Page 208 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 2 of 6 Original Research

In this study, we aimed to determine the prevalence of HIV once to the hospital: one patient underwent surgery three
in surgical inpatients and the extent of ART coverage, as times and the remaining 50 patients were admitted twice.
well as assess any differences between HIV-positive and Eight hundred and ninety patients (61.0%) were male.
HIV-negative patients in type of surgery undergone and The average age was 46.2 years (range 1–97, median 49).
in-hospital mortality at Karanda Mission Hospital, Mount Forty-seven patients (3.1%) died in hospital.
Darwin, Zimbabwe.
We established 32 different categories of surgery (Figure 1).
Methods Hernia repair was the most common procedure (216
cases; 14.3%), followed by fracture repairs (179; 11.9%),
Karanda Mission Hospital is a 150-bed rural community orchidectomies as palliative therapy in metastasised prostate
hospital in northern Zimbabwe where over 4000 surgeries cancer (129; 8.0%) and other urology cases and prostatectomies
are performed annually.
(107, 7.1%, and 104, 6.9%, respectively).
A retrospective chart review of surgical inpatient records
from 01 January 2016 to 31 December 2016 was conducted Histology
to collect clinical and demographic data including age, sex, Histology was usually not performed for the bilateral
type of surgery performed, HIV status, CD4+ counts and, orchidectomy (BLO) cases. The diagnosis of metastasised
if patient was HIV-positive, whether he or she was taking prostate cancer was therefore either based on clinical
ART. In addition, histological information was collected presentation and PSA levels and/or on histology provided
from a separate record that contains pathology results by the patient. Two hundred and sixty-eight cases for
provided by Lancet Laboratories Harare, Zimbabwe. histology were sent to Lancet Laboratories Harare. The most
Missing CD4+ counts were extracted from the locally common findings were benign (N = 109) or not classifiable
available IT system at Karanda Mission Hospital. All (N = 59). Including the BLO cases, prostate cancer was by far
inpatient surgeries performed on children (defined as those the most common malignancy, accounting for 129 cases
below 15 years of age) and adults, excluding maternity (58.4%), followed by squamous cell carcinomas (all sites 27;
cases, were included. Each visit corresponded to a separate 12.2%), adenocarcinoma (all sites 26; 11.8%) and cervical
entry in the study. cancer (19; 8.6%) (Figure 2).

Before analysing the data, all cases were anonymised.
General descriptive statistical analysis and further testing 250
for statistical significance with cross tables, chi-square, phi
and Cramer’s V was performed. Additionally, we used 200
Monte Carlo simulation and univariate analysis. All statistical 150
analysis was performed with IBM SPSS Statistics 22. Number of cases

Ethical consideration 100
50
There is no local institutional ethics committee; thus, ethics
approval for this retrospective chart review was granted by 0
Orchidectomy
Abscess
Prostatectomy
Cataract
VP shunts
Hysterectomy tumour
Orthopedic tumour
Volvulus/lleus
the administrators at the hospital. Hernia Fractures Other urology Orthopedics other Gynecological other Abdominal tumour Cosme c Breast tumour Other
Results Hysterectomy symptoma c Orthopedic infec ous
Patient characteristics
Type of surgery
A total of 1510 surgical inpatient cases were identified
(Table 1). Fifty-one patients (3.4%) presented more than FIGURE 1: Type of surgery.
TABLE 1: Patient characteristics.
Variable HIV+ HIV- Status unknown (test not performed)
n % mean s.d. n % mean s.d. n % mean s.d.
Age (years) 45.56 - 1–87 14.62 48.9 - 1–96 24.67 39.76 - 1–97 31.35
Total 177 43.5† - - 1044 61.9† - - 288 70.1† - -
Children (< 15) 4 75.0† - - 140 67.1† - - 114 71.9† - -
Adult (15–49) 110 35.5† - - 356 46.6† - - 41 70.7† - -
Older adults (> 49) 63 55.6† - - 548 70.4† - - 133 68.4† - -
Diabetes 3 1.7 - - 53 5.1 - - 7 2.4 - -
HTN 17 9.6 - - 215 20.6 - - 46 16.0 - -
RPR performed 118 66.8 - - 238 22.8 - - 19 6.6 - -
Positive 4 2.5 - - 22 2.4 - - 5 1.7 - -
RPR, rapid plasma reagin test for syphilis; HTN, arterial hypertension; s.d., standard deviation.
†, male.

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