Inpatient mortality of HIV-infected adults in sub-Saharan Africa and possible interventions: a mixed methods review. Review uri icon

Overview

abstract

  • BACKGROUND: Despite the increased availability of anti-retroviral therapy, in-hospital HIV mortality remains high in sub-Saharan Africa. Reports from Senegal, Malawi, and Tanzania show rates of in-hospital, HIV-related mortality ranging from 24.2% to 44%. This mixed methods review explored the potential causes of preventable in-hospital mortality associated with HIV infections in sub-Saharan Africa in the anti-retroviral era. RESULTS: Based on our experience as healthcare providers in Africa and a review of the literature we identified 5 health systems failures which may cause preventable in-hospital mortality, including: 1) late presentation of HIV cases, 2) low rates of in-hospital HIV testing, 3) poor laboratory capacity which limits CD4 T-cell testing and the diagnosis of opportunistic infections, 4) delay in initiation of anti-retroviral therapy in-hospital, and 5) problems associated with loss to follow-up upon discharge from hospital. CONCLUSION: Our findings, together with the current available literature, should be used to develop practical interventions that can be implemented to reduce in-hospital mortality.

publication date

  • December 3, 2014

Research

keywords

  • HIV Infections
  • Hospital Mortality
  • Inpatients

Identity

PubMed Central ID

  • PMC4265398

Scopus Document Identifier

  • 84988643551

Digital Object Identifier (DOI)

  • 10.1371/journal.pmed.1000173

PubMed ID

  • 25465206

Additional Document Info

volume

  • 14