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Dysphagia in a group of adult in-patients living with HIV/AIDS in Gauteng, South Africa.Alborough, Kim 03 July 2012 (has links)
Aims: The aims of this research were to describe the signs and symptoms of dysphagia in
people who are living with HIV/AIDS and to see what participant variables such as CD4
count, age and diagnosis affect dysphagia.
Methods: This study was a descriptive, cross-sectional, quasi non-experimental design. The
sampling method that was used for this research was non-probability and convenient. These
patients were referred to the speech therapy and audiology department from various
multidisciplinary team members for dysphagia assessments. There were 106 participants in
total. Eighty participants underwent only a clinical bedside assessment and 26 underwent a
bedside assessment as well as a modified barium swallow. The Mann Assessment of
Swallowing Ability (MASA) was used to conduct the clinical bedside assessments and a
modified barium swallow (MBS) was used as an objective measure. The data was analysed
using both descriptive and inferential statistics. These tests included the Wilcoxon signed
rank test, Spearman Rho test, Kruskal-Wallis and Mann Whitney U-test.
Results: Descriptively, the results revealed that participants with neurological conditions
appeared to present with more severe signs and symptoms of dysphagia. The results from the
Wilcoxon signed rank test showed that participants with a neurological disorder experienced
more severe signs and symptoms of dysphagia, except with laryngeal elevation. The
Wilcoxon signed rank test also showed that older participants experienced more dysarthria
and oral transit difficulties. The results from the Kruskal-Wallis test highlighted that
participants with a lower CD4 count had more significant respiration and voice difficulties.
The results from the Mann-Whitney U test showed that participants who were on a HAART
regimen experienced increased difficulty in the pharyngeal phase and aspirated more
frequently. The Spearman-Rho test results showed that the MASA was seen as a valid
bedside assessment tool for assessing adult dysphagia in an acute hospital setting.
Discussions: Dysphagia does occur in the HIV/AIDS population in South Africa in
participants who have neurological conditions as well as opportunistic infections. The SLP
needs to play a key role in the assessment and management of these patients. The MASA is a
good assessment tool to use in settings where objective measures are not available.
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