RESEARCH ARTICLE


Mortality in Hospitalised HIV/AIDS Patients in a Tertiary Centre in Sub-Saharan Africa: Trends Between 2007 and 2015, Causes and Associated Factors



Henry Namme Luma1, 2, *, Fanny Mboringong3, Marie-Solange Doualla1, 4, Miriam Nji3, Olivier-Tresor Donfack1, Felicite Kamdem1, 4, Eveline Ngouadjeu1, 4, Fernando Kemta Lepka1, Yakouba Njankou Mapoure1, 4, Hugo Bertrand Mbatchou1, 4
1 Douala General Hospital, Douala, Cameroon
2 Faculty of Medicine and Biomedical Sciences, University of Yaoundé1, Yaoundé, Cameroon.
3 Faculty of Health Sciences, University of Buea, Buea, Cameroon
4 Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon


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© 2018 Luma et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Douala General Hospital, P.0.Box 4856, Douala, Cameroon; Tel: 237677707416; Fax: +237233370146; E-mail: hnluma@yahoo.com


Abstract

Background:

With easy accessibility to combination Antiretroviral Therapy (cART), mortality amongst hospitalized HIV/AIDS patients needs to be described.

Objective:

We aimed at determining the trends, causes and factors associated with in-hospital mortality amongst HIV/AIDS patients in the Douala General Hospital.

Methods:

We retrospectively reviewed hospitalisation records of HIV/AIDS patients hospitalized in the medical wards of the DGH from 2007 to 2015. Four cause-of-death categories were defined: 1. Communicable conditions and AIDS-defining malignancies, 2. Chronic non-communicable conditions and non-AIDS defining malignancies’, 3. Other non-communicable conditions and 4. Unknown conditions. Logistic regression was used to determine factors associated mortality.

Results:

We analyzed 891 eligible files. The mean age was 43 (standard deviation (SD): 10) years and median length of hospital stay was 9 (interquatile range (IQR)4 - 15) days. The overall all-cause mortality was 23.5% (95% CI: 20.8% - 26.4%). The category - communicable conditions and AIDS defining malignancies represented 79.9%, of deaths and this remained constant for each year during the study period. Tuberculosis was the most common specific cause of death (23.9%). Patients who had two (OR=2.35, 95%CI: 1.35 - 4.06) and more than two (OR=4.23, 95%CI: 1.62 – 11.12) opportunistic infections, a haemoglobin level less than 10g/l (OR=2.38, 95%CI: 1.58 - 3.59) had increased odds of dying.

Conclusion:

In-hospital mortality is high amongst HIV/AIDS patients at the Douala general hospital. The category - communicable conditions and AIDS defining malignancies - is still the main underlying cause of death. We hope that our findings will help to develop interventions aimed at reducing in-hospital mortality.

Keywords: HIV/AIDS, Mortality, Trends, Opportunistic infections, Anaemia, Cameroon.