{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:10:06Z","timestamp":1793391006124,"version":"4.5.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University Hospitals Cleveland Medical Center\/Roe Green Travel Medicine Award 2019","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>HIV infection is a growing public health problem in Sierra Leone and the wider West Africa region. The countrywide HIV prevalence was estimated at 1.7% (67,000 people), with less than 30% receiving life-saving ART in 2016. Thus, HIV-infected patients tend to present to health facilities late, with high mortality risk.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a prospective study of HIV inpatients aged \u226515\u2009years at Connaught Hospital in Freetown\u2014the main referral hospital in Sierra Leone\u2014from July through September 2017, to assess associated factors and predictors of HIV-related mortality.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One hundred seventy-three HIV inpatients were included, accounting for 14.2% (173\/1221) of all hospital admissions during the study period. The majority were female (59.5%, 70\/173), median age was 34\u2009years, with 51.4% (89\/173) of them diagnosed with HIV infection for the first time during the current hospitalization. The most common admitting diagnoses were anemia (48%, 84\/173), tuberculosis (24.3%, 42\/173), pneumonia (17.3%, 30\/173) and diarrheal illness (15.0%, 26\/173). CD4 count was obtained in 64.7% (112\/173) of patients, with median value of 87 cells\/\u03bcL (IQR 25\u2013266), and was further staged as severe immunosuppression: CD4\u2009&lt;\u2009100 cells\/\u03bcL (50%, 56\/112); AIDS: CD4\u2009&lt;\u2009200 cells\/\u03bcL (69.6%, 78\/112); and late-stage HIV disease: CD4\u2009&lt;\u2009350 cells\/\u03bcL (83%, 93\/112). Fifty-two patients (30.1%, 52\/173) died during hospitalization, 23% (12\/52) of them within the first week. The leading causes of death were anemia (23.1%, 12\/52), pneumonia (19.2%, 10\/52), diarrheal illness (15.4%, 8\/52) and tuberculosis (13.6%, 7\/52). Neurological symptoms, i.e., loss of consciousness (<jats:italic>p<\/jats:italic>\u2009=\u20090.04) and focal limb weakness (<jats:italic>p<\/jats:italic>\u2009=\u20090.04); alcohol use (<jats:italic>p<\/jats:italic>\u2009=\u20090.01); jaundice (<jats:italic>p<\/jats:italic>\u2009=\u20090.02); cerebral toxoplasmosis (<jats:italic>p<\/jats:italic>\u2009=\u20090.01); and tuberculosis (<jats:italic>p<\/jats:italic>\u2009=\u20090.04) were significantly associated with mortality; however, only jaundice (AOR 0.11, 95% CI [0.02\u20130.65]; <jats:italic>p<\/jats:italic>\u2009=\u20090.01) emerged as an independent predictor of mortality.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>HIV-infected patients account for a substantial proportion of admissions at Connaught Hospital, with a high morbidity and in-hospital mortality burden. These findings necessitate the implementation of specific measures to enhance early HIV diagnosis and expand treatment access to all HIV-infected patients in Sierra Leone.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12889-019-7614-3","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T15:21:33Z","timestamp":1571671293000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Causes of hospitalization and predictors of HIV-associated mortality at the main referral hospital in Sierra Leone: a prospective study"],"prefix":"10.1186","volume":"19","author":[{"given":"Sulaiman","family":"Lakoh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darlinda F.","family":"Jiba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph E.","family":"Kanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Poveda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Salgado-Barreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Foday","family":"Sahr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momodu","family":"Sesay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gibrilla F.","family":"Deen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Sesay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wadzani","family":"Gashau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Salata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-1812","authenticated-orcid":false,"given":"George A.","family":"Yendewa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,21]]},"reference":[{"key":"7614_CR1","volume-title":"Global HIV & AIDS statistics \u2014 2018 fact sheet","author":"UNAIDS","year":"2018","unstructured":"UNAIDS 2018. 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Informed written consent from participants aged \u226518\u2009years and written parental consent was obtained for patients aged 15\u201318\u2009years prior to enrollment in the study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable, as our manuscript does not contain individual patients\u2019 personal information.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1320"}}