Disease diagnosis in primary care in Uganda

BMC Family Practice

Research Article

Sarah M Burnett¹  Jean-Pierre Van Geertruyden²  Robert Colebunders³  Allan Ronald⁴  Sarah Naikoba⁵  Martin Kayitale Mbonye⁵  Marcia R Weaver⁶ 

[1] Accordia Global Health Foundation, Washington, DC, USA;Department of Epidemiology and Social Medicine, University of Antwerp, Campus Drie Eiken, S.4.10 Universiteitsplein 1, B-2610, Wilrijk, Antwerp, Belgium;Department of Epidemiology and Social Medicine, University of Antwerp, Campus Drie Eiken, S.4.10 Universiteitsplein 1, B-2610, Wilrijk, Antwerp, Belgium;Department of Epidemiology and Social Medicine, University of Antwerp, Campus Drie Eiken, S.4.10 Universiteitsplein 1, B-2610, Wilrijk, Antwerp, Belgium;Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada;Infectious Diseases Institute, Makerere University, P.O. BOX 22418, Mulago Hospital ComplexKampala, Uganda;Department of Epidemiology and Social Medicine, University of Antwerp, Campus Drie Eiken, S.4.10 Universiteitsplein 1, B-2610, Wilrijk, Antwerp, Belgium;International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, Seattle, USA;

关键词: Primary care;    Disease diagnosis;    Uganda;   

DOI  :  10.1186/1471-2296-15-165

 received in 2014-06-24, accepted in 2014-09-24,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe overall burden of disease (BOD) especially for infectious diseases is higher in Sub-Saharan Africa than other regions of the world. Existing data collected through the Health Management Information System (HMIS) may not be optimal to measure BOD. The Infectious Diseases Capacity Building Evaluation (IDCAP) cooperated with the Ugandan Ministry of Health to improve the quality of HMIS data. We describe diagnoses with associated clinical assessments and laboratory investigations of outpatients attending primary care in Uganda.MethodsIDCAP supported HMIS data collection at 36 health center IVs in Uganda for five months (November 2009 to March 2010) prior to implementation of the IDCAP interventions. Descriptive analyses were performed on a cross-sectional dataset of 209,734 outpatient visits during this period.ResultsOver 500 illnesses were diagnosed. Infectious diseases accounted for 76.3% of these and over 30% of visits resulted in multiple diagnoses. Malaria (48.3%), cough/cold (19.4%), and intestinal worms (6.6%) were the most frequently diagnosed illnesses. Body weight was recorded for 36.8% of patients and less than 10% had other clinical assessments recorded. Malaria smears (64.2%) and HIV tests (12.2%) accounted for the majority of 84,638 laboratory tests ordered. Fewer than 30% of patients for whom a laboratory investigation was available to confirm the clinical impression had the specific test performed.ConclusionsWe observed a broad range of diagnoses, a high percentage of multiple diagnoses including true co-morbidities, and underutilization of laboratory support. This emphasizes the complexity of illnesses to be addressed by primary healthcare workers. An improved HMIS collecting timely, quality data is needed. This would adequately describe the burden of disease and processes of care at primary care level, enable appropriate national guidelines, programs and policies and improve accountability for the quality of care.

【 授权许可】

CC BY   
© Mbonye et al.; licensee BioMed Central Ltd. 2014