Descriptive study of an emergency centre in Western Kenya: Challenges and opportunities

Abstract

With the highest global burden of disease and injury, there is an urgent need for Emergency Centres (EC) and physicians in Africa. Essential to this is the need for information on demographics, complaints, and acuity of patients presenting for acute care in Sub-Saharan Africa. The goal of this study was to determine the characteristics of EC patients in Eldoret, Kenya. Methods: Between January 1, 2011 and December 31, 2011, patient demographics, chief complaints, diagnoses, and dispositions were recorded for all patients presenting to an EC in Eldoret, Kenya. Patient volumes were averaged by month, week, and time of day. EC provider diagnoses were categorized according to the World Health Organization (WHO) ICD-10 Classifications. Dispositions were categorized into the following categories: admitted, observed, discharged, died, or unknown. Results: 20,666 patients were seen with 17,336 (83.9%) having complete visit information. The average age was 35.6 years and 52.6% of patients were female. The majority of patients (70%) presented between the hours of 8 am and 5 pm. Deaths were highest in the early morning. The most common diagnoses were related to injury (20.2%) followed by infectious diseases (11.7%) and mental health disorders (11.3%). Patient acuity was high as 58.6% of patients required observation or admission. Conclusions: The most common presentation for acute care in western Kenya was injury related. However, the severity of illness, lack of pre-hospital transportation, and lack of community mental health services provide significant challenges and opportunities for developing ECs in sub-Saharan Africa.

Keywords

• Emergency medicine
• Demography
• Kenya