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Research paper thumbnail of The burden of poisoning in children hospitalised at a tertiary-level hospital in South Africa

Frontiers in Public Health, Oct 19, 2023

Introduction: Globally, childhood poisoning, accounts for a significant proportion of emergency d... more Introduction: Globally, childhood poisoning, accounts for a significant proportion of emergency department admissions. There is a paucity of data from low-and middle-income countries on poisoning in children. Objective: To describe the incidence, case fatality rate, and types of poisoning in children admitted to a tertiary-level hospital in Johannesburg, South Africa. Methods: This was a retrospective descriptive study of children hospitalised with poisoning from January 2016 to December 2021 at Chris Hani Baragwanath Academic Hospital. Children were identified from a discharge summary database using ICD-10 codes that describe poisoning. Trends in incidence of poison exposure were reported. Results: Of the 60,901 admissions during the study period, 2,652 (4.4%) children were diagnosed with poisoning. Most (71.3%) children were less than 5 years of age and 55% were male. The incidence of poisoning per 100,000 was highest at 108.4 (95% CI: 104.3-112.6) in 2019 and decreased to 77.3 (95% CI: 73.9-80.7) in 2020 and 59.6 (95% CI: 56.3-62.5) in 2021. Main causes of poisoning were organic solvents (37.6%), medications (32.9%), and pesticides (17.5%). The overall case fatality rate was 2.1%. In a multivariate analysis, poisoning secondary to pesticides (aOR: 13.9; 95% CI: 4.52-60.8; p < 0.001), and unspecified agents (aOR: 12.7; 95% CI: 3.27-62.8; p < 0.001) were associated with an increased odds of death. Conclusion: We report a high prevalence of poisoning in children hospitalised in this tertiary-level hospital in South Africa. Public health measures to reduce the burden of organic solvents, medications and pesticide poisoning are urgently warranted.

Research paper thumbnail of Predicting the loss to follow-up of HIV-infected patients on ART in a rural area in South Africa using generalized gamma distributions

Research Square (Research Square), Feb 5, 2021

Background-Long-term regular follow-up and high retention are the anticipated outcomes for the we... more Background-Long-term regular follow-up and high retention are the anticipated outcomes for the wellness and longevity of HIV/AIDS patients on antiretroviral treatment. However, these anticipated outcomes are marred by patient loss to follow-up (LTFU) which is currently exacerbated by the Covid-19 pandemic. This study aims to determine the prevalence and potential risk factors to LTFU among HIV/AIDS patients on ART at two rural district hospitals in South Africa. Methods-This is a retrogressive observational study whereby a cohort of HIV/AIDS patients was retrospectively followed from 2010 to 2017 until loss to follow-up occurred or until the end of the observation period at Carolina and Embhuleni hospitals. An institutional based retrospective cohort study was undertaken among children, adolescents and adults living with HIV/AIDS and attending ART clinic between January 1, 2010 and June 30, 2017. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as 'dead' or 'transferred-out' patient. Patient information was obtained from the routine hospitals' records, and the data were analysed using Generalized gamma distribution to identify the predictors of loss to follow up among HIV/AIDS patients while Kaplan-Meier model was used to estimate and compare the LTFU survival probabilities of heterogenous groups among the patients. Results-Of the 357 patients, 60.5% were female. The mean (SD) age of the cohort was 36.2 (14.1), 15.4 (3.5), and 5.1 (3.5) years for adults, adolescents, and children, respectively. From 357 HIV/AIDS patients, 93 (26.05%) were lost to follow-up. Empirical results show that the Weibull distribution gives the best fit to the data. The Weibull model determined the Factors associated with significant risk factors to patient loss to follow up as: regimen EFV+D4T+3TC [

Research paper thumbnail of Factors associated with chronic kidney disease in HIV+ patients in Albert Luthuli Municipality of South Africa

