Adherence to Community Acquired Pneumonia guideleines and patients outcomes in a peri-urban hospital in Natal, South Africa
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Published:2021-09-30
Issue:09
Volume:15
Page:1321-1327
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ISSN:1972-2680
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Container-title:The Journal of Infection in Developing Countries
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language:
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Short-container-title:J Infect Dev Ctries
Author:
Madani Waheeba,Dawood Halima
Abstract
Introduction: Community-acquired pneumonia (CAP) is an important cause of mortality and morbidity worldwide. This issue is further exacerbated by the Human Immunodeficiency Virus (HIV) epidemic.
Methodology: The study was a retrospective, clinical record review of hospitalized patients (18 years and older) with a diagnosis of LRTI between the 1st of January 2012 and 31 December 2012, descriptive and comparable analysis was performed.
Results: Number of patients was 274; 142 (51.8%) males. The commonest final diagnosis was Pulmonary Tuberclosis (PTB) in 131 (47.8%) and CAP in 127 (46.4%). The case fatality rate was 25.5% (70/274) and was significantly associated with HIV infection (77.4%) (p < 0,01), CD4 cell count ≤ 200 cells (96.3), final diagnosis of TB (65.7%) (p < 0.01), female sex (57%) (p < 0.01), confusion (50%) (p < 0.01), age of 65 years or more (29%) (p < 0.01). CURB-65 score (Confusion, Urea more than 7mmol/l, Respiratory rate (RR) ≥30 breaths /min, low blood pressure (less than 90 mmHg systolic and 60mmHg diastolic) and age ≥ 65 years) was only documented in 4 % (11/274) patients. Only 63 patients (23%) met the admission criteria of two or more points when the CURB-65 score was calculated.
Conclusions: Failure to use the CURB-65 score resulted in an increase admission of patients presenting with LRTI. There was an increased case fatality rate in this high HIV prevalence setting.
Publisher
Journal of Infection in Developing Countries
Subject
Virology,Infectious Diseases,General Medicine,Microbiology,Parasitology