Elisante Mchomvu1, Geoffrey Mbunda1, Noemi Simon2, Faradji Kitila1, Yvan Temba1, Isaiac Msumba1, Jabir Namamba1, Said Kilindimo3, Hellen Mgubike1, Winfrid Gingo1, Christoph Hatz4, Daniel H Paris4, Maja Weisser5, Martin Rohacek6. 1. St Francis Referral Hospital, Ifakara, United Republic of Tanzania. 2. Division of Infectious Diseases, University Hospital, Basel, Switzerland. 3. Emergency Department, Muhimbili University of Health and Allied Sciences, Dar es salaam, United Republic of Tanzania. 4. Swiss Tropical and Public Health Institute, Basel, Switzerland / University of Basel, Switzerland. 5. Division of Infectious Diseases, University Hospital, Basel, Switzerland / Emergency Department, Muhimbili University of Health and Allied Sciences, Dar es salaam, United Republic of Tanzania / Swiss Tropical and Public Health Institute, Basel, Switzerland / University of Basel, Switzerland. 6. St Francis Referral Hospital, Ifakara, United Republic of Tanzania / Ifakara Health Institute, Ifakara, United Republic of Tanzania / Swiss Tropical and Public Health Institute, Basel, Switzerland / University of Basel, Switzerland.
Abstract
BACKGROUND: Information on diagnoses made in emergency departments situated in rural sub-Saharan Africa is scarce. The aim was: to evaluate the frequency of different diagnoses made in a new emergency department to define relevant healthcare requirements; and to find out if in-hospital mortality rates would decrease after the implementation of the emergency department. METHODS: In this observational study, we prospectively collated diagnoses of all patients presenting to the emergency department of the St Francis Referral Hospital in Ifakara, Tanzania during 1 year. In addition, we compared in-hospital mortality rates before and after the implementation of the emergency department. RESULTS: From July 2016 through to June 2017, a total of 35,903 patients were included. The median age was 33.6 years (range 1 day to 100 years), 57% were female, 25% were children <5 years, 4% were pregnant and 9% were hospitalised. The most common diagnoses were respiratory tract infection (12.6%), urinary tract infection (11.4%), trauma (9.8%), undifferentiated febrile illness (5.4%), and malaria (5.2%). The most common clinical diagnoses per age group were: lower respiratory tract infection (16.1%) in children <5 years old; trauma (21.6%) in 5- to 17-year-olds; urinary tract infection (13.5%) in 18- to 50-year-olds; and hypertensive emergency (12.4%) in >50-year-olds. Respiratory tract infections peaked in April during the rainy season, whereas malaria peaked 3 months after the rainy season. In-hospital mortality rates did not decrease during the study period (5.6% in 2015 vs 7.6% in 2017). CONCLUSIONS: The majority of diagnosed disorders were of infectious or traumatic origin. The majority of febrile illnesses were poorly defined because of the lack of diagnostic methods. Trauma systems and inexpensive accurate diagnostic methods for febrile illnesses are needed in rural sub-Saharan Africa.
BACKGROUND: Information on diagnoses made in emergency departments situated in rural sub-Saharan Africa is scarce. The aim was: to evaluate the frequency of different diagnoses made in a new emergency department to define relevant healthcare requirements; and to find out if in-hospital mortality rates would decrease after the implementation of the emergency department. METHODS: In this observational study, we prospectively collated diagnoses of all patients presenting to the emergency department of the St Francis Referral Hospital in Ifakara, Tanzania during 1 year. In addition, we compared in-hospital mortality rates before and after the implementation of the emergency department. RESULTS: From July 2016 through to June 2017, a total of 35,903 patients were included. The median age was 33.6 years (range 1 day to 100 years), 57% were female, 25% were children &lt;5 years, 4% were pregnant and 9% were hospitalised. The most common diagnoses were respiratory tract infection (12.6%), urinary tract infection (11.4%), trauma (9.8%), undifferentiated febrile illness (5.4%), and malaria (5.2%). The most common clinical diagnoses per age group were: lower respiratory tract infection (16.1%) in children &lt;5 years old; trauma (21.6%) in 5- to 17-year-olds; urinary tract infection (13.5%) in 18- to 50-year-olds; and hypertensive emergency (12.4%) in &gt;50-year-olds. Respiratory tract infections peaked in April during the rainy season, whereas malaria peaked 3 months after the rainy season. In-hospital mortality rates did not decrease during the study period (5.6% in 2015 vs 7.6% in 2017). CONCLUSIONS: The majority of diagnosed disorders were of infectious or traumatic origin. The majority of febrile illnesses were poorly defined because of the lack of diagnostic methods. Trauma systems and inexpensive accurate diagnostic methods for febrile illnesses are needed in rural sub-Saharan Africa.
Authors: Alice Kidder Bukhman; Vizir Jean Paul Nsengimana; Mindy C Lipsitz; Patricia C Henwood; Endale Tefera; Shada A Rouhani; Damas Dukundane; Gene Y Bukhman Journal: Curr Cardiol Rep Date: 2019-08-31 Impact factor: 2.931
Authors: Max Bauer; Faraja Kitila; Ipyana Mwasongwe; Issa S Abdallah; Evelyne Siongo; Sylvester Kasunga; Winfrid Gingo; Robert Ndege; Karin Hasler; Daniel H Paris; Maja Weisser; Martin Rohacek Journal: PLoS One Date: 2022-06-02 Impact factor: 3.752