Research Square (Research Square), Mar 4, 2020

Background: Current research indicates that chronic kidney disease is a global problem which pose... more Background: Current research indicates that chronic kidney disease is a global problem which poses a major health threat to people of poor countries who have HIV/AIDS and are on antiretroviral treatment. In this study, the prevalence of chronic kidney disease and the factors 8 associated with it were investigated among the HIV/AIDS patients in a rural community of South Africa. Methods: A cohort of HIV + terminal ill patients was retrospectively followed from 2010 to 11 2017 until chronic kidney disease was diagnosed or until the end of the observation period at two hospitals (Carolina and Embhuleni). Patient information was obtained from the routine hospitals' records, and the data were analysed using logistic regression and survival analysis (Kaplan-Meier hazard functions and ratios, and log-rank tests) methods. Results: Out of a random sample of 357 HIV/AIDS patients, 53 patients (14.85%) had chronic kidney disease. The factors associated with chronic kidney disease were: Gender (p-17 value<0.0024); Age (p-value<0.0420); Baseline creatinine (p-value<0.0116); Baseline alanine transaminase (p-value<0.0111); Treatment regimen 1 (p-value<0.0001); ART adherence (poor, fair, good) (p-value<0.0005); Hospital (p-value<0.0001); and Lost to follow-up (ye, no) (p-value<0.0069). 21 Discussion: Whilst antiretroviral treatment is associated with some improvement in virology 22 and immunology in HIV-infected patients, research is still needed for the assessment of the 23 impact of ART and other risk factors on renal function in marginalised communities in Africa. 24 Conclusion: The research findings on HIV + patients in Albert Luthuli Municipality concurred 25 with several previous research findings on risk factors to CKD. The expected action to alleviate 26 the health threat due to CKD in South Africa is to educate the nation on prevention, early 27 detection and on the management of the disease. The study established diverse baseline 28 statistics against which future research may be based.

Research paper thumbnail of Accelerated failure time modelling of Tuberculosis predictors in HIV/AIDS patients in Albert Luthuli Municipality of South Africa

Background: Tuberculosis (TB) is one of the most common opportunistic diseases and leading cause ... more Background: Tuberculosis (TB) is one of the most common opportunistic diseases and leading cause of death among Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) patients. There has been a drastic rise of TB infection associated with the pandemic occurrence of HIV/AIDS infection in South Africa and other resource-limited countries world-wide. South Africa faces an immense burden on health care systems posed by diagnostic and therapeutic challenges resulting from the concomitant HIV and TB epidemics. This study aimed to determine the prevalence and the factors associated with TB and HIV co-infection for patients attending clinical care at rural public health facilities in Albert Luthuli municipality of South Africa. Methods: A cohort of HIV/AIDS patients was retrospectively followed from inception in 2010 to 2017 until TB was diagnosed or until the end of the study. Accelerated Failure Time (AFT) model was used to analyse survival data on HIV/AIDS patien...

Research paper thumbnail of Censored quantile regression of the factors associated with chronic kidney disease in HIV/AIDS patients in Albert Luthuli Municipality of South Africa

Research paper thumbnail of Predicting the loss to follow-up of HIV-infected patients on ART in a rural area in South Africa using generalized gamma distributions

Background - Long-term regular follow-up and high retention are the anticipated outcomes for the ... more Background - Long-term regular follow-up and high retention are the anticipated outcomes for the wellness and longevity of HIV/AIDS patients on antiretroviral treatment. However, these anticipated outcomes are marred by patient loss to follow-up (LTFU) which is currently exacerbated by the Covid-19 pandemic. This study aims to determine the prevalence and potential risk factors to LTFU among HIV/AIDS patients on ART at two rural district hospitals in South Africa.Methods— This is a retrogressive observational study whereby a cohort of HIV/AIDS patients was retrospectively followed from 2010 to 2017 until loss to follow-up occurred or until the end of the observation period at Carolina and Embhuleni hospitals. An institutional based retrospective cohort study was undertaken among children, adolescents and adults living with HIV/AIDS and attending ART clinic between January 1, 2010 and June 30, 2017. Loss to follow up was defined as not taking an ART refill for a period of 90 days or ...

