Abstract
BackgroundHigh rates of HIV infection have decreased life expectancy in many African countries. Regardless of worldwide efforts to escalate treatment, care and prevention strategies, the number of deaths due to AIDS-related disorders is still high. Local healthcare workers suspect that there are modifiable factors in the care of HIV and/or AIDS patients which can be identified and improved.AimTo describe the HIV and/or AIDS-related causes of adult mortality and identify modifiable factors amongst patients admitted to Oshakati Intermediate Hospital, northern Namibia.MethodsData was extracted retrospectively and coded using the modified CoDe protocol for AIDS. Modifiable factors relating to the patient, health system or clinical care were identified using a standardised data collection tool.ResultsA total of 177 HIV and/or AIDS patients were identified, 94 (53.1%) were male and 120 (68%) had a CD4 count of less than 200 cells/mL. The common HIV-related causes of death were tuberculosis (25.9%), renal failure (15.8%), Pneumocystis jirovecii pneumonia (11.3%), cryptococcal meningitis (9%), HIV wasting syndrome (7.9%) and AIDS-defining malignancy (7.9%). The analysis revealed 281 modifiable factors; patient-related factors were the most common (153 [54.4%]), followed by health system factors (97 [34.5%]) and healthcare personnel factors (31 [11%]).ConclusionOur findings have highlighted the challenges in overall HIV and/or AIDS inpatient care and surrounding primary care facilities. The identification of specific modifiable factors can be used to reduce mortality by providing training as well as rational monitoring, planning and resource allocation.
Highlights
HIV and/or AIDS is one of the major global public health problems and causes substantial morbidity, mortality, negative socio-economic impact, and human suffering.[1,2] Since the beginning of 1981, HIV and/or AIDS has become a pandemic disease, claiming some 20 million lives.[1]
The study was undertaken at Oshakati Intermediate Hospital, which is located in Oshana region, northern Namibia
Of 177 audited folders, 94 (53.1%) patients were on highly active antiretroviral therapy (HAART) and 48 (51.1%) had been initiated on HAART within the previous 90 days
Summary
HIV and/or AIDS is one of the major global public health problems and causes substantial morbidity, mortality, negative socio-economic impact, and human suffering.[1,2] Since the beginning of 1981, HIV and/or AIDS has become a pandemic disease, claiming some 20 million lives.[1]. Sub-Saharan Africa, with only 12% of the global population, ranks top amongst the regions that are drastically affected by HIV.[3] The region contributes 68% of all HIV and/or AIDS patients in the world, whilst South-East Asia has 12%, Eastern Europe and Central Asia 4%, Latin America 4% and North America 4%. South Africa has the highest number of people living with HIV and/or AIDS (having more than 4 million patients).[2]. Regardless of worldwide efforts to escalate treatment, care and prevention strategies, the number of deaths due to AIDS-related disorders is still high. Local healthcare workers suspect that there are modifiable factors in the care of HIV and/or AIDS patients which can be identified and improved
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