TUBERCULOUS PERICARDIAL-EFFUSION - A PROSPECTIVE CLINICAL-STUDY IN A LOW-RESOURCE SETTING - BLANTYRE, MALAWI

SETTING: Queen Elizabeth Central Hospital, Blantyre, Malawi. OBJECTIVE : Review of clinical and investigation findings and outcome, using a s tandard management protocol, in human immunodeficiency virus (HIV)-pos itive and HIV-negative patients with tuberculous pericardial effusion, in a low-resource setting in sub-Saharan Africa. DESIGN: A prospectiv e study under field conditions of adult patients with tuberculous peri cardial effusion admitted to Queen Elizabeth Central Hospital between May 1993 and December 1994. RESULTS: In total 77 patients fulfilled th e diagnostic criteria for tuberculous pericardial effusion. Of 74 pati ents sere-tested, 68 (92%) were HIV seropositive. Classical clinical f eatures of pericardial effusion were often absent. Many patients had n o other clinical features of HIV infection. Outcome compared favourabl y with quoted survival rates from the pre-HIV era. CONCLUSION: Tubercu lous pericardial effusion is a common problem in Blantyre and is stron gly associated with HIV infection. Successful management using a stand ard protocol is possible in a low-resource setting.