Research paper thumbnail of Identification of factors affecting the survival lifetime of HIV+ terminal patients in Albert Luthuli municipality of South Africa

Background: South Africa has the biggest HIV epidemic in the world, with Mpumalanga province in w... more Background: South Africa has the biggest HIV epidemic in the world, with Mpumalanga province in which Albert Luthuli municipality is located having the second highest HIV prevalence rate after KwaZulu-Natal province. The objective of the study was to identify the factors that affect the survival lifetime of HIV+ terminal patients in rural district hospitals of Albert Luthuli municipality.Methods: This is a typical retrospective cohort longitudinal design study whereby cohort of HIV+ terminal patients was retrospectively followed from 2010 to 2017 until a patient died, transferred to another hospital, lost to follow-up or was still alive at the end of the observation period. The follow-up time for each patient started at the time the patient got initiated to the ART programme at the hospital’s wellness centre. Nonparametric survival analysis and semiparametric survival analysis methods were used to analyse the data.Results: Through Cox proportional hazards regression modelling, it wa...

Research paper thumbnail of Cox regression of factors associated with the onset of chronic kidney disease in HIV/AIDS patients in Albert Luthuli Municipality of South Africa

Background: Current research indicates that chronic kidney disease is a global problem which pose... more Background: Current research indicates that chronic kidney disease is a global problem which poses a major health threat to people of poor countries with HIV/AIDS and on antiretroviral treatment. In this study, the prevalence of chronic kidney disease and the factors associated with it were investigated among the HIV/AIDS patients in a rural community of South Africa. Methods: A cohort of HIV+ terminal ill patients was retrospectively followed from 2010 to 2017 until chronic kidney disease was diagnosed or until the end of the observation period at two hospitals (Carolina and Embhuleni). Patient information was obtained from the routine hospitals’ records, and the data were analysed using Cox regression and survival analysis (Kaplan-Meier hazard functions and ratios, and log-rank tests) methods. Results: Out of a random sample of 320 HIV/AIDS patients, 51 patients (15.9%) had chronic kidney disease. The factors associated with chronic kidney disease were: Gender (p-value=0.0356), Ag...

Research paper thumbnail of The burden of poisoning in children hospitalised at a tertiary-level hospital in South Africa

Frontiers in Public Health, Oct 19, 2023

Introduction: Globally, childhood poisoning, accounts for a significant proportion of emergency d... more Introduction: Globally, childhood poisoning, accounts for a significant proportion of emergency department admissions. There is a paucity of data from low-and middle-income countries on poisoning in children. Objective: To describe the incidence, case fatality rate, and types of poisoning in children admitted to a tertiary-level hospital in Johannesburg, South Africa. Methods: This was a retrospective descriptive study of children hospitalised with poisoning from January 2016 to December 2021 at Chris Hani Baragwanath Academic Hospital. Children were identified from a discharge summary database using ICD-10 codes that describe poisoning. Trends in incidence of poison exposure were reported. Results: Of the 60,901 admissions during the study period, 2,652 (4.4%) children were diagnosed with poisoning. Most (71.3%) children were less than 5 years of age and 55% were male. The incidence of poisoning per 100,000 was highest at 108.4 (95% CI: 104.3-112.6) in 2019 and decreased to 77.3 (95% CI: 73.9-80.7) in 2020 and 59.6 (95% CI: 56.3-62.5) in 2021. Main causes of poisoning were organic solvents (37.6%), medications (32.9%), and pesticides (17.5%). The overall case fatality rate was 2.1%. In a multivariate analysis, poisoning secondary to pesticides (aOR: 13.9; 95% CI: 4.52-60.8; p < 0.001), and unspecified agents (aOR: 12.7; 95% CI: 3.27-62.8; p < 0.001) were associated with an increased odds of death. Conclusion: We report a high prevalence of poisoning in children hospitalised in this tertiary-level hospital in South Africa. Public health measures to reduce the burden of organic solvents, medications and pesticide poisoning are urgently warranted.

