Symptoms and sites of pain experienced by AIDS patients.
BACKGROUND
HIV/AIDS is the top single cause of mortality burden in South Africa and patients with AIDS present with unique and challenging symptoms and pain syndromes.


OBJECTIVE
To identify and increase awareness of the 10 most prevalent symptoms and 5 most common sites of pain in patients with advanced AIDS.


METHODS
A nurse-led questionnaire was used to collect data, and a descriptive, quantitative analysis was done. Subjects included 103 adult patients with World Health Organisation (WHO) stage 4 AIDS. Patients with impaired cognitive function were excluded.


METHODS
The main outcome measures included a list of 30 symptoms, 13 site-specific pains, age, gender, worst overall symptom and access to antiretroviral therapy (ART). Results were based on review of data collected between May 2002 and February 2003.


RESULTS
Results showed the mean age of patients to be 35.4 years, with females an average of 4.4 years younger than males. There were a higher number of female respondents (62.6%) than males (37.4%). The 10 most common symptoms in order of prevalence were pain (98%), weight loss (81%), loss of appetite (70.9%), low mood (69.9%), weakness (66%), dry skin (56.3%), diarrhoea (53.4%), nausea and vomiting (44.7%), cough (44.7%) and fatigue (42.7%). Of the of respondents 34.4% mentioned pain as the worst overall symptom. The average number of pains experienced was 2.91. Females reported significantly more anxiety, genital sores and pain than males. Of the patients 3.9% had had access to ART. Lower limb pain was the most prevalent pain (66%) followed by mouth pain (50.5%), headache (42.3%), throat pain (39.8%) and chest pain (17.5%).


CONCLUSIONS
Patients with advanced AIDS in South Africa suffer significantly from pain and many distressing symptoms. In the light of the HIV/AIDS pandemic in South Africa reforms are needed to increase knowledge and education in the palliative management of AIDS.
Norval
D A
DA
Centre for Palliative Learning, Hospice Association of the Witwatersrand, Johannesburg.
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active; D001007:Anxiety / Q000453:epidemiology / Q000628:therapy; D003863:Depression / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000473:pathology*; D059408:Pain Management; D010166:Palliative Care; D015995:Prevalence; D012737:Sex Factors; D013019:South Africa / Q000453:epidemiology; D016896:Treatment Outcome