Patient Characteristics from an Emergency Care Center in Rural Western Kenya

J Emerg Med. 2019 Jan;56(1):80-86. doi: 10.1016/j.jemermed.2018.10.019. Epub 2018 Dec 4.

Abstract

Background: Emergency care is a neglected area of focus in many low- and middle-income countries. There is a paucity of research on types and frequencies of acute illnesses and injuries in low-resource settings.

Objective: The primary objective of this study was to describe the demographic characteristics and emergency conditions of patients that presented to a new emergency care center (ECC) at Sagam Community Hospital in Luanda, Kenya.

Methods: Patient demographic characteristics, modes of arrival, chief symptoms, triage priorities, self-reported human immunodeficiency virus status, tests performed, interventions, discharge diagnoses, and dispositions were collected for all patients that presented to the Sagam Community Hospital ECC.

Results: Between October 1, 2016 and September 30, 2017, 14,518 patients presented to the ECC. The most common mode of arrival to Sagam Community Hospital was by foot (n = 12,605 [86.8%]). There were 8931 (61.5%) female patients and 5571 (38.4%) male patients. Of the total visits, 12,668 (87.3%) were triaged Priority III (lowest priority), 1239 (8.5%) were Priority II, and 293 (2.0%) were Priority I (highest priority). The most common chief symptoms were headache (n = 3923 [15.2%]), hotness of body or chills (n = 2877 [8.8%]), and cough (n = 1827 [5.5%]). The three most common discharge diagnoses were malaria (n = 3692 [18.9%]), acute upper respiratory infection (n = 1242 [6.3%]), and gastritis/duodenitis (n = 1210 [6.2%]).

Conclusions: Although opening an ECC in rural Kenya attracted patients in need of care, access was limited primarily to those that could arrive on foot. ECCs in rural sub-Saharan Africa have the potential to provide quality care and support attainment of Sustainable Development Goals.

Keywords: Kenya; chief symptoms; discharge diagnosis; electronic medical record; emergency care; low-resource setting; triage.

MeSH terms

  • Adolescent
  • Adult
  • Demography / methods
  • Demography / statistics & numerical data*
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • HIV Infections / epidemiology
  • Health Services Accessibility / standards
  • Humans
  • Kenya / epidemiology
  • Male
  • Middle Aged
  • Rural Population / statistics & numerical data