Research paper thumbnail of Predicting the loss to follow-up of HIV-infected patients on ART in a rural area in South Africa using generalized gamma distributions

Research Square (Research Square), Feb 5, 2021

Background-Long-term regular follow-up and high retention are the anticipated outcomes for the we... more Background-Long-term regular follow-up and high retention are the anticipated outcomes for the wellness and longevity of HIV/AIDS patients on antiretroviral treatment. However, these anticipated outcomes are marred by patient loss to follow-up (LTFU) which is currently exacerbated by the Covid-19 pandemic. This study aims to determine the prevalence and potential risk factors to LTFU among HIV/AIDS patients on ART at two rural district hospitals in South Africa. Methods-This is a retrogressive observational study whereby a cohort of HIV/AIDS patients was retrospectively followed from 2010 to 2017 until loss to follow-up occurred or until the end of the observation period at Carolina and Embhuleni hospitals. An institutional based retrospective cohort study was undertaken among children, adolescents and adults living with HIV/AIDS and attending ART clinic between January 1, 2010 and June 30, 2017. Loss to follow up was defined as not taking an ART refill for a period of 90 days or longer from the last attendance for refill and not yet classified as 'dead' or 'transferred-out' patient. Patient information was obtained from the routine hospitals' records, and the data were analysed using Generalized gamma distribution to identify the predictors of loss to follow up among HIV/AIDS patients while Kaplan-Meier model was used to estimate and compare the LTFU survival probabilities of heterogenous groups among the patients. Results-Of the 357 patients, 60.5% were female. The mean (SD) age of the cohort was 36.2 (14.1), 15.4 (3.5), and 5.1 (3.5) years for adults, adolescents, and children, respectively. From 357 HIV/AIDS patients, 93 (26.05%) were lost to follow-up. Empirical results show that the Weibull distribution gives the best fit to the data. The Weibull model determined the Factors associated with significant risk factors to patient loss to follow up as: regimen EFV+D4T+3TC [

Research paper thumbnail of Factors associated with chronic kidney disease in HIV+ patients in Albert Luthuli Municipality of South Africa

Research Square (Research Square), Mar 4, 2020

Background: Current research indicates that chronic kidney disease is a global problem which pose... more Background: Current research indicates that chronic kidney disease is a global problem which poses a major health threat to people of poor countries who have HIV/AIDS and are on antiretroviral treatment. In this study, the prevalence of chronic kidney disease and the factors 8 associated with it were investigated among the HIV/AIDS patients in a rural community of South Africa. Methods: A cohort of HIV + terminal ill patients was retrospectively followed from 2010 to 11 2017 until chronic kidney disease was diagnosed or until the end of the observation period at two hospitals (Carolina and Embhuleni). Patient information was obtained from the routine hospitals' records, and the data were analysed using logistic regression and survival analysis (Kaplan-Meier hazard functions and ratios, and log-rank tests) methods. Results: Out of a random sample of 357 HIV/AIDS patients, 53 patients (14.85%) had chronic kidney disease. The factors associated with chronic kidney disease were: Gender (p-17 value<0.0024); Age (p-value<0.0420); Baseline creatinine (p-value<0.0116); Baseline alanine transaminase (p-value<0.0111); Treatment regimen 1 (p-value<0.0001); ART adherence (poor, fair, good) (p-value<0.0005); Hospital (p-value<0.0001); and Lost to follow-up (ye, no) (p-value<0.0069). 21 Discussion: Whilst antiretroviral treatment is associated with some improvement in virology 22 and immunology in HIV-infected patients, research is still needed for the assessment of the 23 impact of ART and other risk factors on renal function in marginalised communities in Africa. 24 Conclusion: The research findings on HIV + patients in Albert Luthuli Municipality concurred 25 with several previous research findings on risk factors to CKD. The expected action to alleviate 26 the health threat due to CKD in South Africa is to educate the nation on prevention, early 27 detection and on the management of the disease. The study established diverse baseline 28 statistics against which future research may be based.

