Clinical outcome of burns in the treatment in HIV positive patients at the University teaching hospital(UTH),Lusaka,Zambia

Background: Zambia is among the countries with the highest Human Immunodeficiency Virus (HIV) prevalence in Africa. Burn injuries are a common form of trauma in Zambia and are a significant source of morbidity and mortality. HIV infection and burns are both known to induce a state of immunosuppression that can predispose burn patients to infectious complications. This study sought to find out the clinical outcome in burns patients who are HIV positive at the University Teaching Hospital (UTH) in terms of prevalence of HIV infection among burn patients, in-hospital burn wound infections and mortality.
Patients and Methods: A prospective observational cohort, hospital-based study was performed at the UTH, Lusaka, Zambia between November 2009 and November 2010. Patients with recent burns (less than 24 hours old) who presented to the hospital during this period were recruited into the study and the parameters studied included patient’s demographics, HIV status, burn history, management and clinical outcome. Data collected was analysed using STATA 10.
Results: A total of 452 burn patients with a median age of 10.5 years gave written consent to be included into the study during this one year period. Of all the 452 burns patients, 92.26% were below the age of 5 years. The male to female ratio was 1:1.3. 80.06% of the patients were burnt with hot liquids (scalds) and 16.1% of the patients tested positive for HIV. In HIV positive patients 60.3% developed burn wound infection and mortality occurred in 9.6%.
Wound infection occurred in 39.58% of HIV negative patients. 89.06% of the mortalities
were HIV negative. The average CD4 percentage of the HIV positive burn patients who died was 21.23% while for those who were discharged was 17.83%. The average CD4 percentage in HIV positive patients who developed wound infection was 18.88% while the average percentage for HIV negative patients with wound infection was 17.04%.
Conclusions: The majority of burn cases admitted to UTH are below the age of 5 years. There is no difference in prevalence of HIV infection in burn patients and the general population. HIV positive patients are more likely to have burn wound infections than those who do not have HIV. The HIV status of a burns patient does not significantly alter the outcome of burns in terms of mortality.