Effect of fluoride varnish on early childhood caries in immunization clinics of roatan, Honduras

Background: In order to reduce mortality among HIV/AIDS patients, it is imperative to understand the cause of mortality in these individuals. In this study, we reviewed clinical characteristics and outcome of HIV/AIDS inpatients in a tertiary hospital setting in Ethiopia in 2008. Methods: Retrospective medical chart review was done for HIVinfected patients admitted to the All Africa Leprosy, Tuberculosis and Rehabilitation training (ALERT) Centre, a tertiary referral hospital in Addis Ababa, Ethiopia from January 1 to December 31 in 2008. Basic information (sex, age etc), HIV profile (CD4 count, WHO stage, ART regimen etc), presenting symptoms, diagnosis, and outcomes were obtained, and the data were analyzed. Ethical approval was obtained from the Albert Einstein College of Medicine, ALERT Centre and the Ethiopian National Review Board. Findings: A total of 290HIV positive patients admitted to the ALERT Centre in 2008were included in this study.Out of the total patients, 187 of them had been onARTprior to admission (the ART group), and 103 of them were not on ART (the non-ART group). The mean CD4 count was 142.9 cell/mm for theART group and101.6 cell/mm for thenonART group (p1⁄40.002). The distribution of WHO stage was similar between the ART and non-ART groups; more than 90% of patients in both groups were either WHO stage III or IV. For overall patients, bacterial pneumonia (27.9%), all-extrapulmonary TB (26.9%), pulmonary TB (26.0%) and bacterial sepsis (18.6%) were the most common diagnosis. About 70% of TB diagnoses and more than 90% of CNS diagnoses were made empirically. Themortality was 36.4% for the ART group and 59.2% for the non-ART group (p1⁄40.000). The highest mortality was associated with final diagnoses of bacterial sepsis (61.4%) followed by CNS diagnoses (58.1%), pulmonary TB (53.7%), bacterial pneumonia (52.7%) and all-extrapulmonary TB (51.2%). About 60%of the ART group showed improvement during the admission; only 35% of the non-ART group showed improvement (p1⁄40.000). Interpretation: The non-ART group was associated with higher inpatient mortality than the ART group. Nevertheless, both groups had extremely high death rate with the overall mortality rate of 44.5%. The majority of patients presented at advanced stage of HIV disease, and the majority of the diagnoses were made empirically. In addition, more than half of the patients were diagnosed as co-infected with TB. Better diagnostic tools and treatment options will likely improve the outcome of HIV patients in Ethiopia. Of paramount importance is the implementation of the June 2013 WHO guideline to enroll people on ART with the CD4 count less than 500 cell/mm before their immune system is severely immunocompromised. Funding: NIH sponsored Einstein Center For Aids Research. Abstract #: 02CD012