Research paper thumbnail of Accelerated failure time modelling of Tuberculosis predictors in HIV/AIDS patients in Albert Luthuli Municipality of South Africa

Background: Tuberculosis (TB) is one of the most common opportunistic diseases and leading cause ... more Background: Tuberculosis (TB) is one of the most common opportunistic diseases and leading cause of death among Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) patients. There has been a drastic rise of TB infection associated with the pandemic occurrence of HIV/AIDS infection in South Africa and other resource-limited countries world-wide. South Africa faces an immense burden on health care systems posed by diagnostic and therapeutic challenges resulting from the concomitant HIV and TB epidemics. This study aimed to determine the prevalence and the factors associated with TB and HIV co-infection for patients attending clinical care at rural public health facilities in Albert Luthuli municipality of South Africa. Methods: A cohort of HIV/AIDS patients was retrospectively followed from inception in 2010 to 2017 until TB was diagnosed or until the end of the study. Accelerated Failure Time (AFT) model was used to analyse survival data on HIV/AIDS patien...

Research paper thumbnail of Censored quantile regression of the factors associated with chronic kidney disease in HIV/AIDS patients in Albert Luthuli Municipality of South Africa

Research paper thumbnail of Predicting the loss to follow-up of HIV-infected patients on ART in a rural area in South Africa using generalized gamma distributions

Background - Long-term regular follow-up and high retention are the anticipated outcomes for the ... more Background - Long-term regular follow-up and high retention are the anticipated outcomes for the wellness and longevity of HIV/AIDS patients on antiretroviral treatment. However, these anticipated outcomes are marred by patient loss to follow-up (LTFU) which is currently exacerbated by the Covid-19 pandemic. This study aims to determine the prevalence and potential risk factors to LTFU among HIV/AIDS patients on ART at two rural district hospitals in South Africa.Methods— This is a retrogressive observational study whereby a cohort of HIV/AIDS patients was retrospectively followed from 2010 to 2017 until loss to follow-up occurred or until the end of the observation period at Carolina and Embhuleni hospitals. An institutional based retrospective cohort study was undertaken among children, adolescents and adults living with HIV/AIDS and attending ART clinic between January 1, 2010 and June 30, 2017. Loss to follow up was defined as not taking an ART refill for a period of 90 days or ...

Research paper thumbnail of Identification of factors affecting the survival lifetime of HIV+ terminal patients in Albert Luthuli municipality of South Africa

Background: South Africa has the biggest HIV epidemic in the world, with Mpumalanga province in w... more Background: South Africa has the biggest HIV epidemic in the world, with Mpumalanga province in which Albert Luthuli municipality is located having the second highest HIV prevalence rate after KwaZulu-Natal province. The objective of the study was to identify the factors that affect the survival lifetime of HIV+ terminal patients in rural district hospitals of Albert Luthuli municipality.Methods: This is a typical retrospective cohort longitudinal design study whereby cohort of HIV+ terminal patients was retrospectively followed from 2010 to 2017 until a patient died, transferred to another hospital, lost to follow-up or was still alive at the end of the observation period. The follow-up time for each patient started at the time the patient got initiated to the ART programme at the hospital’s wellness centre. Nonparametric survival analysis and semiparametric survival analysis methods were used to analyse the data.Results: Through Cox proportional hazards regression modelling, it wa...

Research paper thumbnail of Cox regression of factors associated with the onset of chronic kidney disease in HIV/AIDS patients in Albert Luthuli Municipality of South Africa

Background: Current research indicates that chronic kidney disease is a global problem which pose... more Background: Current research indicates that chronic kidney disease is a global problem which poses a major health threat to people of poor countries with HIV/AIDS and on antiretroviral treatment. In this study, the prevalence of chronic kidney disease and the factors associated with it were investigated among the HIV/AIDS patients in a rural community of South Africa. Methods: A cohort of HIV+ terminal ill patients was retrospectively followed from 2010 to 2017 until chronic kidney disease was diagnosed or until the end of the observation period at two hospitals (Carolina and Embhuleni). Patient information was obtained from the routine hospitals’ records, and the data were analysed using Cox regression and survival analysis (Kaplan-Meier hazard functions and ratios, and log-rank tests) methods. Results: Out of a random sample of 320 HIV/AIDS patients, 51 patients (15.9%) had chronic kidney disease. The factors associated with chronic kidney disease were: Gender (p-value=0.0356), Ag...