000			02663nam a22003377a 4500
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022			_2 BMC Health Services Research _a1472-6963
028			_b Phone: +255 28 298 3384
028			_bFax: +255 28 298 3386
028			_b Email: vc@bugando.ac.tz
028			_b Website: www.bugando.ac.tz
040			_bEnglish _cDLC
041			_aEnglish
100			_aBahati MK Wajanga _945957
222			_a HIV AIDS Sub-Saharan Africa Mortality Health system Inpatients
245			_aInpatient mortality of HIV-infected adults in sub-Saharan Africa and possible interventions: a mixed methods review
260			_aMwanza, Tanzania: _bBioMed Central & _bCatholic University of Health and Allied Sciences [CUHAS – Bugando] _c03 December 2014
300			_aPages 1-8
490			_3BMC Health Services Research: _aWajanga, B.M., Webster, L.E., Peck, R.N. et al. Inpatient mortality of HIV-infected adults in sub-Saharan Africa and possible interventions: a mixed methods review. BMC Health Serv Res 14, 627 (2014). https://doi.org/10.1186/s12913-014-0627-9
520			_aAbstract: Background: Despite the increased availability of anti-retroviral therapy, in-hospital HIV mortality remains high in sub-Saharan Africa. Reports from Senegal, Malawi, and Tanzania show rates of in-hospital, HIV-related mortality ranging from 24.2% to 44%. This mixed methods review explored the potential causes of preventable in-hospital mortality associated with HIV infections in sub-Saharan Africa in the anti-retroviral era. Results: Based on our experience as healthcare providers in Africa and a review of the literature we identified 5 health systems failures which may cause preventable in-hospital mortality, including: 1) late presentation of HIV cases, 2) low rates of in-hospital HIV testing, 3) poor laboratory capacity which limits CD4 T-cell testing and the diagnosis of opportunistic infections, 4) delay in initiation of anti-retroviral therapy in-hospital, and 5) problems associated with loss to follow-up upon discharge from hospital. Conclusion: Our findings, together with the current available literature, should be used to develop practical interventions that can be implemented to reduce in-hospital mortality.
700			_a Daniel W Fitzgerald _923036
700			_aLauren E Webster _945478
700			_aRobert N Peck _922982
700			_a Jennifer A Downs _923034
700			_a Kedar Mate _946686
700			_a Luke R Smart _923177
856			_uhttps://doi.org/10.1186/s12913-014-0627-9
942			_2ddc _cVM
999			_c19922 _d19922