HIV, appendectomy and postoperative complications at a reference hospital in Northwest Tanzania: cross-sectional study

We performed a cross sectional study at Weill-Bugando Medical Centre in northwest Tanzania. In total, 199 patients undergoing appendectomy were included. Demographic characteristics of patients, clinical features, laboratory, intraoperative and histopathological findings, and HIV serostatus were recorded.In total, 26/199 (13.1%) were HIV-seropositive. The HIV-positive population was significantly older (mean age: 38.4 years) than the HIV-negative population (25.3 years; p < 0.001). Leukocytosis was present in 87% of seronegative patients, as compared to 34% in seropositive patients (p = 0.0001), and peritonitis was significantly more frequent among HIV-positives (31% vs. 2%; p < 0.001). The mean (SD) length of hospital stay was significantly longer in HIV-positives (7.12 ± 2.94 days vs. 4.02 ± 1.14 days; p < 0.001); 11.5% of HIV patients developed surgical site infections, as compared to 0.6% in the HIV-negative group (p = 0.004).HIV infections are common among patients with appendicitis in Tanzania, and are associated with severe morbidity, postoperative complications and longer hospital stays. Early diagnosis of appendicitis and prompt appendectomy are crucial in areas with high prevalence of HIV infection. Routine pre-test counseling and HIV screening for appendicitis patients is recommended to detect early cases who may benefit from HAART.Appendicitis is the most frequent abdominal emergency worldwide [1-4], and also the most common cause of surgical emergency admissions in many parts of Africa [2,5]. Interestingly, the occurrence of appendicitis appears to be increasing in many low and middle income countries [6-8]. This may partly be explained by the increasing number of HIV/AIDS cases in the sub-Saharan region, as compared to high income countries [9].In the early years of the HIV epidemic it was noted that HIV-infected patients had a higher risk of appendicitis, even beyond the risks accounted for by opportunistic infections [10]. However, little is known ab