Infectious disease consultations at a South African academic hospital: A 6-month assessment of inpatient consultations

Abstract

Citation Richards L, Spencer DC, Nel JS, Ive P. Infectious disease consultations at a South African academic hospital: A 6-month assessment of inpatient consultations. S Afr J Infect Dis. 2020;35(1), a169. https://doi.org/10.4102/sajid .v35i1.169 (https://doi.org/10.4102/sajid.v 35i1.169) 11.2% of the SA population was human immunodeficiency virus (HIV increase in life expectancy is in part attributed to a decrease in the n (AIDS), primarily because of the increased use of antiretroviral thera lives longer, new medical challenges arise, increasing the need for sp In addition to an ageing HIV population, there are still a large numb facilities at a late stage of their illness with infections, opportunistic o diagnostic difficulty as they may have more than one disease proces involving the initial diagnosis and therapy, the initiation of ART and m patients with HIV requires specialist knowledge and training for whic In many SA hospitals, ID specialist input is mainly in the form of bed evaluation of the role of ID specialists more difficult. To date, there i SA ID departments encounter. This review may assist in highlighting that need further attention or improvement and define where furthe particularly in relation to the developed world, this review may cast Methods and design This is a retrospective descriptive review of all formal ID consultation Helen Joseph Hospital (HJH) located in Johannesburg, South Africa. University of the Witwatersrand. During the study period, the IDs de two medical registrars and one medical officer. There is no specific ID From October 2015, all consecutive, inpatient IDs consultations were officer performing the consultation. All consultations performed by th analysed and made up the study population. Consultation details rec admission and ID consultation, the reason for the ID consultation, H the main infectious diagnoses, the non-infectious comorbidities and during the period of consultation) or discharge (if the patient was sti recorded as an absolute number and sorted into three categories (≤ as this implies that a patient is at risk of specific opportunistic infect as this was the number at which South Africa initiated ART during th requested via a referral letter, were included and telephonic or inform admission were not recorded as additional consultations. Sample siz this case the estimation of proportions (e.g. the proportion of wome 50%, precision of 5% and the confidence level of 95%, a sample siz thus more than adequate and corresponds to a precision of 3.6% (ra Data analysis included the previously mentioned consultation details tabulation. Continuous variables were summarised by the mean, sta number of deaths per 100 consultations and the number of total hos Lastly, an attempt to associate a patient's length of stay (≤ 10 days ratio (OR), controlling for HIV status or CD4 count category, number infectious diagnoses (0 vs. 1 or more). Analysis was performed using < 0.05 indicates significant associations. Ethical consideration Ethical clearance was obtained from the University of the Witwatersr M160486). Results During the 6-month study period, a total of 15 472 patients were ad these, 749 (4.8%) were seen by ID as inpatient consultations. There study, from 3.6% at the start to 5.2% at the end. The median perce inpatient consultations was 4.9% (IQR 4.38-5.35). These inpatient c 49.1% women. The male to female ratio was 1:04. The median age stay of a patient prior to an ID consultation was 6 days (IQR 3-9 day consultation after more than 10 days. There was no significant assoc given the other variables in the model (OR 1.24; 95% CI 0.63-2.42) TABLE 1: (https://sajid.co.za/index.php/sajid/article/viewFile/16 total hospital admissions at Helen Joseph Hospital. TABLE 2: (https://sajid.co.za/index.php/sajid/article/viewFile/16 patients seen by the infectious diseases department at Helen Joseph The most common reasons for consultation were ART initiation (27.8 (21.6%), assistance in managing a drug-induced liver injury (DILI) (7/3/25, 3:30 PM Richards https://sajid.co.za/index.php/sajid/rt/printerFriendly/169/358 2/6