Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
Ergebnis 12 von 214

Details

Autor(en) / Beteiligte
Titel
Chronic Cough in Primary Health Care Attendees, Harare, Zimbabwe: Diagnosis and Impact of HIV Infection
Ist Teil von
  • Clinical infectious diseases, 2005-06, Vol.40 (12), p.1818-1827
Ort / Verlag
Chicago, IL: The University of Chicago Press
Erscheinungsjahr
2005
Quelle
Oxford Journals 2020 Medicine
Beschreibungen/Notizen
  • Background. Cough lasting for ⩾3 weeks (i.e., chronic cough) indicates that a patient has suspected tuberculosis (TB). At the primary health care level, the spectrum of disease that causes chronic cough has not been previously investigated in a setting with a high prevalence of human immunodeficiency virus (HIV) infection. Methods. A total of 544 adults with chronic cough were recruited systematically from 2 primary health care clinics, and they were evaluated using preset first- and second-line investigations and diagnostic case definitions. Results. The overall prevalence of HIV infection among the study cohort was 83%. TB was the most common diagnosis, with 207 HIV-positive patients (46%) and 27 HIV-negative patients (30%) having confirmed or probable TB. Of these, 145 HIV-positive patients with TB (70%) and 20 HIV-negative patients with TB (74%) had smear-positive cases of TB. Only 17 HIV-positive and 2 HIV-negative patients had smear-negative but culture-positive cases of TB. Lower respiratory tract infections (n = 178; HIV prevalence, 79%) and pneumonia (n = 87; HIV prevalence, 89%) were the next most common diagnoses. Asthma (n = 26; HIV prevalence, 46%), posttuberculous disease and other fibrotic lung disease (n = 34; HIV prevalence, 88%), and cardiac disease (n = 15; HIV prevalence, 93%) were more common than werePneumocystis jiroveci pneumonia and cryptococcosis (n = 8 andn = 5, respectively; HIV prevalence, 100%), and we found no cases of nocardiosis or histoplasmosis. Conclusions. TB was diagnosed for 43% of patients who presented with chronic cough to primary health care clinics in Harare, with 71% having smear-positive disease. The findings of TB culture added relatively little to the findings of fluorescent microscopy of concentrated sputum specimens. The prevalence of HIV infection was high across a range of diagnoses, suggesting that an HIV test should be recommended in the initial investigation of chronic cough.

Weiterführende Literatur

Empfehlungen zum selben Thema automatisch vorgeschlagen von bX