Acute appendicitis in a Kenyan rural hospital.

OBJECTIVES: The literature on appendicitis in Africa is almost all derived from urban teaching hospitals. As most of Africa's people are from rural areas, we sought to review our experience from a rural hospital in Kenya.
DESIGN: Retrospective chart review.
SETTING: A rural Kenyan church hospital.
SUBJECTS: One hundred and twelve cases of acute appendicitis presenting at Kijabe Hospital over a five year period were reviewed. INTERVENTION: Appendicectomy. MAIN OUTCOME MEASURES: Sex, age, pre-hospital delay, operative findings, wound infection, post-operative length of stay.
RESULTS: The male to female ratio was 1.8:1. The median age was 29 (4-71 years). Median prehospital delays were one day (normal appendix), one and a half days (simple appendicitis), three days (perforated appendix) and six and a half days (appendical abscess). Operative findings were 14% normal appendix, 42% simple appendicitis, 22% perforated, 21% abscess. Overall wound infection rate was 22%; ranging from 11% for simple appendicitis to 46% for an appendiceal abscess. The mean post-operative length of stay was nine and a half days.
CONCLUSIONS: Acute appendicitis in rural Kenya is similar to patterns reported in urban African centres. The main difference from western data is the high complicated appendicitis rate which is most likely related to prolonged pre-hospital delay.