Inpatient Package to Reduce HIV and AIDS-related Death in Zambia

Early post-discharge mortality is high among HIV-infected Zambians admitted to the hospital. Likely this is in part due to missed opportunities to identify lethal coinfections and optimize HIV care during admission (and before discharge). In this study the investigators will develop and pilot a new approach to inpatient HIV care that follows international guidelines for management of advanced HIV disease.

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Key information

Conditions

HIV/AIDS Acquired Immunodeficiency Syndrome Actinomycetales Infections Bacterial Infections Bacterial Infections and Mycoses Blood-Borne Infections Communicable Diseases Cryptococcosis Genital Diseases Gram-Positive Bacterial Infections HIV Infections HIV Testing Hospitalization Immune System Diseases Immunologic Deficiency Syndromes Infections Lentivirus Infections Mycobacterium Infections Mycoses RNA Virus Infections Retroviridae Infections Sexually Transmitted Diseases Sexually Transmitted Diseases, Viral Slow Virus Diseases Transitions of Care Tuberculosis Urogenital Diseases Virus Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University Teaching Hospital

Lusaka, Zambia

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

18+ years old
HIV-positive (by self-report or DCT result in UTH file)
Resident of Lusaka
Admitted to the hospital

Exclusion criteria

Too sick to provide informed consent (based on clinician opinion)
Likely to be discharged in the next 48 hours (based on clinician opinion)

Treatment and study plan

Inpatient lab bundling

Diagnostic Test

The investigators will provide patients a package of diagnostic tests at the time of admission to comprehensively assess for HIV coinfections and treatment failure. These labs are all recommended in advanced HIV guidelines but in this study we will provide all tests as a bundle rather than step-by-step as suggested in guidelines.

Inpatient navigation

Behavioral

Participants will be assigned a patient navigator who will support the patient and bedsider (treatment supporter/guardian) during the hospitalization. The navigator will be an HIV counselor who can provide counseling and health education, as well as support specimen transport, obtaining results, booking tests in other departments, linkages to ART clinic, and discharge planning

Primary outcomes

Coinfection diagnosis

Time frame: Through hospital discharge, an average of 2 weeks

Positive test for tuberculosis or cryptococcus on admission

Sponsors and collaborators

Lead sponsor

University of Alabama at Birmingham

Other

Collaborators

University Teaching Hospital
University of Maryland

Registry information

Acronym: IPADZ

Important dates

Study start: 2021
Primary completion: 2024
Study completion: 2024
First posted: Jul 26, 2019
Registry last updated: Aug 9, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed