchai R;Sawatwong P;Harris JR;Park BJ;Chiller T;Balajee SA;Poonwan N
通讯作者：
Poonwan N