The changing pattern of diseases in the Mid 1990's: experience of a teaching hospital in North Western Ethiopia

Abstract

Abstract: Between October 1994 and September 1995 consecutive adult medical admissions to the Gondar College of Medical Sciences (GCMS) teaching hospital were studied prospectively. The final diagnoses made or verified by consultant physicians before discharge or death were used for analysis. The median age was 30 years (range 12-98). Those below 50 and 40 years constituted 80.6% and 66.7%, respectively. Male to female ratio was 1.05:1.00. The median duration of hospital stay was 12 days (range 1-141). Tuberculosis and Insulin dependent Diabetes Mellitus were diseases associated with prolonged hospitalization, [OR, 95% CI = 4.66 (3.46, 6.29) and 2.4 (1.51, 3.83), respectively]. Of all admissions, 458 (40.2%) were screened for human immuno deficiency virus (HIV) and 232 (50.6%) were positive. The top ten diseases responsible for admissions, in order of decreasing frequency, were as follows: tuberculosis (25.4%), anaemia (6.5%), acute gastroenteritis and colitis (6.1%), diabetes mellitus (6.0%), pneumonia (5.9%), chronic diarrhea (4.96%), falciparum malaria (4.6%), chronic liver disease (4.2%), severe hypertension (4.2%), and stroke (3.0%). The mortality rate was 19.1%, which is high in comparison with similar reports from elsewhere. Tuberculosis and central nervous system diseases were the leading causes of hospital mortality, accounting for 35% and 18% of all deaths, respectively. There is a striking change in the pattern of diseases responsible for hospitalization compared to reports in the past. There is no study that revealed a single disease to be responsible for more than 20% of hospitalization except tuberculosis in this report. In addition, anaemia, chronic diarrhea, diabetes mellitus, hypertension, stroke and intracranial space occupying lesions were increasingly encountered. This marked change in pattern is partly explained by the current pandemic of human immuno deficiency virus/acquired immuno deficiency syndrome (HIV/AIDS) but other factors remain to be explained. [Ethiop. J. Health Dev. 1999;13(1):1-7]