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Clinical presentation and aetiologies of acute or complicated headache among HIV-seropositive patients in a Ugandan clinic

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dc.contributor.author Katwere, M.
dc.contributor.author Kambugu, A.
dc.contributor.author Piloya, T.
dc.contributor.author Wong, M.
dc.contributor.author Hendel-Paterson, B.
dc.contributor.author Sande, M. A.
dc.contributor.author Ronald, A.
dc.contributor.author Katabira, E.
dc.contributor.author Were, E. M.
dc.contributor.author Menten, J.
dc.contributor.author Colebunders, R.
dc.date.accessioned 2009-12-16T09:39:02Z
dc.date.available 2009-12-16T09:39:02Z
dc.date.issued 2009
dc.identifier.issn 1758-2652
dc.identifier.doi http://dx.doi.org/10.1186/1758-2652-12-21
dc.identifier.other ITG-I10A
dc.identifier.other ITG-CLA
dc.identifier.other INTER
dc.identifier.other U-CTU
dc.identifier.other CLINIC
dc.identifier.other U-HIVCLI
dc.identifier.other ELECTRONIC
dc.identifier.other DOI
dc.identifier.other URL
dc.identifier.other UPD17
dc.identifier.other FTA
dc.identifier.other ABSTRACT
dc.identifier.uri http://hdl.handle.net/10390/2799
dc.description.abstract ABSTRACT: BACKGROUND: We set out to define the relative prevalence and common presentations of the various aetiologies of headache within an ambulant HIV-seropositive adult population in Kampala, Uganda. METHODS: We conducted a prospective study of adult HIV-1-seropositive ambulatory patients consecutively presenting with new onset headaches. Patients were classified as focal-febrile, focal-afebrile, non-focal-febrile or non-focal-afebrile, depending on presence or absence of fever and localizing neurological signs. Further management followed along a pre-defined diagnostic algorithm to an endpoint of a diagnosis. We assessed outcomes during four months of follow up. RESULTS: One hundred and eighty patients were enrolled (72% women). Most subjects presented at WHO clinical stages III and IV of HIV disease, with a median Karnofsky performance rating of 70% (IQR 60-80).The most common diagnoses were cryptococcal meningitis (28%, n = 50) and bacterial sinusitis (31%, n = 56). Less frequent diagnoses included cerebral toxoplasmosis (4%, n = 7), and tuberculous meningitis (4%, n = 7). Thirty-two (18%) had other diagnoses (malaria, bacteraemia, etc.). No aetiology could be elucidated in 28 persons (15%). Overall mortality was 13.3% (24 of 180) after four months of follow up. Those without an established headache aetiology had good clinical outcomes, with only one death (4% mortality), and 86% were ambulatory at four months. CONCLUSION: In an African HIV-infected ambulatory population presenting with new onset headache, aetiology was found in at least 70%. Cryptococcal meningitis and sinusitis accounted for more than half of the cases. en
dc.language English en
dc.subject Viral diseases en
dc.subject HIV en
dc.subject AIDS en
dc.subject Opportunistic infections en
dc.subject Clinical manifestations en
dc.subject Headache en
dc.subject Etiology en
dc.subject Diagnosis en
dc.subject Uganda en
dc.subject Africa, East en
dc.title Clinical presentation and aetiologies of acute or complicated headache among HIV-seropositive patients in a Ugandan clinic en
dc.type Article-E en
dc.citation.issue 21 en
dc.citation.jtitle Journal of the International AIDS Society en
dc.citation.volume 12 en
dc.citation.pages 8 pp. en
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/19765315
dc.identifier.url http://www.jiasociety.org/content/12/1/21
dc.citation.jabbreviation J Int AIDS Soc en


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