Background/Aims Musculoskeletal (MSK) disorders affect many people worldwide, but there is minimal access to medical care in low and middle-income countries (LMICs). Few hospital-based studies on MSK disorders have been conducted and there are limited prevalence data on MSK diseases in sub-Saharan Africa (SSA). Arthritis is the most common MSK condition, both reducing physical activity and increasing the risk of disability and other non-communicable diseases (NCDs). Given the high prevalence of MSK disorders and the associated significant clinical and economic burden in developed countries, an estimate of the frequency of these conditions in SSA is overdue. We aimed to determine the recorded prevalence of arthritis and related clinical features among patients admitted to a tertiary care hospital in Northern Tanzania from 2017-19. Methods Ethical approval was obtained to review the medical records retrospectively for all patients aged over 13 admitted to medical wards at Kilimanjaro Christian Medical Centre, a zonal tertiary care hospital, over this 3-year period. We collected demographic characteristics including age, gender, diagnoses and outcome. Diagnoses specifying arthritis were specifically sought. The prevalence of arthritis among inpatients over this period estimated. Analysis was conducted using STATA version 15 with categorical variables summarized using frequency and percentage. Results A total of 8023 patient files were examined with a slight majority of males 4181 (52.1%). An arthritis was recorded in 129 (1.6%) with 71 (55%) aged ≥60 years and 74 (57.4%) being female. The commonest presenting symptoms were joint pain in 69 (53.5%), swelling in 38 (29.5%) and stiffness in 18 (14%). A precise diagnosis for the arthritis was rarely recorded, although rheumatoid arthritis and gout were specified in a minority. Overall mortality was 12.4% among patients with arthritis. In addition, a diagnosis of systemic lupus erythematosus was recorded in a further 16 (0.2%) patients. Conclusion The recorded prevalence of arthritis among hospital inpatients in this LMIC study was low but the associated mortality appeared high. The retrospective nature of the data is highly likely to have underestimated the true prevalence of MSK disease and emphasizes the need for improved awareness of MSK diagnostic and management strategies. A teaching and training program has been developed to assist with this. Disclosure N.M. Yongolo: None. S.J. Krauth: None. S.M. Biswaro: None. B. Moshi: None. M. Mwanswila: None. A. Hemed: None. R. Njau: None. N. Allen Ng’unda: None. R. Walker: None. K. Kilonzo: None. S. Siebert: None. J. Halliday: None. E. McIntosh: None. C. Kelly: None. B. Mmbaga: None. G. Temu: None.
Background and Aims The burden of noncommunicable diseases is increasing in developing countries and in settings with an existing communicable burden. The study aim was to identify the disease pattern, length of stay, and clinical outcome of medical admissions. Methods A retrospective observational study of patients admitted to medical wards between 1st July 2019 and 30th June 2020, excluding those admitted for chemotherapy. The outcome measures were the pattern of disease, length of stay, and clinical outcome. Results A total of 3930 patients were analyzed. A total of 53.5% were males, and 42.9% were aged 51–75 years, with a median age of 57 years (IQR 41–71). A total of 41.3% had health insurance, 21.7% died, and the median length of stay was 6 days (IQR 4–9). Cardiovascular diseases were the most common diagnosis (26.8%) on admission and cause of death (27.9%). The common causes of death were stroke (15.1%), chronic kidney disease (11.1%), and heart failure (9.0%). Noninsured patients had a high mortality risk (odds ratios [OR] 1.67, 95% confidence interval [CI] 1.42–1.96), which was also seen among patients aged more than 75 years (OR 1.3, 95% CI 1.08–1.57), patients with communicable diseases (OR 1.44, 95% CI 1.23–1.68), and weekend admissions (OR 1.29, 95% CI 1.08–1.55). The 72‐h admission window is critical due to a very high mortality risk (OR 3.03, 95% CI 2.58–3.56). Conclusion Cardiovascular diseases are the leading cause of hospital admissions and deaths in a tertiary hospital in Northern Tanzania. Lifestyle modification, health education, and community resources are needed to combat the growing burden of cardiovascular and renal disease.
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