Fabiani Massimo, Accorsi Sandro, Aleni Robert, Rizzardini Giuliano, Nattabi Barbara, Gabrielli Antonio, Opira Cyprian, Declich Silvia
Laboratory of Epidemiology and Biostatistics, Istituto Superiore di Sanità, Rome, Italy.
J Acquir Immune Defic Syndr. 2003 Sep 1;34(1):62-6. doi: 10.1097/00126334-200309010-00009.
To estimate the disease-specific HIV prevalence in a northern Ugandan hospital and to evaluate the impact of HIV/AIDS on hospital services.
HIV serosurvey and analysis of routinely compiled hospital records.
The serosurvey was conducted among all 352 patients admitted to the medical ward of the Lacor Hospital in March 1999 (this ward consists of 3 units: general medicine, tuberculosis, and cancer). The impact on hospital services was estimated using the hospital discharge records for all 3447 patients admitted in 1999, in combination with serosurvey data, and was expressed as the percentage of bed-days attributable to HIV-positive patients.
The overall HIV prevalence was 42.0% (52.6, 44.6, and 13.2% in the general medicine, tuberculosis, and cancer units, respectively). The disease-specific prevalence ranged from 45-65% for patients with tuberculosis, pneumonia, malaria, and enteritis. HIV-positive patients, compared with HIV-negative patients, had a higher in-hospital mortality (14.6 vs. 3.0%) and a lower average length of stay (41.4 vs. 48.9 days). AIDS cases accounted for 5.0% of hospital admissions, 4.1% of bed-days, and 11.5% of deaths. When considering all HIV-positive patients, these accounted for 37.2% of the bed-days.
Knowledge of disease-specific HIV prevalence and of the patterns of HIV-related diseases is crucial for early case management. The impact of HIV-positive patients on hospital services is quite high, accounting for >1/3 of the bed-days in 1999. Providing a continuum of care through inpatient, outpatient, and outreach home care services probably represents the only means of relieving the pressure on overloaded hospitals.
评估乌干达北部一家医院特定疾病的艾滋病毒流行情况，并评估艾滋病毒/艾滋病对医院服务的影响。
艾滋病毒血清学调查及对常规收集的医院记录进行分析。
1999年3月，在拉科尔医院内科病房收治的所有352名患者中进行了血清学调查（该病房由3个单元组成：普通内科、结核病和癌症）。利用1999年收治的所有3447名患者的医院出院记录，并结合血清学调查数据，评估对医院服务的影响，并以艾滋病毒阳性患者占用床位天数的百分比来表示。
总体艾滋病毒流行率为42.0%（普通内科、结核病和癌症单元分别为52.6%、44.6%和13.2%）。结核病、肺炎、疟疾和肠炎患者的特定疾病流行率在45%-65%之间。与艾滋病毒阴性患者相比，艾滋病毒阳性患者的院内死亡率更高（分别为14.6%和3.0%），平均住院时间更短（分别为41.4天和48.9天）。艾滋病病例占医院入院人数的5.0%、床位占用天数的4.1%和死亡人数的11.5%。若将所有艾滋病毒阳性患者考虑在内，他们占用了37.2%的床位天数。
了解特定疾病的艾滋病毒流行情况以及艾滋病毒相关疾病模式对于早期病例管理至关重要。艾滋病毒阳性患者对医院服务的影响相当大，在1999年占床位天数的1/3以上。通过住院、门诊和外展家庭护理服务提供连续护理可能是缓解超负荷医院压力的唯一途径。
