Original Research

HIV status and mortality of surgical inpatients in rural Zimbabwe: A retrospective chart review

Pascal Migaud, Michael Silverman, Paul Thistle
Southern African Journal of HIV Medicine | Vol 20, No 1 | a812 | DOI: https://doi.org/10.4102/sajhivmed.v20i1.812 | © 2019 Pascal Migaud, Michael Silverman, Paul Thistle | This work is licensed under CC Attribution 4.0
Submitted: 31 October 2017 | Published: 24 January 2019

About the author(s)

Pascal Migaud, Department of Infectious Diseases and Gastroenterology, Vivantes Auguste-Viktoria-Klinikum, Germany
Michael Silverman, Department of Infectious Disease, Faculty of Medicine, Western University, Canada
Paul Thistle, Department of Obstetrics and Gynaecology, Karanda Mission Hospital, Zimbabwe; and, Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto, Canada


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Abstract

Background: People living with HIV treated with antiretroviral therapy (ART) are now living longer and thus many are requiring surgical procedures. For healthcare resource planning, it would be helpful to better understand the prevalence of HIV in surgical patients, the types of surgery HIV-positive patients are undergoing and whether HIV status impacts mortality.

Objective: The goal of this study was to determine the prevalence of HIV in surgical inpatients and the extent of ART coverage, as well as to assess any differences between HIV-positive and HIV-negative patients in type of surgery undergone and in-hospital mortality at Karanda Mission Hospital, Mount Darwin, Zimbabwe.

Method: A 1-year retrospective chart review was undertaken to collect clinical and demographic data for adult (excluding maternity cases) and paediatric surgical inpatients including age, sex, type of surgery, HIV status, CD4+ counts and, if patient was HIV-positive, whether he or she was taking ART.

Results and conclusion: Charts for 1510 surgical inpatient stays were reviewed. HIV prevalence among the adults was higher than that in the general population in Zimbabwe in 2016 (23.2% vs. 14.7%). There was no significant difference in inpatient mortality between the HIV-negative group and the HIV-positive group. Within the group of patients with malignancies, people living with HIV were significantly younger than uninfected patients (mean age 50.5 vs. 64.4 years; p < 0.01). There were correlations between HIV and certain malignancies. Thus, in addition to AIDS-defining illnesses, clinicians must be alert to squamous cell carcinoma and oesophageal, anal and penile cancers in HIV-positive patients.


Keywords

HIV; AIDS; Sub-Sahara Africa; surgical patients

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