Article
HIV infection and in-hospital mortality at an academic hospital
in South Africa
Karen Zwi, John Pettifor, Neil Soderlund, Tammy Meyers
Division of
Community Paediatrics, University of the Witwatersrand, PO WITS 2050, South Africa
Correspondence to: Dr K Zwi email: karen_zwi{at}bigpond.com
Accepted 24 March 2000
AIM
To document the impact that
rapid increases in HIV infection in hospitalised children at Chris Hani
Baragwanath Hospital has had on in-hospital mortality.
METHODSHospital discharge
summaries from January 1992 to the end of 1996 were reviewed.
RESULTSThere were 20 733
admissions in the five year period; 7985 (39%) were tested for HIV. In
tested admissions above 15 months of age, 4.9% were HIV infected in
1992, increasing to 35% in 1996. Under 15 months of age, 9% of tested
admissions were positive in 1992, increasing to 46% in 1996. The
proportion of all hospital deaths occurring in children considered HIV
infected (ELISA testing together with clinical features if 15 months or
younger) increased from 6.7% in 1992 to 46.1% in 1996 (p < 0.001).
In-hospital mortality for all children increased by 21% from 4.3% in
1992 to 5.2% in 1996. Mortality rates declined in uninfected children
from 5.4% in 1992 to 4.5% in 1996 (
2 trend 3.3;
p = 0.06).
CONCLUSIONThe mortality rate of
children has increased at Chris Hani Baragwanath Hospital as a result
of HIV infection. Almost half the deaths were HIV related in 1996. HIV
infection is threatening the advances that have been made on child
survival in South Africa over the last few decades.
Keywords: hospital mortality; HIV infection; AIDS; child mortality; mortality rates; South Africa
© 2000 by Archives of Disease in Childhood
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- HARVEY MARCOVITCH
Arch. Dis. Child. 2000 83: 0.[Extract] [Full Text] [PDF]
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