title: Patterns of disease presentation and management in Egyptian primary care: findings from a survey of 2458 primary care patient consultations.
abstract: BACKGROUND
  The Egyptian government is considering embarking on a new wave of health sector reform. Although primary care is seen as central to the anticipated reforms, little is known about the current morbidity and utilization patterns in Egyptian publicly funded primary care. We conducted this survey study of patient encounters to describe the demographic characteristics of patients attending publicly-funded primary care practices, the relative frequency of conditions encountered in these practices, and the rates of drug prescription, investigation and referral.
  
  
  METHODS
  Cross-sectional survey of twelve primary care practices and 2458 patient consultations. Additional secondary data were collected from five of the twelve practices for preventive services provided at these practices i.e. immunizations, family planning and ante-natal care.
  
  
  RESULTS
  54% of the attendances were for people below the age of twenty, of which 54% were females. In patients above the age of twenty, women accounted for 73% of consultations. Upper respiratory tract infection was the most common reason for encounter, accounting for 24% of the presentations, followed by gastroenteritis (10%), intestinal parasites (5%), and lower respiratory tract infections (5%). Over 97% of patients were prescribed at least one drug, whereas investigation and referral rates were low (15% and 5% respectively). When the analysis was repeated for practices where data on both curative and preventive services were available (5 practices and 2146 consultations), substantial proportions of patients were found to seek care for immunizations (25%), family planning (12%), and ante-natal care (11%).
  
  
  CONCLUSIONS
  Most patients utilizing primary care practices in Egypt seek care for minor and preventive services with relatively few consultations for more serious conditions. There is also a pattern of prescribing drugs to most primary care patients which may reflect over-prescribing by primary care doctors.
authors.affiliation: Institute of Public Health, Cambridge Centre for Health Services Research, Robinson way Forvie site, Cambridge CB2 0SR, UK. a.aboulghate@gmail.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Aboulghate
authors.forename: Gary
authors.initials: G
authors.lastname: Abel
authors.forename: Georgios
authors.initials: G
authors.lastname: Lyratzopoulos
authors.forename: Aida
authors.initials: A
authors.lastname: Abdelmohsen
authors.forename: Ahmed R
authors.initials: AR
authors.lastname: Hamed
authors.forename: Martin
authors.initials: M
authors.lastname: Roland
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004534:Egypt / Q000453:epidemiology; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy / Q000453:epidemiology; D006302:Health Services Research; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007411:Intestinal Diseases, Parasitic / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011322:Primary Prevention / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000453:epidemiology; D017678:Sex Distribution; D055815:Young Adult