title: Poverty, inequality and health: the challenge of the double burden of disease in a non-profit hospital in rural Ethiopia.
abstract: This study was aimed at describing disease patterns in a rural zone of Oromiya region, Ethiopia through a retrospective analysis of discharge records for 22,377 inpatients of St. Luke Hospital, Wolisso, Ethiopia in the period 2005-2007. The leading cause of admission was childbirth, followed by injuries, malaria and pneumonia. Injuries were the leading cause of in-hospital deaths, followed by pneumonia, malaria, cardiovascular disease and AIDS. Vulnerable groups (infants, children and women) accounted for 73.3% of admissions. Most of the disease burden resulted from infectious diseases, the occurrence of which could be dramatically reduced by cost-effective preventive and curative interventions. Furthermore, a double burden of disease is already emerging at the early stage of the epidemiological transition, with a mix of persistent, emerging and re-emerging infectious diseases and increasing prevalence of chronic conditions and injuries. This will lead to fundamental changes in the volume and composition of demand for healthcare, with a more complex case mix and more costly service utilization patterns. The challenge is to address the double burden of disease, while focusing on poverty-related conditions and targeting vulnerable groups. Monitoring disease and service utilization patterns through routine hospital information systems can provide sustainable, low-cost support for evidence-based health practice.
authors.affiliation: Project Italian Contribution to the Health Sector Development Programme, Italian Cooperation, P.O. Box 13018, Addis Ababa, Ethiopia. saccorsi@iii.it
authors.forename: Sandro
authors.initials: S
authors.lastname: Accorsi
authors.forename: Nejmudin
authors.initials: N
authors.lastname: Kedir
authors.forename: Pasquale
authors.initials: P
authors.lastname: Farese
authors.forename: Shallo
authors.initials: S
authors.lastname: Dhaba
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Racalbuto
authors.forename: Abera
authors.initials: A
authors.lastname: Seifu
authors.forename: Fabio
authors.initials: F
authors.lastname: Manenti
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D003141:Communicable Diseases / Q000191:economics / Q000453:epidemiology*; D005002:Ethiopia / Q000453:epidemiology; D019317:Evidence-Based Medicine; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000639:trends; D006780:Hospitals, Rural; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records; D020380:Needs Assessment; D009748:Nutrition Disorders / Q000191:economics / Q000453:epidemiology*; D010343:Patient Admission / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics / Q000453:epidemiology*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology*; D055815:Young Adult