Disease diagnosis in primary care in Uganda
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Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Family Practice
Abstract
The overall burden of disease (BOD) especially for infectious diseases is higher in Sub-Saharan Africa
than other regions of the world. Existing data collected through the Health Management Information System (HMIS)
may not be optimal to measure BOD. The Infectious Diseases Capacity Building Evaluation (IDCAP) cooperated with
the Ugandan Ministry of Health to improve the quality of HMIS data. We describe diagnoses with associated clinical
assessments and laboratory investigations of outpatients attending primary care in Uganda.
Methods: IDCAP supported HMIS data collection at 36 health center IVs in Uganda for five months (November
2009 to March 2010) prior to implementation of the IDCAP interventions. Descriptive analyses were performed on a
cross-sectional dataset of 209,734 outpatient visits during this period.
Results: Over 500 illnesses were diagnosed. Infectious diseases accounted for 76.3% of these and over 30% of visits
resulted in multiple diagnoses. Malaria (48.3%), cough/cold (19.4%), and intestinal worms (6.6%) were the most
frequently diagnosed illnesses. Body weight was recorded for 36.8% of patients and less than 10% had other clinical
assessments recorded. Malaria smears (64.2%) and HIV tests (12.2%) accounted for the majority of 84,638 laboratory
tests ordered. Fewer than 30% of patients for whom a laboratory investigation was available to confirm the clinical
impression had the specific test performed.
Conclusions: We observed a broad range of diagnoses, a high percentage of multiple diagnoses including true
co-morbidities, and underutilization of laboratory support. This emphasizes the complexity of illnesses to be
addressed by primary healthcare workers. An improved HMIS collecting timely, quality data is needed. This would
adequately describe the burden of disease and processes of care at primary care level, enable appropriate national
guidelines, programs and policies and improve accountability for the quality of care.
Description
Keywords
Primary care, Disease diagnosis
Citation
Mbonye, M. K., Burnett, S. M., Colebunders, R., Naikoba, S., Van Geertruyden, J. P., Weaver, M. R., & Ronald, A. (2014). Disease diagnosis in primary care in Uganda. BMC Family Practice, 15(1), 1-13. doi:10.1186/1471-2296-15-165