title: A retrospective study of acute mountain sickness on Mt. Kilimanjaro using trekking company data.
abstract: BACKGROUND
  High altitude illnesses (HAI) are a risk factor for any individual who is exposed to a significant increase in altitude. To learn more about the epidemiology of HAI, we sought to determine if health records from a commercial trekking company could provide novel data on the prevalence of HAI, as well as efficacy data regarding common HAI therapeutics.
  
  
  METHODS
  Health parameters from 917 tourists ascending Mt. Kilimanjaro over a 10-yr period were analyzed for meaningful data.
  
  
  RESULTS
  Of all subjects, 70% experienced at least one instance of a symptom related to HAI (headache, nausea, vomiting, diarrhea, or loss of appetite) during the trek. Acetazolamide was used at least once by 90% of subjects and, of those who used acetazolamide, 92% began taking it on day 1 of the ascent. Acetazolamide was found to improve oxygen saturation 1.2% above 9842.5 ft (3000 m). Dexamethasone use 12 h prior to ascending above 18,996 ft (5790 m) decreased the probability of a subject exhibiting at least one AMS symptom at that altitude.
  
  
  CONCLUSIONS
  The prevalence of AMS symptoms was not reduced by taking 2 extra days to reach the summit of Mt. Kilimanjaro. Prophylactic acetazolamide modestly improved oxygen saturation; however, it did not reduce symptoms. Therapeutic dexamethasone, especially at higher altitudes, was effective at reducing symptoms. We conclude that meaningful high altitude physiological data can be obtained from private trekking companies.
authors.affiliation: University of Colorado, Denver, Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Eigenberger
authors.forename: Anna
authors.initials: A
authors.lastname: Faino
authors.forename: Joanne
authors.initials: J
authors.lastname: Maltzahn
authors.forename: Christina
authors.initials: C
authors.lastname: Lisk
authors.forename: Eddie
authors.initials: E
authors.lastname: Frank
authors.forename: Amy
authors.initials: A
authors.lastname: Frank
authors.forename: Zoe
authors.initials: Z
authors.lastname: Loomis
authors.forename: Thies
authors.initials: T
authors.lastname: Schroeder
authors.forename: Matthew
authors.initials: M
authors.lastname: Strand
authors.forename: David
authors.initials: D
authors.lastname: Irwin
mesh_terms: D000086:Acetazolamide / Q000627:therapeutic use; D000532:Altitude Sickness / Q000453:epidemiology* / Q000517:prevention & control; D000932:Antiemetics / Q000627:therapeutic use; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D003132:Commerce; D003625:Data Collection; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009051:Mountaineering / Q000502:physiology; D010100:Oxygen / Q000097:blood; D012189:Retrospective Studies; D013636:Tanzania / Q000453:epidemiology; D014195:Travel
chemical_list: D000932:Antiemetics; D002257:Carbonic Anhydrase Inhibitors; D003907:Dexamethasone; D000086:Acetazolamide; D010100:Oxygen