Respiratory diseases morbidity and mortality among adults attending a tertiary hospital in Nigeria

Abstract

Objective: To determine the morbidity and mortality related to respiratory diseases among adults attending a tertiary-care hospital in Nigeria. Methods: We carried out a retrospective study of 183 adult patients (> 15 years of age), diagnosed with respiratory diseases between November of 2006 and October of 2008 at the Federal Medical Centre in Ido-Ekiti, Nigeria. Results: Of the 183 patients enrolled in the study, 78 (42.6%) were male and 105 (57.4%) were female, the male:female ratio being 1:1.4. Respiratory diseases were predominant in the 25-44 year age bracket (37.2%) and lower socioeconomic class (81.4%). Pulmonary TB was the leading cause of morbidity (in 42.1%), followed by asthma (in 17.5%) and pneumonia (in 15.3%). Lung cancer was uncommon (in only 0.6%). Pulmonary TB was the leading cause of hospitalization for respiratory disease (in 32%). Pulmonary TB, asthma, pneumonia and pleural pathologies were more common in women, whereas COPD was more common in men. The most common comorbidity was HIV infection (in 11.5%). The overall mean length of hospital stay was 14 days. Overall mortality was 8.7%; 50% of the deaths were attributed to pulmonary TB, 25% were attributed to pleural disease, 12.5% were attributed to pneumonia, and 6.25% were attributed to acute exacerbation of COPD. Mortality was higher in women and in the 25-44 year age bracket. Conclusions: Pulmonary TB, asthma and pneumonia were the leading causes of respiratory disease-related morbidity. Pulmonary TB was the leading cause of respiratory disease-related mortality among the adult Nigerians evaluated. Therefore, these conditions should be given higher priority in patient care. In addition, antiretroviral therapy should be readily accessible and affordable to HIV-infected individuals.Keywords: Morbidity; Mortality; Respiratory tract diseases; Africa. ResumoObjetivo: Determinar a morbidade e a mortalidade relacionadas a doenças respiratórias em adultos atendidos em um hospital terciário na Nigéria. Métodos: Estudo retrospectivo com 183 pacientes adultos (> 15 anos) diagnosticados com doenças respiratórias, entre novembro de 2006 e outubro de 2008, no Centro Médico Federal em Ido-Ekiti, Nigéria. Resultados: Dos 183 pacientes estudados, 78 (42,6%) eram do sexo masculino e 105 (57,4%) do sexo feminino (razão entre homens e mulheres: 1:1,4). As doenças respiratórias foram predominantes na faixa etária entre 25 e 44 anos (37,2%) e classe socioeconômica baixa (81,4%). A forma pulmonar da TB foi a principal causa de morbidade (em 42,1%), seguida por asma (em 17,5%) e pneumonia (em 15,3%). O câncer de pulmão foi raro (em somente 0,6%). A TB pulmonar foi a principal causa de hospitalização devido à doença respiratória (em 32%). A forma pulmonar da TB, asma, pneumonia e patologias da pleura foram mais frequentes no sexo feminino, ao passo que a DPOC foi mais frequente no sexo masculino. A comorbidade mais frequente foi a infecção por HIV (em 11,5%). A média do tempo de hospitalização foi de 14 dias. A mortalidade foi 8,7%; 50% das mortes foram ...

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

“…Approximately 40% of the total mortality was due to PTB and pneumonia and these two conditions are the leading causes of early mortality among adult patients with respiratory diseases seen in the ER in our facility. Our result is in agreement with a study in south western Nigeria [22]. The mortalities also had a bimodal age group distribution as the highest death was recorded in ages 30-39 and ≥70 years.…”

Respiratory-Related Medical Admissions in a Tertiary Institution in South-Western Nigeria

“…Our findings are in accordance with previous studies documenting extremely low percentages of admitted cases of interstitial lung disease, lung cancers and acute respiratory distress syndrome [11,21]. Similarly, even in immunocompromised patients, opportunistic infections like pneumocystis jirovecii pneumonia, pulmonary toxoplasmosis and pulmonary nocardiosis were not found in our study.…”

“…TB and HIV/AIDS were the leading causes of morbidity and mortality in patients admitted to our facility. In our study, pulmonary tuberculosis constituted about 44% of admitted respiratory cases which was comparable to reports from previous studies [10,11]. Pulmonary tuberculosis is a major health challenge in the developing countries and the burden is fuelled by the dual epidemics of HIV/AIDS and NCDs like diabetes mellitus [12].…”

“…In spite of the epidemics of the chronic noncommunicable diseases like cardiovascular and metabolic diseases in developing countries, as already established in the developed ones, communicable diseases are still a major threat. Erstwhile studies have been conducted in several parts of Nigeria on the profile of respiratory-related medical admissions [10,11], but none has been documented in Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria.…”

An audit of spirometry at the University of Ilorin Teaching Hospital, Ilorin, Nigeria (2002-2009)

“…Our result is similar to what was reported in south eastern Nigeria and Australia [13,18] but is in contrast to a study in Nepal where COPD was the commonest indication for spirometry. [19] Although pulmonary tuberculosis (PTB), asthma and pneumonia were the commonest causes of respiratory morbidity in our localities, [20] only bronchial asthma requires spirometry for diagnosis. We also found that 70.6% of the patients who had the test were referred by respiratory physicians, followed by the family physicians/GP (21.0%), who were mostly from other private hospitals; our finding is similar to that of previous studies.…”