Ansari N A, Kombe A H, Kenyon T A, Hone N M, Tappero J W, Nyirenda S T, Binkin N J, Lucas S B
The BOTUSA Project, Gaborone, Botswana.
Int J Tuberc Lung Dis. 2002 Jan;6(1):55-63.
Little is known about causes of death in countries of southern Africa seriously affected by the HIV/AIDS epidemic.
After obtaining informed consent, autopsies were performed on 128 mainly hospitalised adults in Francistown, Botswana, between July 1997 and June 1998. Criteria for case selection included those who died before a diagnosis could be established, those whose condition deteriorated unexpectedly during hospitalization, and those who had respiratory disease. This represented 14% of adult medical patients who died in hospital during the study period.
Of the 128 patients, 104 (81%) were HIV-positive. Among HIV-positive patients, the most common pathologic findings were tuberculosis (TB) (40%), bacterial pneumonia (23%), Pneumocystis carinii pneumonia (11%), and Kaposi's sarcoma (11%); these conditions were the cause of death in 38%, 14%, 11%, and 6%, respectively. Of the 40 pulmonary TB cases, 90% also had disseminated extra-pulmonary TB. Chest radiology could not reliably distinguish the pathologies pre-mortem.
TB was the leading cause of death in our series of HIV-positive adults in Botswana, selected towards those with chest disease; in most, it was widely disseminated. Bacterial pneumonia also played an important role in mortality. Pneumocystis carinii pneumonia was present, but relatively uncommon.
在受艾滋病毒/艾滋病疫情严重影响的南部非洲国家，人们对死亡原因知之甚少。
在获得知情同意后，于1997年7月至1998年6月期间，对博茨瓦纳弗朗西斯敦的128名主要住院成人进行了尸检。病例选择标准包括那些在确诊前死亡的患者、那些在住院期间病情意外恶化的患者以及那些患有呼吸系统疾病的患者。这占研究期间在医院死亡的成年内科患者的14%。
128名患者中，104名（81%）为艾滋病毒阳性。在艾滋病毒阳性患者中，最常见的病理发现是结核病（TB）（40%）、细菌性肺炎（23%）、卡氏肺孢子虫肺炎（11%）和卡波西肉瘤（11%）；这些病症分别导致38%、14%、11%和6%的患者死亡。在40例肺结核病例中，90%还伴有播散性肺外结核。胸部放射学检查无法在生前可靠地区分这些病理情况。
在我们选取的博茨瓦纳患有胸部疾病的艾滋病毒阳性成年患者系列中，结核病是主要死因；在大多数病例中，它广泛播散。细菌性肺炎在死亡率方面也起重要作用。存在卡氏肺孢子虫肺炎，但相对不常见。
