MMed (Otorhinolaryngology), Faculty of Health Sciences, University of the Witwatersrand / HIV/AIDS continues to be an important public health challenge in sub Saharan Africa.
It is estimated that approximately 68% of people living with HIV in the world are from
this region [1]. South Africa has the largest infected population in the world, the adult
(15-49 years) HIV prevalence is estimated at 17.64% [2]. It has been estimated that
40 - 70% of such HIV positive individuals present with head and neck manifestations,
which include infection, inflammation and tumours, and are often the only and initial
presenting sign [3,4]. Peritonsillar abscess is the most common deep infection of the
head and neck in young adults and can occur in all age groups, but the highest
incidence is in adults 20 to 40 years of age [5].
The aim of this study was to assess the relationship between peritonsillar abscess
and the HIV status of patients. Method: An analytical cross sectional study utilising
retrospective clinical data from ward registers, patient records, treatment registers
and National Health Laboratory System (NHLS) databases. This study was
conducted in the adult ENT ward at the Chris Hani Baragwanath Hospital and sample
consisted of patient records over a 4 year period from January 2005 to December
2008. All patients admitted to the ENT ward with the discharge diagnosis of
peritonsillar abscess that have been tested for HIV were included in this study.
In this study period 450 patient files were reviewed of which 291 fulfilled the inclusion
criteria. The demographic details, clinical presentation which included head and
neck manifestations of HIV, the HIV status, management and complications of
peritonsillar abscess were recorded. This data was analysed using STATA-10
software.
Results: The age ranged from 15 to 63 years with a mean (SD) 29.3 years (9.58).
From the 291 patients, 86 (29.55%) were HIV positive. This is significantly higher
than the adult (15-49years) HIV prevalence rate of 17.64% [6]. The male: female
ratio of HIV positive patients 1:1.53. Forty-nine (16.84%) patients presented with
cervical lymph nodes of which 65.31% were HIV positive (P< 0.001). From the 86
HIV positive patients oral candida was present in 15.12% (P<0.001), lymphoma in
6.98% (P<0.001), oral hairy leukoplakia in 2.33%, Kaposi’s sarcoma in 1.16% and
complications (parapharyngeal abscess) 3.48%. There was no statistical
significance in the management of HIV positive patients, however hospital stay was
longer with a mean of 3.802 days (P<0.001).
From this study sample the HIV prevalence of 29.55% suggests that peritonsillar
abscess may be an early clinical marker of HIV infection. Due to the high incidence of
head and neck manifestations in HIV positive patients identifying a clinical marker
(quinsy) in the earlier stages of HIV infection would allow for better screening, earlier
diagnosis and treatment of HIV infection.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/8826 |
| Date | 12 October 2010 |
| Creators | Variava, Imraan |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf |
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