Airway Foreign Body Aspirations in Children at Muhimbili National Hospital, Dar es Salaam - Tanzania.

Abstract

Background: Foreign body inhalation is a life-threatening clinical situation worldwide especially in those less than 3 years old. The purpose of this report was to define the clinical characteristics of airway foreign body aspirations (FBAs) in children and to analyze the reasons for delay in diagnosis so as to improve the treatment. Methods: In Muhimbili National Hospital, bronchoscopy was performed on 26 patients diagnosed with FBAs between December 2009 and May 2011. Diagnosis was made based on the history, physical examination, radiology and bronchoscopy. Data was collected using a structured questionnaire and analyzed with SPSS computer software version 15. Results: Boys aspirated foreign bodies (FBs) more than the girls with 1.6:1 sex ratio. The majority (53.85%) of the patients were aged 3 years or less. The seed was the most common type of foreign body accounting for 53.8% of the cases. In 80.8%, the site of enlodgement was the main bronchus. All patients presented with coughing. Other symptoms included wheezing (23.1%) and breathing difficulty (19.2%). Because there were no ENT doctors at the district or regional hospitals associated with a lack of knowledge on the disease presentation by the physician, 88.5% of the patients with FBAs were misdiagnosed and had delayed management. The foreign bodies were successfully removed in 92.3% of cases. Conclusion: There is a need to spread awareness about clinical features of FBAs to physicians and ENT doctors in order to reduce a delay in diagnosis. Rigid bronchoscopy with or without tracheostomy under general anesthesia is safe and effective for foreign body removal.