AEGiS-14IAC: Pneumocystis carinii Pneumonia: A major cause of infections among AAFB sputum smear negative patients admitted to Mulago Hospital, Kampala, Uganda.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Pneumocystis carinii Pneumonia: A major cause of infections among AAFB sputum smear negative patients admitted to Mulago Hospital, Kampala, Uganda.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10251)

Worodria WW, Okot-Nwang MO, Yoo SD, Aisu AT
Makerere University, Kampala, Uganda

BACKGROUND: Up to 60% of HIV infected patients develop pulmonary complications during their illness. Tuberculosis (TB) is a common cause of such infections. Sputum smear negative TB is common in advanced AIDS disease. African studies have found varied rates of pulmonary infections in HIV patients. This study was conducted to determine the prevalence of pulmonary infections among sputum smear negative HIV infected TB suspects admitted to Mulago Hospital.

METHODS: Consecutive adult patients admitted to Mulago Hospital medical wards with chest symptoms of at least 3 weeks, infiltrates on chest radiograph and no past TB treatment were enrolled into the study. Two spot and one early morning sputa were screened for AAFB. Pre and post-test counselling was done for HIV. Chest radiographs done were reported by a radiologist. AAFB smear negative and HIV positive patients had bronchoscopy done on them and bronchoalveolar lavage (BAL) fluid obtained. The BAL fluid was stained for AAFB, for Pneumocystis carinii organisms and cultured for pyogenic bacteria, fungi and mycobacteria. Data collection was done using predesigned forms and analysed using the Epi INFO 6 Statistical programme.

RESULTS: We screened 198 patients for entry into the study. Fourty eight were sputum smear positive for AAFB, 67 were excluded for various reasons leaving 83 patients on whom bronchoscopy was done and BAL fluid obtained. Thirty-two were found to have Pneumocystis carinii infection, 20 patients had TB, 9 patients had PKS and pyogenic bacteria were identified in 7 patients. No fungi were identified. No diagnosis was made in 24 patients. Nine patients had more than one diagnosis.

CONCLUSIONS: Using bronchoscopy, it was possible to identify Pneumocystis Carinii Pneumonia (38.6%), PTB (24.1%), PKS (10.8%) and pyogenic bacteria (8.4%) among AAFB sputum smear negative, HIV positive adults presenting to Mulago Hospital with pulmonary symptoms.

Keywords: AEGIS, Pneumonia, Pneumocystis, Sputum, Bronchoscopy, Prevalence, Acquired Immunodeficiency Syndrome, HIV Infections, Uganda, Respiratory Tract Infections, Hospitals, HIV Seropositivity, Cytodiagnosis, Tuberculosis, Adult, Human, etiology

020707
B10251