• Login
    View Item 
    •   UNZA Repository Home
    • Theses and Dissertations
    • Medicine
    • View Item
    •   UNZA Repository Home
    • Theses and Dissertations
    • Medicine
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Associatioin of severe anaemia with tuberculosis mycobacteraemia in HIV positive patients admitted with severe sepsis to the University Teaching Hospital, Lusaka,Zambia

    Thumbnail
    View/Open
    Main Document (469.1Kb)
    Date
    2015
    Author
    Muchemwa, Levy
    Type
    Thesis
    Language
    en
    Metadata
    Show full item record

    Abstract
    INTRODUCTION: Tuberculosis is recognised as one the leading causes of severe sepsis among HIV positive patients. Most patients with tuberculosis mycobacteraemia have advanced HIV disease with CD4 counts less than 100cells/ul and many do not present with the classical signs of tuberculosis. Unusual presentation of tuberculosis mycobacteraemia makes the diagnosis of tuberculosis in these patients a challenge. METHODOLOGY: This was a cross-sectional study which was done by analyzing data from 199 HIV positive patients enrolled in two randomized control studies; the Simplified Severe Sepsis Protocol (SSSP) and SSSP-2 and data from 2 patients enrolled independently. Participants were adults who met the inclusion criteria for severe sepsis. Baseline data was collected on demographic and laboratory characteristics including blood cultures for tuberculosis and aerobic organisms. RESULTS: The prevalence of tuberculosis mycobacteraemia in the study population was 34.8%.The study population was generally underweight but the population with tuberculosis mycobacteraemia had a significantly lower mid-upper arm circumference (MUAC) than the population without (20.2[SD: 2.4] vs 21.4 [SD: 3.8] cm; p=0.01).There was a higher proportion of patients with tuberculosis mycobacteraemia in patients who were not on anti-retroviral therapy (ART) compared to those on ART (p=0.01). The study population was generally anaemic with mean haemoglobin of 8.0(SD: 3.0) g/dl but the tuberculosis mycobacteraemia group had significantly lower haemoglobin. The population with tuberculosis mycobacteraemia had a significantly lower median CD4 count compared to the population without (44cells/dl vs 56 cells/dl; p=0.01). Aerobes were isolated in 20.4% (41) of the study population. The commonest isolate was Staphylococcus aureus 5% (10). Factors that were independently associated with tuberculosis mycobacteraemia include low MUAC, unknown ART history, low albumin and low sodium. CONCLUSION: Tuberculosis mycobacteraemia is very common in HIV infected patients with severe sepsis. Low CD4 count, albumin, sodium levels and low MUAC were independently associated with tuberculosis mycobacteraemia in patients with severe sepsis. Severe anaemia was not independently associated with tuberculosis mycobacteraemia.
    URI
    http://dspace.unza.zm/handle/123456789/4334
    Publisher
    The University of Zambia
    Subject
    HIV Infections--Zambia
    Tuberculosis--Zambia
    Collections
    • Medical Theses and Dissertations [525]
    • Medicine [891]

    DSpace software copyright © 2002-2016  DuraSpace
    UNZA homepage | UNZA Library | Contact Us | Send Feedback
    Theme by 
    Atmire NV
     

     

    Browse

    All of UNZA RepositoryCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Statistics

    View Usage Statistics

    DSpace software copyright © 2002-2016  DuraSpace
    UNZA homepage | UNZA Library | Contact Us | Send Feedback
    Theme by 
    Atmire NV