Acute care in Tanzania: Epidemiology of acute care in a small community medical centre

Introduction: Without uniform recognition of Emergency Medicine as a specialty in developing sub-Saharan African countries, data are limited on the epidemiology of emergency care needs. The purposes of this study were to quantify the burden of disease presenting as medical or surgical emergencies and describe the patient population at a small community medical centre in the Republic of Tanzania. Methods: An observational study was conducted from March to June 2011 at the University of Arusha (UOA) Medical Centre in Arusha, Tanzania. All consenting patients presenting with acute illness or injury were eligible for inclusion in the study. A standardized form was used to record demographic information, chief complaint, diagnosis/diagnoses, procedure(s), treatment(s), and disposition. Results: Data were collected on 719 patients, with a mean age of 21.8 years (range neonate to 83 years). Fever (19.5%), respiratory (17.5%), and gastrointestinal complaints (15.0%) were the top three chief complaints; 94.9% of chief complaints were atraumatic. The top three diagnoses included respiratory infection (22.1%); malaria (21.4%); and skin or soft tissue infection (7.9%). Forty-three percent of patients required no procedures or tests, and 42% required only one procedure or test. Of treatments administered, 67.6% were analgesics, 51.3% were cough medications, and 47.6% were antipyretics. Ninety-seven percent of patients were discharged home after their visits. Discussion: Respiratory infections, malaria, and skin or soft tissue infections are leading reasons for seeking medical care at a small community medical centre in Arusha, Tanzania, highlighting the burden of infectious diseases in this type of facility. Males may be more likely to present with trauma, burns, and laceration injuries than females. Many patients required one or no procedures to determine their diagnosis, most treatments administered were inexpensive, and most patients were discharged home, suggesting that providing acute care in this setting could be accomplished with limited resources. (C) 2013 Production and hosting by Elsevier on behalf of African Federation for Emergency Medicine.