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Non-communicable disease burden among inpatients at a rural district hospital in Malawi

Global Health Research and Policy 2023年第1期8卷 522-531页

作者： Peter Olds Chiyembekezo Kachimanga George Talama bright mailosi Enoch Ndarama Jodie Totten Nicholas Musinguzi Dickson Hangiwa Gene Bukhman Emily B.Wroe Massachusetts General Hospital BostonMAUSA Harvard Medical School BostonMAUSA Partners in Health NenoMalawi Ministry of Health and Population LilongweMalawi Department of Emergency Medicine University of WashingtonSeattleWAUSA Global Health Collaborative Mbarara University of Science and TechnologyMbararaUganda Center for Integration Science Division of Global Health EquityBrigham and Women’s HospitalBostonMAUSA Program in Global NCDs and Social Change Deparment of Global Health and Social MedicineHarvard Medical SchoolBostonMAUSA

Background The burden of non-communicable diseases(NCDs)is high in ***,resources and training for NCD care remain scarce,especially in rural *** care for NCDs in the developing world focuses on the WHO’s traditional 4×4 ***,we do not know the full burden of NCDs outside of that scope,like neurological disease,psychiatric illness,sickle cell disease,and *** goal of this study was to understand the burden of NCDs among inpatients in a rural district hospital in *** broadened our definition of NCDs beyond the traditional 4×4 set of NCDs,and included neurological disease,psychiatric illness,sickle cell disease,and *** We conducted a retrospective chart review of all inpatients who were admitted to the Neno District Hospital between January 2017 and October *** broke patients down by age,date of admission,type,and number of NCD diagnoses,and HIV status,and constructed multivariate regression models for length of stay and in-hospital *** Of 2239 total visits,27.5%were patients with *** with NCDs were older(37.6 vs 19.7 years,p<0.001)and made up 40.2%of total hospital *** also found two distinct populations of NCD *** first were patients 40 years and older with primary diagnoses of hypertension,heart failure,cancer,and *** second were patients under 40 years old with primary diagnoses of mental health conditions,burns,epilepsy,and *** also found significant trauma burden,accounting for 40%of all NCD *** multivariate analysis,carrying a medical NCD diagnosis was associated with longer length of stay(coefficient 5.2,p<0.001)and a higher risk of in-hospital mortality(OR 1.9,p=0.03).Burn patients also had significantly longer length of stay(coefficient 11.6,p<0.001).Conclusions There is a significant burden of NCDs in a rural hospital in Malawi,including those outside of the traditional 4×4 *** also found high rates of NCDs in the younger population(under 40

关键词： Malawi Non-communicable disease Burden of disease Inpatient Rural Hospital

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