Evidence map›Paper›PMID 33437593›Full record

ArticleAfrican journal of emergency medicine : Revue africaine de la medecine d'urgence2021

Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence.

Johannes P Mouton, Nicole Jobanputra, Christine Njuguna, Hannah Gunter, Annemie Stewart, Ushma Mehta, Sa'ad Lahri, Richard Court, Ehimario Igumbor, Gary Maartens and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in African journal of emergency medicine : Revue africaine de la medecine d'urgence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 43% of its field
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

2 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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

11 authors at 2 institutions in 2 countries.

Johannes P MoutonDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Nicole JobanputraDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Christine NjugunaDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Hannah GunterDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Annemie StewartDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Ushma MehtaCentre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Sa'ad LahriDivision of Emergency Medicine, Department of Surgery, University of Cape Town, Cape Town, South Africa.
Richard CourtDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Ehimario IgumborUnited States Centers for Disease Control and Prevention, Pretoria, South Africa.
Gary MaartensDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Karen CohenDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
University of Cape Town · ZACenters for Disease Control and Prevention · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSouth Africa has the world's largest antiretroviral treatment programme, which may contribute to the adverse drug reaction (ADR) burden. We aimed to determine the proportion of adult non-trauma emergency unit (EU) presentations attributable to ADRs and to characterise ADR-related EU presentations, stratified according to HIV status, to determine the contribution of drugs used in management of HIV and its complications to ADR-related EU presentations, and identify factors associated with ADR-related EU presentation.

methodsWe conducted a retrospective folder review on a random 1.7% sample of presentations over a 12-month period in 2014/2015 to the EUs of two hospitals in Cape Town, South Africa. We identified potential ADRs with the help of a trigger tool. A multidisciplinary panel assessed potential ADRs for causality, severity, and preventability.

resultsWe included 1010 EU presentations and assessed 80/1010 (7.9%) as ADR-related, including 20/239 (8.4%) presentations among HIV-positive attendees. Among HIV-positive EU attendees with ADRs 17/20 (85%) were admitted, versus 22/60 (37%) of HIV-negative/unknown EU attendees. Only 5/21 (24%) ADRs in HIV-positive EU attendees were preventable, versus 24/63 (38%) in HIV-negative/unknown EU attendees. On multivariate analysis, only increasing drug count was associated with ADR-related EU presentation (adjusted odds ratio 1.10 per additional drug, 95% confidence interval 1.03 to 1.18), adjusted for age, sex, HIV status, comorbidity, and hospital.

conclusionsADRs caused a significant proportion of EU presentations, similar to findings from other resource-limited settings. The spectrum of ADR manifestations in our EUs reflects South Africa's colliding epidemics of infectious and non-communicable diseases. ADRs among HIV-positive EU attendees were more severe and less likely to be preventable.

Indexed as

Adverse drug reactionEmergency departmentHIVPrevalence

Identifiers

PMID33437593
PMCPMC7787921
OpenAlexW3110177257

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.