Admission characteristics, diagnoses and outcomes of HIV-Infected patients registered in an ambulatory HIV-Care programme in western kenya

A. M. Siika, P. O. Ayuo, A. W. Mwangij, John Sidle, Kara Wools-Kaloustian, S. N. Kimaiyo, W. M. Tierney

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: To determine admissions diagnosis and outcomes of HIV-infected patients attending AMPATH ambulatory HIV-care clinics. Design: Prospective cohort study. Setting: Academic Model for Prevention and Treatment of HIV/ AIDS (AMPATH) ambulatory HIV-care clinic in western Kenya. Results: Between January 2005 and December 2006,495 HIV-infected patients enrolled in AMPATH were admitted. Median age at admission was 38 years (range: 19 - 74), 62% females, 375 (76%) initiated cART a median 56 days (range: 1-1288) before admission. Majority (53%) had pre-admission CD4 counts <100 cells/ml and 23% had counts >200 cells/ml. Common admissions diagnoses were: tuberculosis (27%); pneumonia (15%); meningitis (11%); diarrhoea (11%); malaria (6%); severe anaemia (4%); and toxoplasmosis (3%). Deaths occurred in 147 (30%) patients who enrolled at AMPATH a median 44 days (range: 1 - 711) before admission and died a median 41 days (range: 1 -713) after initiating cART. Tuberculosis (27%) and meningitis (14%) were the most common diagnoses in the deceased. Median admission duration was six days (range: 1 - 30) for deceased patients and eight days (range: I - 44) for survivors (P=0.0024). Deceased patients enrolled in AMPATH or initiated cART more recently, had lower CD4 counts and were more frequently lost to follow-up than survivors (P<0.05 for each comparison). Initiation of cART before admission and clinic appointment adherence were independent predictors of survival. Conclusion: Although high mortality rate is seen in HIV-infected in-patients, those initiating cART before admission were more likely to survive.

Original languageEnglish
Pages (from-to)523-528
Number of pages6
JournalEast African Medical Journal
Volume85
Issue number11
StatePublished - Nov 2008

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Kenya
Ambulatory Care
HIV
Acquired Immunodeficiency Syndrome
CD4 Lymphocyte Count
Survivors
Therapeutics
Meningeal Tuberculosis
Lost to Follow-Up
Toxoplasmosis
Meningitis
Malaria
Anemia
Diarrhea
Pneumonia
Appointments and Schedules
Tuberculosis
Cohort Studies
Prospective Studies
Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Admission characteristics, diagnoses and outcomes of HIV-Infected patients registered in an ambulatory HIV-Care programme in western kenya. / Siika, A. M.; Ayuo, P. O.; Mwangij, A. W.; Sidle, John; Wools-Kaloustian, Kara; Kimaiyo, S. N.; Tierney, W. M.

In: East African Medical Journal, Vol. 85, No. 11, 11.2008, p. 523-528.

Research output: Contribution to journalArticle

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abstract = "Objective: To determine admissions diagnosis and outcomes of HIV-infected patients attending AMPATH ambulatory HIV-care clinics. Design: Prospective cohort study. Setting: Academic Model for Prevention and Treatment of HIV/ AIDS (AMPATH) ambulatory HIV-care clinic in western Kenya. Results: Between January 2005 and December 2006,495 HIV-infected patients enrolled in AMPATH were admitted. Median age at admission was 38 years (range: 19 - 74), 62{\%} females, 375 (76{\%}) initiated cART a median 56 days (range: 1-1288) before admission. Majority (53{\%}) had pre-admission CD4 counts <100 cells/ml and 23{\%} had counts >200 cells/ml. Common admissions diagnoses were: tuberculosis (27{\%}); pneumonia (15{\%}); meningitis (11{\%}); diarrhoea (11{\%}); malaria (6{\%}); severe anaemia (4{\%}); and toxoplasmosis (3{\%}). Deaths occurred in 147 (30{\%}) patients who enrolled at AMPATH a median 44 days (range: 1 - 711) before admission and died a median 41 days (range: 1 -713) after initiating cART. Tuberculosis (27{\%}) and meningitis (14{\%}) were the most common diagnoses in the deceased. Median admission duration was six days (range: 1 - 30) for deceased patients and eight days (range: I - 44) for survivors (P=0.0024). Deceased patients enrolled in AMPATH or initiated cART more recently, had lower CD4 counts and were more frequently lost to follow-up than survivors (P<0.05 for each comparison). Initiation of cART before admission and clinic appointment adherence were independent predictors of survival. Conclusion: Although high mortality rate is seen in HIV-infected in-patients, those initiating cART before admission were more likely to survive.",
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AU - Siika, A. M.

