RESUMEN
BACKGROUND: Cardiovascular disorders vary throughout the world in type and distribution especially between the developed and the developing countries. Data on spectrum of cardiovascular diseases in Ethiopia is scarce. OBJECTIVE: To assess the spectrum of cardiovascular disorders at Tikur Anbessa Specialized Tertiary Referral Hospital. METHODS: A record review of patient registers from January 2001 to December 2012 was done for 3282 Ethiopian patients with confirmed cardiovascular disorders at adult Cardiology clinic and Neurology clinic of Tikur Anbessa Specialized hospital. Spectrum of valvular heart disease, heart failure, hypertension, ischemic heart disease, congenital heart disease, arrhythmias, cardiomyopathies, cerebrovascular diseases, and peripheral vascular diseases, defined by Physician International Classification of Diseases, Version 9, codes, were directly standardized to the population. Descriptive statitistics was applied to present results. RESULTS: The study population contained more women (n = 1937 [59.0%]) than men. The mean age of the patients was 31.6 +/- 16.6 years. Women were younger than men (mean 29.6 [SD 15.1] years vs 34.52 [18.3] years). Valvular Heart Disease was the most common primary diagnosis in 2036 (62.0%) with significantly higher proportion in the 3rd decade of life. About 300 (9.1%) of the patients were diagnosed with heart failure. Other major diagnoses included hypertension 482 (14.7%), cerebrovascular diseases or stroke 377 (11.5%), congenital heart disease 279 (8.5%) and ischemic heart disease 224 (7.4%). Fifty seven (26.5%) patients with ischemic heart disease had diabetes mellitus. CONCLUSION: While valvular heart disease is the commonest cardiovascular disorder in Ethiopian patients at the largest public hospital of the country, ischemic heart disease has dramatically increased over the years. It is high-time that effective population-based, health promotive strategies for primary prevention as well as secondary measures for the established cardiovascular disorders and risk factors are in place.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Etiopía/epidemiología , Femenino , Hospitales de Enseñanza , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Sistema de Registros , Estudios Retrospectivos , Distribución por Sexo , Adulto JovenRESUMEN
A case-series study of all admissions using patient registers was carried out to analyse patterns of medical admissions into the Medical Intensive Care Unit (MICU) of the Addis Ababa University Teaching Hospital, and evaluate for any changes in that pattern over a study period. All patients admitted to the MICU of a 500-bed Teaching Hospital in Addis Ababa between 1985-2000 were the study subjects. Demographic variables, specific categories of diagnoses and their outcomes were recorded A total of 3548 patients (male to female ratio of 1.4:1, mean age 37.10 +/- 17.29) were admitted from September 1985 to August 2000. Acute infectious and cardiovascular diseases accounted for half of the entire critical care admissions with infectious diseases accounting for 30%. Among specific diagnoses, diabetic ketoacidosis was the leading cause of admission followed by acute myocardial infarction and severe and complicated malaria, each accounting for 10.7, 9.8 and 9.3% of all admissions respectively. Trends of admissions over the sixteen-year period showed steady increase in relative frequency of acute complications of non-communicable diseases consisting of diabetes, acute myocardial infarction and stroke while infectious diseases showed interspersed peaks of admissions coinciding with epidemics. The overall mortality of the MICU was 32%, with proportionally more female deaths, 34.8 versus 29% (P = 0.0002). Severe and complicated malaria was the leading cause of death (10.3%) followed by tetanus (6.4%) and acute myocardial infarction (6.3%). The increase in relative and absolute frequency of acute complications of non-communicable diseases most probably heralds an emerging epidemic of non-communicable diseases related to life style changes in the urban well to do in addition to existing problems of infectious diseases of poverty.
Asunto(s)
Unidades de Cuidados Intensivos/estadística & datos numéricos , Admisión del Paciente/estadística & datos numéricos , Enfermedad Aguda , Adulto , Diabetes Mellitus/epidemiología , Cetoacidosis Diabética/epidemiología , Etiopía/epidemiología , Femenino , Mortalidad Hospitalaria , Hospitales Universitarios/estadística & datos numéricos , Humanos , Malaria/epidemiología , Masculino , Infarto del Miocardio/epidemiología , Admisión del Paciente/tendencias , Factores de Riesgo , Sepsis/epidemiología , Tétanos/epidemiología , Revisión de Utilización de RecursosRESUMEN
The potential medical transmission of HIV through unsafe medical injections was evaluated in 16 rural health institutions in Ethiopia. Most institutions reported re-using disposable needle/syringes, and 12% of observed injections were given with used, disposable syringes prepared for re-use. Analysis of used needle flushes showed no HIV RNA; however, the sensitivity of our method was limited. Despite the re-use of disposable needles, medical injection practices are not likely to contribute significantly to HIV transmission in this region.
Asunto(s)
Infección Hospitalaria/transmisión , Países en Desarrollo , Infecciones por VIH/transmisión , Adolescente , Adulto , Anciano , Equipos Desechables/virología , Contaminación de Equipos , Equipo Reutilizado/estadística & datos numéricos , Etiopía , Femenino , VIH/aislamiento & purificación , Humanos , Inyecciones/efectos adversos , Masculino , Persona de Mediana Edad , Agujas/virología , Esterilización/normas , JeringasRESUMEN
The objectives of the study were to evaluate severity of rhenumatic heart disease (RHD) using age at time of death as its indicator and to look for factors associated with the severity. Retrospective study of consecutive cardiovascular deaths in the medical wards of Tikur Anbassa Teaching Hospital (TAH) from January 1995 to December 2001 was carried out. Information on age at the time of death, sex, type of valve lesions, status of secondary prophylaxis, presence or absence of arrhythmia, infective endocarditis, embolic phenomena, co-morbid illness, immediate cause(s) of death and duration of follow up at health institutions were obtained There were a total of 457 cardiovascular deaths including cerebrovascular accidents (CVA). 121(26.5%) were due to RHD. Charts of 115 RHD patients were available for detailed analysis. The overall mean age at the time of death was 25.89+/-11.05 years. The median age for males was lower than that of females (19 years, I.Q. 16-32 versus 25 years, IQ 15 - 30 years), but not statistically significantly different (p = 0. 10). There were more female deaths accounting for 57.4 %. About 70% of RHD patients died from congestive heart failure. Eleven per cent (13 patients) each died from systemic embolism and co-morbid conditions. Combined mitral and aortic valve disease within a patient accounted for majority (42.6%) of the lesions followed by combined mitral regurgitation and stenosis (24.4%). Isolated mitral stenosis, or regurgitation was a relatively less common cause of death. Aortic valve lesion without mitral valve involvement was a rare cause (3.5%) of death. In conclusion RHD in our patients ran more aggressive course as indicated by death occurring at much younger age than in even the preprophylaxis era in western world. The more frequent combined valve lesions and infrequent secondary prophylaxis may significantly contribute to the rapid course, but cannot fully explain the very low mean age. Factors responsible for rapid course in an Ethiopian need to be addressed urgently.