The burden of acute disease in Mahajanga, Madagascar - a 21 month study.

Efforts to develop effective and regionally-appropriate emergency care systems in sub-Saharan Africa are hindered by a lack of data on both the burden of disease in the region and on the state of existing care delivery mechanisms. This study describes the burden of acute disease presenting to an eme...

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Main Authors: Vijay C Kannan, Clara N Andriamalala, Teri A Reynolds
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4349786?pdf=render
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spelling doaj-31d843dd770447a9b558a87996510c4d2020-11-24T21:58:33ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01103e011902910.1371/journal.pone.0119029The burden of acute disease in Mahajanga, Madagascar - a 21 month study.Vijay C KannanClara N AndriamalalaTeri A ReynoldsEfforts to develop effective and regionally-appropriate emergency care systems in sub-Saharan Africa are hindered by a lack of data on both the burden of disease in the region and on the state of existing care delivery mechanisms. This study describes the burden of acute disease presenting to an emergency unit in Mahajanga, Madagascar.Handwritten patient registries on all emergency department patients presenting between 1 January 2011 and 30 September 2012 were reviewed and data entered into a database. Data included age, sex, diagnosis, and disposition. We classified diagnoses into Clinical Classifications Software (CCS) multi-level categories. The population was 53.5% male, with a median age of 31 years. The five most common presenting conditions were 1) Superficial injury; contusion, 2) Open wounds of head; neck; and trunk, 3) Open wounds of extremities, 4) Intracranial injury, and 5) Unspecified injury and poisoning. Trauma accounted for 48%, Infectious Disease for 15%, Mental Health 6.1%, Noncommunicable 29%, and Neoplasms 1.2%. The acuity seen was high, with an admission rate of 43%. Trauma was the most common reason for admission, representing 19% of admitted patients.This study describes the burden of acute disease at a large referral center in northern Madagascar. The Centre Hôpitalier Universitaire de Mahajanga sees a high volume of acutely ill and injured patients. Similar to other reports from the region, trauma is the most common pathology observed, though infectious disease was responsible for the majority of adult mortality. Typhoid fever other intestinal infections were the most lethal CCS-coded pathologies. By utilizing a widely understood classification system, we are able to highlight contrasts between Mahajanga's acute and overall disease burden as well as make comparisons between this region and the rest of the globe. We hope this study will serve to guide the development of context-appropriate emergency medicine systems in the region.http://europepmc.org/articles/PMC4349786?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Vijay C Kannan
Clara N Andriamalala
Teri A Reynolds
spellingShingle Vijay C Kannan
Clara N Andriamalala
Teri A Reynolds
The burden of acute disease in Mahajanga, Madagascar - a 21 month study.
PLoS ONE
author_facet Vijay C Kannan
Clara N Andriamalala
Teri A Reynolds
author_sort Vijay C Kannan
title The burden of acute disease in Mahajanga, Madagascar - a 21 month study.
title_short The burden of acute disease in Mahajanga, Madagascar - a 21 month study.
title_full The burden of acute disease in Mahajanga, Madagascar - a 21 month study.
title_fullStr The burden of acute disease in Mahajanga, Madagascar - a 21 month study.
title_full_unstemmed The burden of acute disease in Mahajanga, Madagascar - a 21 month study.
title_sort burden of acute disease in mahajanga, madagascar - a 21 month study.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2015-01-01
description Efforts to develop effective and regionally-appropriate emergency care systems in sub-Saharan Africa are hindered by a lack of data on both the burden of disease in the region and on the state of existing care delivery mechanisms. This study describes the burden of acute disease presenting to an emergency unit in Mahajanga, Madagascar.Handwritten patient registries on all emergency department patients presenting between 1 January 2011 and 30 September 2012 were reviewed and data entered into a database. Data included age, sex, diagnosis, and disposition. We classified diagnoses into Clinical Classifications Software (CCS) multi-level categories. The population was 53.5% male, with a median age of 31 years. The five most common presenting conditions were 1) Superficial injury; contusion, 2) Open wounds of head; neck; and trunk, 3) Open wounds of extremities, 4) Intracranial injury, and 5) Unspecified injury and poisoning. Trauma accounted for 48%, Infectious Disease for 15%, Mental Health 6.1%, Noncommunicable 29%, and Neoplasms 1.2%. The acuity seen was high, with an admission rate of 43%. Trauma was the most common reason for admission, representing 19% of admitted patients.This study describes the burden of acute disease at a large referral center in northern Madagascar. The Centre Hôpitalier Universitaire de Mahajanga sees a high volume of acutely ill and injured patients. Similar to other reports from the region, trauma is the most common pathology observed, though infectious disease was responsible for the majority of adult mortality. Typhoid fever other intestinal infections were the most lethal CCS-coded pathologies. By utilizing a widely understood classification system, we are able to highlight contrasts between Mahajanga's acute and overall disease burden as well as make comparisons between this region and the rest of the globe. We hope this study will serve to guide the development of context-appropriate emergency medicine systems in the region.
url http://europepmc.org/articles/PMC4349786?pdf=render
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