ACUTE NEUROLOGIC/PSYCHIATRIC PRESENTATION [ANPP] IN HOSPITALIZED HIV INFECTED PATIENTS

Background: There are limitations to diagnosing opportunistic infections and diseases etiologically in Human Immunodeficiency Virus (HIV) infection in much of sub- Saharan Africa. World Health Organization advocates syndromic management approach although certain presentations may have adverse outcome. Objectives: To determine the Prevalence of Acute Neurologic/Psychiatric disorders in Hospitalised HIVinfected patients. Methods: Prospective hospital based study involving patients admitted to adult medical wards at AKTH, Kano, Nigeria over a 6- month period between April and Sept 2005. Acute Neurologic / Psychiatric Presentation [ANPP] was defined by focal deficit, meningism or meningitis, seizures, confusion or recent onset psychiatric ailment. Outcome was evaluated at discharge as dead or alive. Results: A total of 437 patients were admitted in the period. Of the 257 patients with known HIV status 107 (42%) were infected and 43 of them died. At admission most patients were neither on ART nor on co-trimoxazole prophylaxis. Half of those whom were HIV positive had ANPP. There was no difference in gender, mean length of stay, hematocrit and CD4 cell counts between infected patients with and without ANPP (p>0.05) Conclusion: ANPP occurred in half of hospitalized HIV positive patients. Syndromic care might be a sub-optimal approach to management of ANPPin HIV infected patients. Early recognition, aetiologic diagnosis and referral / management in tertiary facility should be emphasized and improved for ANPPin HIVpositive patients.