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


METHODS
Muhimbili National Hospital.


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).


CONCLUSIONS
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.
Mkony
C
C
Department of Surgery, Muhimbili University College of Health Sciences, P.O Box 65001, Dar es Salaam, Tanzania.
Kwesigabo
G
G
Lyamuya
E
E
Mhalu
F
F
D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003376:Counseling; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015528:HIV Seroprevalence; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D013636:Tanzania / Q000453:epidemiology