Acute appendicitis in people living with HIV: What does the emergency surgeon needs to know?

Network visualization to interpret which healthcare services are central to people living with HIV

AIM

To employ network analysis to identify the central healthcare service needs of people living with HIV (PLWH) for integrated care.

DESIGN

Cross-sectional survey.

METHODS

A list of healthcare services was identified through literature reviews, expert workshops and validity evaluations by PLWH. A total of 243 PLWH participated at five hospitals and self-reported their need for healthcare services on a four-point Likert scale. Centrality of healthcare service needs was analysed using network analysis.

RESULTS

The mean score for 20 healthcare service needs was 3.53 out of 4. The highest scoring need, "Precaution for interaction between antiretroviral therapy and other drugs," received a rating of 3.73 but had a centrality of only 0.31. The most central node in the network of healthcare service needs, "Information and coping with opportunistic infections," had a strength centrality of 1.63 and showed significant relationships with "non-HIV-related medical services (e.g., health check-ups)" and "Regular dental services." The correlation stability coefficient, which quantifies the stability of centrality, was 0.44 with an acceptable value.

CONCLUSIONS

The most central need was information on opportunistic infections that had connections with many nodes in network analysis. By interpreting the relationships between needs, healthcare providers can design interventions with an integrative perspective.

IMPLICATIONS FOR PATIENT CARE

Network visualization provides dynamic relationships between needs that are unknown from the score scale by presenting them graphically and qualitatively.

IMPACT

Using network analysis to interpret need assessment offers an integrated nursing perspective. Coping with opportunistic infection is central to connecting the chain of healthcare. This study highlights the multifaceted understanding of patients' needs that nurses gain when they conduct network analysis.

REPORTING METHOD

We adhered to the STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Acute appendicitis secondary to Entamoeba histolytica infestation

Acute appendicitis secondary to amoebic infestation is a rare possibility, especially in endemic areas. If left untreated, significant postoperative morbidity and mortality can result from the spread of amoebic trophozoites and subsequent tissue reaction. Histopathological examination of the resected appendix with demonstration of invasion by the parasite is mandatory for establishing a diagnosis. Careful examination of the specimen is thus of paramount importance.

The clinical characteristics and outcomes of appendicitis in a population with a high HIV-infection prevalence

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Many African countries have a high HIV-infection prevalence. Appendicitis is one of the common emergencies and its incidence is increasing in Africa.

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Literatures documenting the comparative demographics, clinical characteristics, and outcomes of appendicitis between HIV-infected and non-infected patients are limited in Africa.

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This study, conducted in an African country, informs the stakeholders in Botswana and other African countries with a similar setup on the demographics, clinical characteristics, and outcomes of appendicitis patients with HIV-infection, and it helps to design a relevant research and approach to patient management.

Introduction

Method

Results

Conclusion