1 / 7

Tuberculosis as a cause of death in HIV + patients in Africa: autopsy

Tuberculosis as a cause of death in HIV + patients in Africa: autopsy. Autopsies on 108 HIV+ patients in Botswana (selected) Cause of death: Tuberculosis 37% Pneumonia 14% Pneumocystis 11% Kaposi’s sarcoma 7% Cryptococcosis 6% Other 25% - Ansari (Int J Tuberc 2002).

ave
Download Presentation

Tuberculosis as a cause of death in HIV + patients in Africa: autopsy

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Tuberculosis as a cause of death in HIV + patients in Africa: autopsy Autopsies on 108 HIV+ patients in Botswana (selected) Cause of death: Tuberculosis 37% Pneumonia 14% Pneumocystis 11% Kaposi’s sarcoma 7% Cryptococcosis 6% Other 25% - Ansari (Int J Tuberc 2002)

  2. Pre-mortem or initial diagnosis in patients with disseminated TB Diagnosis Fatal cases Non-fatal cases (n=15) (n=5) Pre-mort DxInitial Dx Pulmonary TB 2 4 Extrapulm TB 4 2 AIDS 3 Malaria 6 PCP or pn 7 Other 4 -Kimambo et al, Capetown Intl TB, Nov 07

  3. Disseminated TB cases (n=19) Treatment and outcome Death: 17 (89%) of 19 Survival: 3d – 18 mos (median 30d, mean 87d) Positive TB lab before death: 4 (21%) of 19 TB Rx before death: 7 (37%) of 19 2 survivors had TB Rx within 2 weeks of blood culture 5 fatal cases lived 1d, 2 wks, 2 mos, 5 mos, 8 mos

  4. CD4 and TB microbiology Progressive fall in CD4 needs to be monitored for starting ART TB is most common cause of death from HIV – prompt and accurate reports from lab essential to reducing mortality.

  5. Bakari:CD4 count and TB tests • CD4 count results: • Affirming a diagnosis of Immunosuppression • Initiation of ART • Assessment of response to ARV • Diagnosis of IRIS • TB test results: • Initiation of ART if has CD4 of 200-350 cells/µl • Choice of ART regimen • Diagnosis of IRIS • Anti TB resistance

  6. Mtei: Research setting • test needed to answer research question concerning disease presence & classify disease as per research protocol (also for management) • time of test results should be as per protocol since research schedule has to be adhered to • inaccurate results give wrong research outcome; cannot answer research question; cannot contribute to science • late results give inappropriate research conclusion; delays answer of research question; delays writing of reports; cause financial constraints

More Related