Online citations, reference lists, and bibliographies.
Please confirm you are human
(Sign Up for free to never see this)
← Back to Search

HIV Testing And Epidemiology In A Hospital-Based Surgical Cohort In Malawi

Bryce E. Haac, Anthony G. Charles, Mitch M Matoga, S. LaCourse, Dominic Nonsa, M. Hosseinipour
Published 2013 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy
Share
BackgroundDespite the high prevalence of HIV in adults (11 %) in Malawi, testing among surgical patients is not routine. We examined the feasibility of universal opt-out HIV testing and counseling (HTC) on the surgical wards of Kamuzu Central Hospital in Lilongwe, Malawi, and sought to further delineate the role of HIV in surgical presentation and outcome.MethodsWe reviewed HTC and surgical admission records from May to October 2011 and compared these data to data collected prospectively on patients admitted from November 2011 through April 2012, after universal HTC implementation.ResultsPrior to universal HTC, 270 of the 2,606 (10.4 %) surgical admissions were tested; 13 % were HIV-infected. After universal HTC implementation, HTC counselors reviewed 1,961 of the 2,488 admissions (79 %): 310 (16 %) had known status (157 seropositive, 153 seronegative) and 1,651 had unknown status (81 %). Among those with unknown status, 97 % (1,598, of 64 % of all admissions) accepted testing, of whom 9 % were found to be HIV-infected. Patients with longer lengths of stay (LOS) (mean = 11 vs. 5 days, p < 0.01) and those who underwent surgical intervention (odds ratio [OR] 2.5; confidence interval [CI] 2.0–3.1) were more likely to have a known status on discharge. HIV was more prevalence in patients with infection and genital/anal warts or ulcers and lower in trauma patients. HIV-positive patients received less surgical intervention (OR 0.69; CI 0.52–0.90), but there was no association between HIV status and length of stay or mortality.ConclusionsUniversal opt-out HTC on the surgical wards was well accepted and increased the proportion of patients tested. High HIV prevalence in this setting merits implementation of universal HTC.
This paper references
10.1007/BF00298922
HIV infection and surgeons
Lin Ey (1994)
10.1177/014107689008300513
Surgical Procedures in Patients at Risk of Human Immunodeficiency Virus Infection
R. Wakeman (1990)
10.1016/S0140-6736(11)60842-8
The role of acute and early HIV infection in the spread of HIV and implications for transmission prevention strategies in Lilongwe, Malawi: a modelling study
K. Powers (2011)
Malawi Demographic and Health Survey 2004
Malawi (2001)
10.1016/J.TRSTMH.2006.04.002
High rates of HIV in surgical patients in Soweto, South Africa: impact on resource utilisation and recommendations for HIV testing.
N. Martinson (2007)
10.1136/BMJ.314.7087.1081
Commentary: Failing to seek patients' consent to research is always wrong
R. Kale (1997)
10.1136/bmj.314.7087.1077a
Does HIV status influence the outcome of patients admitted to a surgical intensive care unit? A prospective double blind study
S. Bhagwanjee (1997)
10.4314/MMJ.V14I2.10758
Prevalence and indicators of HIV and AIDS among adults admitted to medical and surgical wards in Blantyre, Malawi.
D. Lewis (2003)
10.4314/MMJ.V18I3.10916
The burden of disease in Malawi.
C. Bowie (2006)
10.1016/S0140-6736(12)61537-2
Routine testing for HIV in patients undergoing elective surgery
D. McGowan (2012)
10.1007/BF02048332
Anorectal surgery in human immunodeficiency virus-infected patients
E. Consten (1995)
10.1097/00002030-199506000-00009
A prospective study on the risk of exposure to HIV during surgery in Zambia
E. Consten (1995)
10.1308/003588406X83050
Prevalence of HIV status and CD4 counts in a surgical cohort: their relationship to clinical outcome.
S. Čačala (2006)
HIV/AIDS and the surgeon.
E. Olapade‐Olaopa (2006)
10.1136/jfprhc-2012-100379
Prevention of HIV-1 infection with early antiretroviral therapy
M. Rayment (2012)
10.1001/ARCHSURG.141.12.1238
Surgical outcomes in human immunodeficiency virus-infected patients in the era of highly active antiretroviral therapy.
M. Horberg (2006)
10.1016/S0140-6736(08)60693-5
Population-level effect of HIV on adult mortality and early evidence of reversal after introduction of antiretroviral therapy in Malawi
A. Jahn (2008)
10.1007/BF00298922
HIV infection and surgeons
E. Lin (2004)
10.1016/S0140-6736(08)61697-9
Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model
R. Granich (2009)
10.1097/QAI.0b013e31821f6bab
Why Did the Scale-up of HIV Treatment Work?: A Case Example From Malawi
A. Harries (2011)
10.1007/s00268-009-9969-6
Human Immunodeficiency Disease: How Should It Affect Surgical Decision Making?
T. Madiba (2009)



This paper is referenced by
10.1371/journal.pone.0069517
Routine HIV Testing among Hospitalized Patients in Argentina. Is It Time for a Policy Change?
M. E. Socías (2013)
10.1371/journal.pone.0193858
HIV testing in a South African Emergency Department: A missed opportunity
B. Hansoti (2018)
10.2174/1874613601610010016
A Review of HIV and Surgery in Africa
K. Bowa (2016)
10.1016/j.surg.2016.11.030
Operative needs in HIV+ populations: An estimation for sub‐Saharan Africa
Megan Cherewick (2017)
10.1093/tropej/fmu065
Lay-screeners and use of WHO growth standards increase case finding of hospitalized Malawian children with severe acute malnutrition.
S. LaCourse (2015)
10.1016/j.surg.2018.07.037
Assessing the impact of HIV status on injury outcomes: A multicenter study of trauma patients in Rwanda☆,☆☆
A. Martin (2019)
10.1186/s12889-020-09170-x
The impact of HIV knowledge and attitudes on HIV testing acceptance among patients in an emergency department in the Eastern Cape, South Africa
Sofia Ryan (2020)
10.1093/inthealth/ihx042
How can male rates of HIV testing be increased? Recommendations from a mixed methods study in southern Malawi.
A. Rankin-Williams (2017)
10.2149/tmh.2013-12
Prevalence of HIV and Disease Outcomes on the Medical and Surgical Wards at Kamuzu Central Hospital, Lilongwe, Malawi
C. Kendig (2013)
10.4102/sajhivmed.v20i1.812
HIV status and mortality of surgical inpatients in rural Zimbabwe: A retrospective chart review
P. Migaud (2019)
10.1089/AID.2018.0127
A Window Into the HIV Epidemic from a South African Emergency Department.
B. Hansoti (2019)
Semantic Scholar Logo Some data provided by SemanticScholar