Trends of morbidity in general medicine at United Bulawayo Hospitals, Bulawayo, Zimbabwe.
OBJECTIVE
To determine the trends of the 10 most common diseases in the Medical Department.


METHODS
Retrospective descriptive study of patients' discharge summaries.


METHODS
United Bulawayo Hospital, tertiary level hospital and referral centre for district hospitals.


METHODS
All patients admitted and discharged from the medical wards from 1987 to 1994, excluding all those who died.


METHODS
Number of discharges, patients' origin, paying status, diagnoses, staffing levels, reasons for transfer out.


RESULTS
The top 10 diseases encountered in 12,280 patients were: pneumonia, HIV/AIDS, pulmonary tuberculosis, hypertension, Diabetes mellitus, malaria, gastro-enteritis, congestive cardiac failure secondary to cardiomyopathy, congestive cardiac failure secondary to hypertension, and asthma. They respectively accounted for 11% and 49% of all hospital and departmental admissions. Most disease prevalences increased from 1987 to 1994, with HIV/AIDS showing the sharpest rise. Tuberculosis was the most frequent disease and hypertension proved to be the leading non communicable disease. A positive diagnosis was made in 76% of cases. Patients' median age was 37 years and sex ratio M/F was 1.7:1. Staffing levels and bed capacity remained unchanged despite an increasing number of patients. Of these, 22% came from rural areas and 77% with low incomes did not pay for services. Transfers out effected mainly for special diagnostic procedures accounted for 0.2%.


CONCLUSIONS
Infections and cardiovascular diseases alone accounted for 50% of the diagnoses made in patients discharged from the Medical Department of United Bulawayo Hospitals from 1987 to 1994. The 10 commonest diseases accounted for 49% of the morbidity and most of them increased in frequencies, while in case of HIV/AIDS, the increase was six fold. Cardiovascular diseases showed unexpectedly high prevalences. Diagnoses were confirmed in 76% of cases. The main problem encountered was multi pathology mainly due to added super infections and inability of 77% of patients to afford adequate health care. They resulted in frequent readmissions, heavy workload and high costs which threatened the quality of care.
Mudiayi
T K
TK
Department of Medicine, United Bulawayo Hospitals, Bulawayo, Zimbabwe.
Onyanga-Omara
A
A
Gelman
M L
ML
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005194:Family Practice; D005260:Female; D006748:Hospital Departments; D006767:Hospitals, District; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends*; D010351:Patient Discharge / Q000639:trends*; D015995:Prevalence; D012017:Referral and Consultation; D012189:Retrospective Studies; D015030:Zimbabwe / Q000453:epidemiology