Dhobha T, Makanza ED, Mtero-Munyati S, Magwenzi J, Wellington M, Mungofa S, Gwanzura L, Butterworth A, Robertson V, Mason P, Corbett EL; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. MoPeB3209.
Biomedical Research and Training Institute, Harare, Zimbabwe
Background: Pre-HIV studies reported tuberculosis (TB) as one of the commonest causes of cough of three weeks or more (chronic cough) among patients attending primary health care clinics in Africa. We investigated the impact of HIV on the burden and case mix of chronic cough in Harare. Methods: 550 adult patients with chronic cough (case patients) were recruited systematically from two primary health care clinics. First- and second-line investigations and management were standardized, and data capture used standardized proformas. Patients were followed until diagnostic criteria were reached using preset case definitions. HIV status was determined for all cases and for 550 controls presenting with minor trauma. Results (Based on the first 400 cases and 274 controls): HIV prevalence was 84% versus 32% respectively, indicating that 73% of chronic cough was attributable to HIV infection. TB was the single most common diagnosis (41% of all cases; HIV prevalence 88%): 30% of all chronic coughers were smear-positive. Among HIV-negative case patients the most common diagnoses were as follows: lower respiratory tract infection (LRTI, [33% of all HIV-negative cases]), TB (26%), bacterial pneumonia (21%) and asthma (12%). The following diagnoses were significantly HIV-associated: TB (44% of all HIV-positive cases), bacterial pneumonia (28%), LRTI (17%), PCP (2%), post-tuberculous lung disease (2%), cardiac failure (2%) and cryptococcosis (1%). Bacterial isolates differed according to HIV status, with Staph. aureus and gram-negative organisms being significantly HIV-associated. Conclusions: TB is now the most common diagnosis among patients presenting with chronic cough at the primary health care level in Harare, Zimbabwe, with 30% of all chronic coughers being smear positive. The impact of HIV was apparent across a range of other diagnoses and HIV prevalence was high throughout, however, suggesting that diagnostic HIV testing should be recommended as part of the initial investigations of chronic cough.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Adult
- Africa
- Cough
- HIV Infections
- HIV Seropositivity
- Health
- Humans
- Prevalence
- Respiratory Tract Infections
- Tuberculosis
- Virus Diseases
- Zimbabwe
- etiology
Other ID:
UI: 102279513
From Meeting Abstracts