Pattern of respiratory diseases seen among adults in an emergency room in a resource-poor nation health facility

Abstract

IntroductionThere is a paucity of information on utilisation of emergency medical services in Nigeria. This study was conducted to determine the pattern of respiratory diseases seen among adults in an emergency room(ER) and their mortality within twenty- four hours in a health facility in Nigeria.MethodsWe carried out a retrospective study on adult patients that presented with respiratory condition from November 2004 to December 2010 at the emergency room of Federal Medical Centre Ido-Ekiti, south western, Nigeria.ResultsA total of 3671 cases were seen, 368 were respiratory cases accounting for 10.2 % of the total emergency room visitations. The male to female patients ratio was 1.2:1 and their mean was 49 9 ± 20.3 years. Pneumonia (34.5%) was the most common cases seen in the ER, followed PTB (29.4%), acute asthma (24.5%) , acute exacerbation of COPD (10.3%), upper airway tract obstruction and malignant pleural effusion were 0.5% respectively. Fourteen of the PTB cases (3.8%) were complicated by cor-pulmonale, 9(2.5%) by pleural effusion, 4(1.1%) by massive haemoptysis and 2(0.5%) by pneumothorax. Twenty-four hours mortality was 7.4% and 44.4% of the death was due to PTB, 37.0% was due to pneumonia and 14.8% due to acute asthma attack. The overall mortalities also had a bimodal age group distribution as the highest death was recorded in ages 30-39 and ≥70 years.ConclusionPneumonia and PTB were the leading respiratory diseases among adults causing of emergency room visit and early mortality in this health facility in Nigeria.

Patterns and outcome of respiratory disease among adult in-patients, in Abuja-Nigeria

“…Our study found that 10.4% of medical emergencies were of respiratory origins. This is similar to a prevalence of 10.2% as recorded in another study done in same geographic location (7).…”

“…4 ±1 6 . 5 y ear s w ith a s lig h t f emale predominance which is comparable to "a M:F ratio of 1:1.2" which was however in contrast to the sex distribution of other studies which found a slight male predominance (7,9,10). The reason for this may be as a result of improving health seeking behavior of females in our locality.…”

“…This finding is not surprising as the communicable diseases and infections still predominate in sub-Saharan Africa where poverty, overcrowding play a major role in the distribution of diseases. However, Desalu et al found a contrasting pattern in which there was pneumonia predominance with a prevalence of 34.5% followed by PTB (29.4%), asthma and AECOPD in that order (7). Whether this was as a result of his previous study in which he found that seasonal variations affect pattern of respiratory disease is unknown.…”

Quality of acute asthma care in two tertiary hospitals in a state in South Western Nigeria: A report of clinical audit

“…This observation may be ascribed to physicians’ poor knowledge of smoking as risk factors for severe asthma and its blunting of the anti-inflammatory action of CSs 2627. Other factor responsible for poor recording of smoking is the perception by doctors that the most women do not smoke and is not a cause of serious morbidity among women who are mostly affected by asthma 5161728…”

“…Asthma causes an estimated 250,000 deaths annually (1 in 250 deaths worldwide) 2. Asthma is also the second leading cause of respiratory disease-related morbidity and third leading cause of respiratory disease-related emergency room visit and mortality within 24 h of admission in Ekiti State, Southwestern Nigeria 56. Smith et al .…”