Distribution of adult respiratory illnesses at a primary health centre in Lesotho.
METHODS
Primary health centre in the highlands of Lesotho.


BACKGROUND
There is limited information about the relative frequencies of common respiratory illnesses in resource-limited settings, particularly in sub-Saharan Africa.


OBJECTIVE
To examine whether the distribution  of respiratory illnesses in this region is unique due to the high prevalence of human immunodeficiency virus infection.


METHODS
In a prospective, cross-sectional study of adults and adolescents with cough or difficulty breathing recruited from the waiting areas of the health centre, the  primary outcome was the respiratory diagnosis for each participant, which was based on history, physical examination, response to antibiotics and the results of chest radiography (CXR) and sputum examinations.


RESULTS
Acute respiratory infections accounted for 65% of all diagnoses among  696 patients who were evaluated by a clinician and CXR. Pneumonia accounted for 10% of all diagnoses, and confirmed or probable tuberculosis (TB) accounted for 13%. Chronic respiratory conditions, including asthma, chronic obstructive pulmonary disease, silicosis and old TB, accounted for  14% of all diagnoses. Excluding 61 patients with an uninterpretable CXR, 36% (228) of the participants had significant pathology on CXR.


CONCLUSIONS
A high proportion of patients presenting to a primary health centre in Lesotho with routine respiratory complaints have serious respiratory  illnesses.
Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. kjseung@pih.org
K J
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Seung
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Rigodon
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Finch
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Gove
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Vasan
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D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007927:Lesotho / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult