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Free Content Tuberculosis at Edendale Hospital in Pietermaritzburg, KwaZulu Natal, South Africa

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Abstract:

SETTING: Edendale Hospital, Pietermaritzburg, KwaZulu Natal, South Africa, a 1275-bed hospital that serves a mainly ethnic African population of 1.6 million.

OBJECTIVE: To describe the demographic and clinical characteristics of hospitalised active tuberculosis (TB) cases, and correlates of their in-hospital survival.

METHODS: A retrospective cohort study of adult TB cases admitted to the medical wards, 16 November to 13 December 2001.

RESULTS: Of 760 (28%) admissions, 215 had active TB, of whom 26.5% died in hospital. Patients were mostly young, first diagnosed on admission, and had pulmonary TB. Human immunodeficiency virus (HIV) co-infection was common and predicted by lower absolute lymphocyte count (OR 1.2, 95%CI 1.05–1.38). Extra-pulmonary TB, including pleural and pericardial, was significantly associated with not having HIV infection. In-hospital death was predicted by TB diagnosed prior to admission (OR 3.18, 95%CI 1.67–6.07), acquired immune-deficiency syndrome (AIDS) associated disease, and higher total leukocyte count—by higher leukocytes only in patients without AIDS (OR 8.52, 95%CI 2.67–27.13).

CONCLUSION: Active TB was common in in-patients at an acute care hospital. TB patients presented late in disease and had high in-hospital mortality. Early detection and effective treatment of active TB in the community is likely to reduce hospitalisation and improve survival.

Keywords: Africa; HIV; TB; hospitalisation; mortality; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Medicine, University of Ottawa at The Ottawa Hospital, Ottawa, Ontario, Canada 2: Edendale Hospital, Pietermaritzburg, KwaZulu Natal, South Africa 3: Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada 4: Department of Medicine, University of Ottawa at The Ottawa Hospital, Ottawa, Ontario, Canada; and Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada

Publication date: 2004-12-01

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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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