New Research on HIV/AIDS from University of Cape Town Summarized

According to the authors of a study from Rondebosch, South Africa, ". To define the patient population at Cape Town's district-level hospital offering specialist tuberculosis (TB) services, concerning the noted increase in complex, sick HIV-TB co-infected patients requiring increased levels of care."

"A cross-sectional study of all hospitalised adult patients in Brooklyn Chest Hospital (a district-level hospital offering specialist TB services) from 27 to 30 October 2008. Outcome measures were: type of TB and drug sensitivity, HIV co-infection, comorbidity, Karnofsky performance score, and frequency and reason for referral to other health care facilities.

More than two-thirds of patients in the acute wards were HIV-co-infected, of whom 98% had significant comorbidities and 60% had a Karnofsky performance score <= 30.

Twenty-eight per cent of patients did not have a confirmed diagnosis of TB.

In contrast, long-stay patients with multidrug-resistant (MDR), pre-extensively (pre-XDR) and extensively drug-resistant (XDR) TB had a lower prevalence of HIV co-infection, but manifested high rates of comorbidity.

Overall, one-fifth of patients required up-referral to higher levels of care.

District-level hospitals such as Brooklyn Chest Hospital that offer specialist TB services share the increasing burden of complex, sick, largely HIV-co-infected TB patients with their secondary and tertiary level counterparts," wrote der Plas H. van and colleagues, University of Cape Town.

The researchers concluded: "To support these hospitals effectively, outreach, skills transfer through training, and improved radiology resources are required to optimise patient care."

van and colleagues published the results of their research in SAMJ South African Medical Journal (High prevalence of comorbidity and need for up-referral among inpatients at a district-level hospital with specialist tuberculosis services in South Africa - the need for specialist support. SAMJ South African Medical Journal, 2011;101(8):529-532).

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