Evidence map›Paper›PMID 25465206›Full record

ReviewBMC health services research2014

Inpatient mortality of HIV-infected adults in sub-Saharan Africa and possible interventions: a mixed methods review.

Bahati Mk Wajanga, Lauren E Webster, Robert N Peck, Jennifer A Downs, Kedar Mate, Luke R Smart, Daniel W Fitzgerald

Abstract readReview
In one paragraph

Review in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  8. Effect of HIV on mortality among hospitalised patients in South Africa.Southern African journal of HIV medicine · 2023
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  17. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Bahati Mk WajangaDepartment of Internal Medicine, Bugando Medical Centre, Bugando Hill Road, Box 1370, Mwanza, Tanzania. wajangabmk@gmail.com.
Lauren E WebsterWeill Cornell Medical College, New York, NY, USA. laurenwebs@gmail.com.
Robert N PeckDepartment of Internal Medicine, Bugando Medical Centre, Bugando Hill Road, Box 1370, Mwanza, Tanzania. rnp2002@gmail.com.
Jennifer A DownsDepartment of Internal Medicine, Bugando Medical Centre, Bugando Hill Road, Box 1370, Mwanza, Tanzania. jna2002@med.cornell.edu.
Kedar MateWeill Cornell Medical College, New York, NY, USA. kmate@ihi.org.
Luke R SmartDepartment of Internal Medicine, Bugando Medical Centre, Bugando Hill Road, Box 1370, Mwanza, Tanzania. smart.luke@gmail.com.
Daniel W FitzgeraldWeill Cornell Medical College, New York, NY, USA. dfitzgerald@gheskio.org.

Funding

Vanderbilt-Emory-Cornell-Duke Consortium for Global Health Fellows (VECDor)R25TW009337 · FIC · VANDERBILT UNIVERSITY MEDICAL CENTER · PI HEIMBURGER, DOUGLAS CORBETT, VERMUND, STEN H. · 2012 to 2016
$6.3M
Global Health Research Training in HIV and TuberculosisK24AI098627 · NIAID · WEILL MEDICAL COLL OF CORNELL UNIV · PI FITZGERALD, DANIEL W · 2012 to 2022
$1.8M
FIC NIH HHS R25 TW009337NIAID NIH HHS K24 AI098627
6 · The paper itself

Abstract

backgroundDespite the increased availability of anti-retroviral therapy, in-hospital HIV mortality remains high in sub-Saharan Africa. Reports from Senegal, Malawi, and Tanzania show rates of in-hospital, HIV-related mortality ranging from 24.2% to 44%. This mixed methods review explored the potential causes of preventable in-hospital mortality associated with HIV infections in sub-Saharan Africa in the anti-retroviral era.

resultsBased on our experience as healthcare providers in Africa and a review of the literature we identified 5 health systems failures which may cause preventable in-hospital mortality, including: 1) late presentation of HIV cases, 2) low rates of in-hospital HIV testing, 3) poor laboratory capacity which limits CD4 T-cell testing and the diagnosis of opportunistic infections, 4) delay in initiation of anti-retroviral therapy in-hospital, and 5) problems associated with loss to follow-up upon discharge from hospital.

conclusionOur findings, together with the current available literature, should be used to develop practical interventions that can be implemented to reduce in-hospital mortality.

Indexed as

Hospital MortalityInpatientsAdultAfrica South of the SaharaCD4-Positive T-LymphocytesFemaleHIV InfectionsHumansMale

Identifiers

PMID25465206
PMCPMC4265398

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.