The prevalence of life-limiting illness at a Ugandan National Referral Hospital: a 1-day census of all admitted patients.
BACKGROUND
Although models of hospital-based palliative care are common in high-income countries, they are rare in low-income countries despite the high burden of progressive disease.


OBJECTIVE
To measure the proportion of all adult and child patients admitted with previously diagnosed active life-limiting disease, who therefore may be appropriate for palliative care provision, across all beds.


METHODS
One-day 24 h census using chart review across every ward and department.


METHODS
All admitted patients at a large tertiary referral hospital in sub-Saharan Africa.


RESULTS
Of 1763 reviewed patients, 663 (37.7%) had a diagnosed active life-limiting disease. Of these, 130 (19.6%) were children. The most prevalent diagnoses were HIV (41.7%), cancer (41.5%) and heart disease (9.2%). During the 24 h census period 19 patients died (population mortality rate 0.01%).


CONCLUSIONS
In order to appropriately respond to need, hospital-based palliative care services in low-income settings must be of adequate size to respond to high prevalence of life-limiting illness, and to provide education and support to clinical colleagues managing all patients with life-limiting disease.
Ugandan Ministry of Health, Kampala, Uganda.
Amandua
A
Jacinto
Mulago Hospital, Kampala, Uganda.
Victoria
V
Masembe
Mulago Hospital, Kampala, Uganda.
Nazarius Mbona
NM
Tumwesigye
Cicely Saunders Institute, King's College London, London, UK.
Richard
R
Harding
D000328:Adult; D019352:Censuses; D002675:Child, Preschool; D003906:Developing Countries / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000706:statistics & numerical data*; D015995:Prevalence; D014454:Uganda / Q000453:epidemiology
Cultural issues; HIV/AIDS; Hospital care