Patterns and trends in mortality among HIV-infected and HIV-uninfected patients in a major Internal Medicine Unit in Yaoundé, Cameroon: a retrospective cohort study.
OBJECTIVE
To describe the trends in mortality and the spectrum of disease in HIV-infected and -uninfected inpatients in a population in Yaoundé.


METHODS
A retrospective study.


METHODS
Internal Medicine Unit, University Hospital Centre, Yaoundé, Cameroon.


METHODS
All deaths registered between January 2000 and May 2007 in the unit.


METHODS
Sociodemographic characteristics, clinical features and results of all investigations done, cause of death.


RESULTS
During the study period, 362 deaths were registered, consisting of 281 (77.6%) in HIV-infected patients, 54.4% of which were women. HIV-infected patients were younger (mean age: 40.2 (SD: 11.6) vs. 55.5 (SD: 18.3) years, p < 0.001) and economically active (60.3% vs. 24.4%, p < 0.001). Most HIV-infected patients (77.6%) were classified as WHO stage IV, with the rest being WHO stage III. Most HIV-infected patients (87.8%) had evidence of profound immunosuppression (CD4 < 200 cells/mm(3)). The mortality trend appeared to be declining with appropriate interventions. The most frequent causes of death in HIV-infected patients were pleural/pulmonary tuberculosis (34.2%), undefined meningoencephalitis (20.3%), other pneumonias (18.2%), toxoplasmosis (16.4%), cryptococcal meningitis (14.2%) and Kaposi sarcoma (15.7%). HIV-uninfected patients died mostly as a result of chronic diseases including liver diseases (17.3%), kidney failure (13.6%), congestive heart failure (11.1%) and stroke (9.9%).


CONCLUSIONS
There was a declining mortality due to HIV with appropriate interventions such as subsidised tests for HIV-infected patients, increased availability of HAART and other medications for prevention and treatment of opportunistic infections. The spectrum of HIV disease was wide and preventable.
Faculty of Health Sciences, University of Buea, PO Box 63, Buea, Cameroon; Internal Medicine Unit, Buea Regional Hospital, PO Box 32, Buea, Cameroon.
Josephine
J
Mbuagbaw
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon.
Ahmadou M
AM
Jingi
Department of Medicine, Groote Schuur Hospital and University of Cape Town, 7925 Cape Town, South Africa; Medical Diagnostic Center, PO Box 6230, Yaoundé, Cameroon.
Jean Jacques N
JJ
Noubiap
Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA.
Arnaud D
AD
Kaze
Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon.
Jobert Richie N
JR
Nansseu
Department of Epidemiology and Public Health, Pasteur Center of Cameroon, PO Box 1274, Yaoundé, Cameroon.
Jean Joel R
JJ
Bigna
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon; Internal Medicine Unit, Yaoundé University Hospital Centre, PO Box 4806, Yaoundé, Cameroon.
Edvine
E
Wawo Yonta
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 1364, Yaoundé, Cameroon; Internal Medicine Unit, Yaoundé University Hospital Centre, PO Box 4806, Yaoundé, Cameroon.
Kathleen
K
Ngu Blackett
Cameroon; HIV; morbidity; mortality; sub-Saharan Africa
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