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Mortality of HIV-Infected Patients on Antiretroviral Therapy in a Large Public Cohort in West Africa, Burkina Faso: Frequency and Associated Factors

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Advances in Infectious Diseases 2013年第4期3卷 281-289页

作者： Armel Poda Arsène Hema Jacques Zoungrana nongodo firmin kaboré Bebar Euloges Kamboulé Ibrahim Soré Guillaume Bado Abdoul-Salam Ouédraogo Nicolas Meda Adrien Bruno Sawadogo Day Care Hospital for HIV-Patients of Bobo Dioulasso Department of Infectious Diseases Souro Sanou Teaching Hospital Bobo Dioulasso Burkina Faso Day Care Hospital for HIV-Patients of Bobo Dioulasso Department of Infectious Diseases Souro Sanou Teaching Hospital Bobo Dioulasso Burkina Faso Department of Virology and Bacteriology Souro Sanou Teaching Hospital Bobo Dioulasso Burkina Faso School of Medicine University of Bobo Dioulasso Bobo Dioulasso Burkina Faso Day Care Hospital for HIV-Patients of Bobo Dioulasso Department of Infectious Diseases Souro Sanou Teaching Hospital Bobo Dioulasso Burkina Faso School of Medicine University of Bobo Dioulasso Bobo Dioulasso Burkina Faso Department of Virology and Bacteriology Souro Sanou Teaching Hospital Bobo Dioulasso Burkina Faso School of Medicine University of Ouagadougou Ouagadougou Burkina Faso Muraz Center Bobo Dioulasso Burkina Faso

Background: In sub Saharan Africa, small size surveys have demonstrated early high mortality among infected patients on antiretroviral therapies (ART). Few studies have been conducted in large cohorts of HIV-patients in public health care system in West Africa. Objectives: Our study aims to determine mortality rate and its predictors in a cohort of patients on ART in a public daycare hospital in Burkina Faso. Methods: We have carried out a retrospective cohort study. All HIV-infected patients on ART between January 1st 2008 and December 31st 2011 were included in the study. Survival probability was estimated by the Kaplan-Meier method. Cox regression analysis was used to identify associated factors to mortality. Results: A total of 2243 HIV-infected patients were included in the study. During the follow-up, 218 patients representing 9.7% were lost. About 104 patients representing 4.6% were transferred and 1691 representing 75.4% were still in the therapeutic cohort. There were 230 death cases for a total of 4282 persons-years, (5.4 deaths for 100 persons-years;95% CI: 4.8 -6.3). The survival probabilities after 6 months, 1 year and 2 years were 92.6%, 91% and 88.9% respectively. For the multivariate analysis, the following factors were independently associated to death: male gender, BMI .5 kg/m2, WHO stage 3 and 4, HIV-2, T-CD4 lymphocytes < 200/μl, haemoglobin rate g/dl and creatinine clearance 2. Conclusions: Our study provides for the first time mortality rates and its predictors among HIV-patients on antiretroviral treatment in a large cohort in public health sector in Burkina Faso. It highlights the importance of early HIV screening to limit ART initiation at advanced HIV infection stages.

关键词： Antiretroviral Therapy Burkina Faso HIV Mortality West Africa

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Morbidity and Mortality of Inpatients in the Department of Infectious Diseases of the University Hospital of Bobo-Dioulasso, Burkina Faso

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Advances in Infectious Diseases 2019年第3期9卷 171-182页

作者： Armel Poda Jacques Zoungrana Arsène Héma Ziemlé Clément Méda Alexandre Boena Rainatou Boly M’winmalo Ines Evelyne DA Apoline Sondo nongodo firmin kaboré Sandrine Hien Ismael Diallo Mamadou Savadogo Eric Arnaud Diendéré Abdoul-Salam Ouédraogo Issiaka Sombié Athanase Millogo Service des Maladies Infectieuses CHU Souro Sanou Bobo-Dioulasso Burkina Faso Institut Supérieur des Sciences de la Santé (INSSA) Université Nazi Boni Bobo-Dioulasso Burkina Faso Centre MURAZ Bobo-Dioulasso Burkina Faso CHU Yalgado Ouédraogo Ouagadougou Burkina Faso Unité de Formation et de Recherche en Sciences de la Santé Université Ouaga I Pr Joseph Ki-Zerbo Ouagadougou Burkina Faso Service de Bactériologie Virologie CHU Sour&#244 Sanou Bobo-Dioulasso Burkina Faso Service de Neurologie CHU Souro Sanou Bobo-Dioulasso Burkina Faso

Background: Infectious Diseases are responsible for nearly 17 million annual deaths worldwide. Burkina Faso, like the majority of poor countries, remains vulnerable to infectious diseases. The objective of the present study was to analyze the profile of inpatients, including the mortality and causes of death, in the Infectious Diseases Department of SourôSanou teaching hospital (Bobo-Dioulasso, Burkina Faso). Methods: We carried out a cross-sectional study based on medical records of all inpatients from 2011 to 2015. Results: We included 1169 patients. The gender ratio was 0.8. The age group 30 to 39 was more represented (30.2%) as well as housewives and farmers (73.7%). Over one-thirds of the patients (35.3%) were consulted within an average of 7 days. The most common reason for consultation was fever (65.1%). Around 62.0% of inpatients were infected by the Human Immunodeficiency Virus (HIV). Digestive diseases ranked first (21.8%) followed by nervous system disorders (19.4%) and tuberculosis (17.8%). Overall morbidity rate was 31.3%. About 42% were admitted to the emergency ward while 83.3% already arrived with poor health condition. And 82.1% of deaths occurred on pathological grounds of which 66.7% were related to HIV. Main causes of death included nervous system diseases (28.6%), tuberculosis (21.9%) and gastrointestinal diseases (18.3%). Conclusion: Infectious diseases remain a major public health issue. Further efforts are needed to improve their management in Burkina Faso.

关键词： Morbidity Mortality Infectious Diseases Causes of Deaths Burkina Faso

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