HYBRID EVENT: You can participate in person at Boston, Massachusetts, USA or Virtually from your home or work.
Dr Lydia Mbatidde, Speaker at
St Cloud State University, United States
Title : HIV infection is an Independent Predictor of Mortality Amongst Adult Individuals with Reduced Level of Consciousness in Southwestern Uganda

Abstract:

Abstract:
The clinical epidemiology of adults admitted with reduced level of consciousness (LOC) in Sub- Saharan Africa (SSA), and the impact of HIV infection on the risk of mortality in this population is not known. We secondarily analyzed data from 336 individuals with reduced LOC and known HIV status, obtaining clinical, laboratory, and 30-day follow-up data. We recorded the investigations and treatments deemed critical by clinicians for patient care but were unavailable (unmet clinical need). We summarized patient characteristics, computed mortality rates, and used logistic regression to determine predictors of 30-day mortality. The mean age was 51 years. Reduced LOC was mostly associated with metabolic encephalopathy 106/336 (32%), CNS infections 93/336 (28%), and stroke 73/336 (22%). The median admission Glasgow Coma Scale was 10. Persons Living with HIV infection (PLWH) accounted for 97/336 (29%) of the cohort. Compared to HIV negative individuals, PLWH were younger and more likely to present with diarrhea, vomiting, headache, cough, anemia, and leukopenia. The thirty-day mortality rate in the total cohort was 159/359 (45%), and this was significantly higher in PLWH (57% vs 40%, adjusted OR [95% CI] 2.48 [1.35, 4.55], p=0.0033). Predictors of mortality on multivariable regression analysis were presence of any unmet clinical need, serum potassium, HIV infection, and an admission FOUR Score <12. Presentation with reduced LOC in Uganda is associated with high mortality rates, with worse outcomes in PLWH. Expansion of existing acute care services and other required diagnostic studies may lead to better outcomes in this population.

Lessons to the audience:

  1. The impact of HIV infection and the risk of mortality among patients who present with reduced level of consciousness.
  2. Factors that increase the risk of mortality among HIV positive individuals who present with reduced levels of consciousness.
  3. What is unmet clinical need and its role in the survival of HIV positive patients who present with reduced level of consciousness?
  4. Critical laboratory investigations to look out for among HIV positive patients who present with reduced levels of consciousness.
  5. Critical early interventions for HIV positive patients who present with reduced levels of consciousness that would improve survival.

Biography:

Dr. Lydia Mbatidde graduated with a Medical Degree from Makerere University College of Health Sciences Uganda in 2015. After Internship in August of 2016, she joined the Infectious Diseases Institute (IDI) until July 2018. While at IDI, Dr Lydia was a Project coordinator for the CDC funded Bunyoro HIV health systems strengthening project where she led a team of field stuff in the successful implementation of comprehensive HIV care and treatment in rural western Uganda. Dr Lydia Is currently working with another team of researchers in neuro HIV care as well as a Research Student at St Cloud State University.

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