AU - Ayuo, P. O.

AU - Mwangij, A. W.

AU - Sidle, John

AU - Wools-Kaloustian, Kara

AU - Kimaiyo, S. N.

AU - Tierney, W. M.

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N2 - Objective: To determine admissions diagnosis and outcomes of HIV-infected patients attending AMPATH ambulatory HIV-care clinics. Design: Prospective cohort study. Setting: Academic Model for Prevention and Treatment of HIV/ AIDS (AMPATH) ambulatory HIV-care clinic in western Kenya. Results: Between January 2005 and December 2006,495 HIV-infected patients enrolled in AMPATH were admitted. Median age at admission was 38 years (range: 19 - 74), 62% females, 375 (76%) initiated cART a median 56 days (range: 1-1288) before admission. Majority (53%) had pre-admission CD4 counts <100 cells/ml and 23% had counts >200 cells/ml. Common admissions diagnoses were: tuberculosis (27%); pneumonia (15%); meningitis (11%); diarrhoea (11%); malaria (6%); severe anaemia (4%); and toxoplasmosis (3%). Deaths occurred in 147 (30%) patients who enrolled at AMPATH a median 44 days (range: 1 - 711) before admission and died a median 41 days (range: 1 -713) after initiating cART. Tuberculosis (27%) and meningitis (14%) were the most common diagnoses in the deceased. Median admission duration was six days (range: 1 - 30) for deceased patients and eight days (range: I - 44) for survivors (P=0.0024). Deceased patients enrolled in AMPATH or initiated cART more recently, had lower CD4 counts and were more frequently lost to follow-up than survivors (P<0.05 for each comparison). Initiation of cART before admission and clinic appointment adherence were independent predictors of survival. Conclusion: Although high mortality rate is seen in HIV-infected in-patients, those initiating cART before admission were more likely to survive.

AB - Objective: To determine admissions diagnosis and outcomes of HIV-infected patients attending AMPATH ambulatory HIV-care clinics. Design: Prospective cohort study. Setting: Academic Model for Prevention and Treatment of HIV/ AIDS (AMPATH) ambulatory HIV-care clinic in western Kenya. Results: Between January 2005 and December 2006,495 HIV-infected patients enrolled in AMPATH were admitted. Median age at admission was 38 years (range: 19 - 74), 62% females, 375 (76%) initiated cART a median 56 days (range: 1-1288) before admission. Majority (53%) had pre-admission CD4 counts <100 cells/ml and 23% had counts >200 cells/ml. Common admissions diagnoses were: tuberculosis (27%); pneumonia (15%); meningitis (11%); diarrhoea (11%); malaria (6%); severe anaemia (4%); and toxoplasmosis (3%). Deaths occurred in 147 (30%) patients who enrolled at AMPATH a median 44 days (range: 1 - 711) before admission and died a median 41 days (range: 1 -713) after initiating cART. Tuberculosis (27%) and meningitis (14%) were the most common diagnoses in the deceased. Median admission duration was six days (range: 1 - 30) for deceased patients and eight days (range: I - 44) for survivors (P=0.0024). Deceased patients enrolled in AMPATH or initiated cART more recently, had lower CD4 counts and were more frequently lost to follow-up than survivors (P<0.05 for each comparison). Initiation of cART before admission and clinic appointment adherence were independent predictors of survival. Conclusion: Although high mortality rate is seen in HIV-infected in-patients, those initiating cART before admission were more likely to survive.

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