Risk factors of Lower Respiratory Tract Infections in the Northern part of Tanzania

Abstract

Master Thesis, Program in Medicine. TITLE:Risk factors of Lower Respiratory Tract Infections in the Northern part of Tanzania. AUTHOR: Beatrice Svensson, 2013 - 2014, Sahlgrenska Academy, Gothenburg, Sweden. Introduction: Tanzania is a low income country in Africa. Respiratory infections are the leading cause of death in low income countries. Risk factors include comorbidities and socioeconomic and environmental factors. Risk factors for severity include high age and comorbidities. Many factors are less well studied. Purpose: To evaluate possible risk factors among adult patients with lower respiratory tract infection (LRTI) in Tanzania. To establish which risk factors are common in more severe cases of community acquired pneumonia (CAP). Methods: Analysis of medical files and a questionnaire distributed to patients admitted to medical wards at two hospitals, Mawenzi Hospital (MH) and Kilimanjaro Christian Medical Centre (KCMC). CRB-65 score was used to evaluate severity among CAP-cases. Results: 70 patients with a mean age of 48 years. 44 % were male and 56 % female. 6 patients died. HIV prevalence in the study population was 47 % compared to national prevalence 5 %. Some factors that seemed to be associated with more severe cases were HIV-infection, unemployment and not having access to clean water. Pulmonary tuberculosis (PTB) was more common in the urban population and CAP in the rural. Mortality rate / total per LRTI was CAP: 1/38, Aspiration Pneumonia (AP): 3/8, PTB: 1/18 and Pneumocystis jiroveci pneumonia (PCP) 1/3. Discussion: HIV is a strong risk factor for LRTI. Unemployment may be a risk factor for more severe cases of CAP, due to financial reasons or a potential higher rate of comorbidities in this group, regrettably the study is too small to make any definite conclusions. It is probable that an urban setting present risk factors for PTB, such as crowding.