Feasibility and yield of HIV screening among adult trauma patients presenting to an urban emergency department of a tertiary referral hospital in Tanzania
Abstract Background The World Health Organization and Tanzanian National Guidelines for HIV and AIDS management, recommends provider initiated testing and counseling for HIV at any point of health care contact. In Tanzania, over 45% of people living with HIV are unaware of their HIV positive status....
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doaj-60a222a40bc0405892f507b0bf1cadeb2020-11-25T02:09:22ZengBMCAIDS Research and Therapy1742-64052019-04-011611810.1186/s12981-019-0223-5Feasibility and yield of HIV screening among adult trauma patients presenting to an urban emergency department of a tertiary referral hospital in TanzaniaJuma Ramadhani0Hendry R. Sawe1Said S. Kilindimo2Juma A. Mfinanga3Ellen J. Weber4Emergency Medicine Department, Muhimbili University of Health and Allied ScienceEmergency Medicine Department, Muhimbili University of Health and Allied ScienceEmergency Medicine Department, Muhimbili University of Health and Allied ScienceEmergency Medicine Department, Muhimbili University of Health and Allied ScienceEmergency Medicine Department, Muhimbili University of Health and Allied ScienceAbstract Background The World Health Organization and Tanzanian National Guidelines for HIV and AIDS management, recommends provider initiated testing and counseling for HIV at any point of health care contact. In Tanzania, over 45% of people living with HIV are unaware of their HIV positive status. We determine the feasibility and yield of HIV screening among otherwise healthy adult trauma patients presenting to the first full-capacity Emergency Department in Tanzania. Methods This was a prospective cohort study of consecutive adult trauma patients presenting to Emergency Medicine Department at Muhimbili National Hospital (EMD-MNH) in Dar es Salaam, from March 2017 to September 2017. Eligible patients provided informed consent, pre and post-test counseling was done. Structured case report forms were completed, documenting demographics, acceptance of testing, results and readiness to receive results. Outcomes were the proportion of patients accepting testing, proportion of positive tests, readiness of the patient to receive the results, and proportion of patients who had an HIV test ordered as part of care. Results We screened 2848 trauma patients, and enrolled 326 (11.5%) eligible patients. Median age was 33 (IQR 25–42 years), and 248 (76.0%) of participants were male. Of those enrolled, 250 (76.7%) patients accepted testing for HIV, and among them 247 (98.8%) were ready to receive their test results. Of those tested, 14 (5.6%) were found to be HIV positive and 12 were ready to receive results. Two months post hospital discharge 6 (50%), of those who were informed of positive results had visited Care and Treatment Clinics (CTC) for HIV treatment. Three additional patients had not yet attended and three could not be reached. The treating ED physician tested none of the enrolled patients for HIV as part of their regular treatment. Conclusions In our cohort of adult trauma patients presenting to ED, routine HIV screening for unrelated reason, was feasible and acceptable. The yield is sufficient to warrant an on-going program and superior to having physicians choose which patients to test. Future studies should focus on factors affecting the linkage to CTC among HIV positive patients identified at the ED.http://link.springer.com/article/10.1186/s12981-019-0223-5FeasibilityYieldHIV screeningTraumaEmergency departmentTanzania |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Juma Ramadhani Hendry R. Sawe Said S. Kilindimo Juma A. Mfinanga Ellen J. Weber |
spellingShingle |
Juma Ramadhani Hendry R. Sawe Said S. Kilindimo Juma A. Mfinanga Ellen J. Weber Feasibility and yield of HIV screening among adult trauma patients presenting to an urban emergency department of a tertiary referral hospital in Tanzania AIDS Research and Therapy Feasibility Yield HIV screening Trauma Emergency department Tanzania |
author_facet |
Juma Ramadhani Hendry R. Sawe Said S. Kilindimo Juma A. Mfinanga Ellen J. Weber |
author_sort |
Juma Ramadhani |
title |
Feasibility and yield of HIV screening among adult trauma patients presenting to an urban emergency department of a tertiary referral hospital in Tanzania |
title_short |
Feasibility and yield of HIV screening among adult trauma patients presenting to an urban emergency department of a tertiary referral hospital in Tanzania |
title_full |
Feasibility and yield of HIV screening among adult trauma patients presenting to an urban emergency department of a tertiary referral hospital in Tanzania |
title_fullStr |
Feasibility and yield of HIV screening among adult trauma patients presenting to an urban emergency department of a tertiary referral hospital in Tanzania |
title_full_unstemmed |
Feasibility and yield of HIV screening among adult trauma patients presenting to an urban emergency department of a tertiary referral hospital in Tanzania |
title_sort |
feasibility and yield of hiv screening among adult trauma patients presenting to an urban emergency department of a tertiary referral hospital in tanzania |
publisher |
BMC |
series |
AIDS Research and Therapy |
issn |
1742-6405 |
publishDate |
2019-04-01 |
description |
Abstract Background The World Health Organization and Tanzanian National Guidelines for HIV and AIDS management, recommends provider initiated testing and counseling for HIV at any point of health care contact. In Tanzania, over 45% of people living with HIV are unaware of their HIV positive status. We determine the feasibility and yield of HIV screening among otherwise healthy adult trauma patients presenting to the first full-capacity Emergency Department in Tanzania. Methods This was a prospective cohort study of consecutive adult trauma patients presenting to Emergency Medicine Department at Muhimbili National Hospital (EMD-MNH) in Dar es Salaam, from March 2017 to September 2017. Eligible patients provided informed consent, pre and post-test counseling was done. Structured case report forms were completed, documenting demographics, acceptance of testing, results and readiness to receive results. Outcomes were the proportion of patients accepting testing, proportion of positive tests, readiness of the patient to receive the results, and proportion of patients who had an HIV test ordered as part of care. Results We screened 2848 trauma patients, and enrolled 326 (11.5%) eligible patients. Median age was 33 (IQR 25–42 years), and 248 (76.0%) of participants were male. Of those enrolled, 250 (76.7%) patients accepted testing for HIV, and among them 247 (98.8%) were ready to receive their test results. Of those tested, 14 (5.6%) were found to be HIV positive and 12 were ready to receive results. Two months post hospital discharge 6 (50%), of those who were informed of positive results had visited Care and Treatment Clinics (CTC) for HIV treatment. Three additional patients had not yet attended and three could not be reached. The treating ED physician tested none of the enrolled patients for HIV as part of their regular treatment. Conclusions In our cohort of adult trauma patients presenting to ED, routine HIV screening for unrelated reason, was feasible and acceptable. The yield is sufficient to warrant an on-going program and superior to having physicians choose which patients to test. Future studies should focus on factors affecting the linkage to CTC among HIV positive patients identified at the ED. |
topic |
Feasibility Yield HIV screening Trauma Emergency department Tanzania |
url |
http://link.springer.com/article/10.1186/s12981-019-0223-5 |
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