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 standard management protocol, in human immunodeficiency virus (HIV)-positive and HIV-negative patients with tuberculous pericardial effusion, in a low-resource setting in sub-Saharan Africa. DESIGN: A prospective study under field conditions of adult patients with tuberculous pericardial effusion admitted to Queen Elizabeth Central Hospital between May 1993 and December 1994. RESULTS: In total 77 patients fulfilled the diagnostic criteria for tuberculous pericardial effusion. Of 74 patients sere-tested, 68 (92%) were HIV seropositive. Classical clinical features of pericardial effusion were often absent. Many patients had no other clinical features of HIV infection. Outcome compared favourably with quoted survival rates from the pre-HIV era. CONCLUSION: Tuberculous pericardial effusion is a common problem in Blantyre and is strongly associated with HIV infection. Successful management using a standard protocol is possible in a low-resource setting.