The burden of respiratory conditions in the emergency department of Muhimbili National Hospital in Tanzania in the first two years of the COVID-19 pandemic: A cross sectional descriptive study

Harrieth P Ndumwa; Erick A Mboya; Davis Elias Amani; Ramadhani Mashoka; Paulina Nicholaus; Rashan Haniffa; Abi Beane; Juma Mfinanga; Bruno Sunguya; Hendry R Sawe; Tim Baker

doi:10.1371/journal.pgph.0000781

The burden of respiratory conditions in the emergency department of Muhimbili National Hospital in Tanzania in the first two years of the COVID-19 pandemic: A cross sectional descriptive study

PLOS Glob Public Health. 2022 Dec 9;2(12):e0000781. doi: 10.1371/journal.pgph.0000781. eCollection 2022.

Authors

Harrieth P Ndumwa¹, Erick A Mboya¹, Davis Elias Amani¹, Ramadhani Mashoka², Paulina Nicholaus², Rashan Haniffa^{3

4

5}, Abi Beane^{3

4}, Juma Mfinanga², Bruno Sunguya¹, Hendry R Sawe⁶, Tim Baker^{6

7

8}

Affiliations

¹ School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
² Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, Tanzania.
³ Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
⁴ Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom.
⁵ University College London Hospitals, London, United Kingdom.
⁶ School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
⁷ Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
⁸ Department of Global Public Health, Karolinska Institutet, Solna, Sweden.

Abstract

Globally, respiratory diseases cause 10 million deaths every year. With the COVID-19 pandemic, the burden of respiratory illness increased and led to significant morbidity and mortality in both high- and low-income countries. This study assessed the burden and trend of respiratory conditions among patients presenting to the emergency department of Muhimbili National Hospital in Tanzania and compared with national COVID-19 data to determine if this knowledge may be useful for the surveillance of disease outbreaks in settings of limited specific diagnostic testing. The study used routinely collected data from the electronic information system in the Emergency Medical Department (EMD) of Muhimbili National Hospital in Tanzania. All patients presenting to the EMD in a 2-year period, 2020 and 2021 with respiratory conditions were included. Descriptive statistics and graphical visualizations were used to describe the burden of respiratory conditions and the trends over time and to compare to national Tanzanian COVID-19 data during the same period. One in every four patients who presented to the EMD of the Muhimbili National Hospital had a respiratory condition- 1039 patients per month. Of the 24,942 patients, 52% were males, and the median age (IQR) was 34.7 (21.7, 53.7) years. The most common respiratory diagnoses were pneumonia (52%), upper respiratory tract infections (31%), asthma (4.8%) and suspected COVID-19 (2.5%). There were four peaks of respiratory conditions coinciding with the four waves in the national COVID-19 data. We conclude that the burden of respiratory conditions among patients presenting to the EMD of Muhimbili National Hospital is high. The trend shows four peaks of respiratory conditions in 2020-2021 seen to coincide with the four waves in the national COVID-19 data. Real-time hospital-based surveillance tools may be useful for early detection of respiratory disease outbreaks and other public health emergencies in settings with limited diagnostic testing.

Copyright: © 2022 Ndumwa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

This study was supported by the African critical care registry network for pandemic surveillance, clinical management and research (MRC/UKRI MR/V030884/1)-RH, AB and TB; and by the Laerdal Foundation (2021-0097)-TB, HPN. HPN, EAM, RM and PN received salary support from the African critical care registry network for pandemic surveillance, clinical management and research funding for coordination and technical activities of the project. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.