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Free Content Tuberculous pericardial effusion: a prospective clinical study in a low-resource setting—Blantyre, Malawi

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SETTING: Queen Elizabeth Central Hospital, Blantyre, Malawi.

OBJECTIVE: Review of clinical and investigation findings and outcome, using a standard management protocol, in human immunodeficiency virus (HIV)-positive and HIV-negative patients with tuberculous pericardial effusion, in a low-resource setting in sub-Saharan Africa.

DESIGN: A prospective study under field conditions of adult patients with tuberculous pericardial effusion admitted to Queen Elizabeth Central Hospital between May 1993 and December 1994.

RESULTS: In total 77 patients fulfilled the diagnostic criteria for tuberculous pericardial effusion. Of 74 patients sero-tested, 68 (92%) were HIV seropositive. Classical clinical features of pericardial effusion were often absent. Many patients had no other clinical features of HIV infection. Outcome compared favourably with quoted survival rates from the pre-HIV era.

CONCLUSION: Tuberculous pericardial effusion is a common problem in Blantyre and is strongly associated with HIV infection. Successful management using a standard protocol is possible in a low-resource setting.

Keywords: Malawi; pericardial effusion; pericardium; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland, 2: Department of Medicine, University of Malawi College of Medicine, Blantyre, Malawi

Publication date: 1997-08-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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