Resumo
Background: There are several respiratory diseases (RDs) in the Nigerian populace. However, reports on the incidence and physiotherapist’s involvement in the care and management of RDs is scarce. This study investigated the incidence, pattern of RDs and referral for physiotherapy care in two Nigerian teaching hospitals.
Methodology: A 10-year retrospective audit of RDs was conducted at two Nigerian University teaching hospitals, Osun State, South-west, Nigeria. A total of 2,637 case files of patients with RDs from January, 2005 to December 2014 were reviewed. Types of RDs, socio-demographic information, duration of hospitalization, referral for physiotherapy care, and status at the point of discharge (dead or alive)] were recorded. Data were summarised using descriptive statistics and graphical representations.
Results: The frequency of RDs was 12.4% in both hospitals. Pneumonia and respiratory tract infections (RTI) 1446(54.8%), tuberculosis 460(17.4%) and chronic obstructive pulmonary diseases (COPD) 296(11.2%) were the predominant forms of RDs. More males than females were affected especially children whose ages ranged between 0 – 9 years constituting 58.2%. Pneumonia/ RTI and COPD were the leading causes of death, 42.1% and 23.3% respectively. Majority of the patients, 77.9% were discharged within the first week of admission while only 4(0.2%) of all cases of RDs were referred for physiotherapy.
Conclusion: The frequency of respiratory diseases in two tertiary health institutions in South-west, Nigeria from a 10 year review was high. Pneumonia and COPD were the leading causes of hospitalisation while male children were more vulnerable with high mortality and referral for physiotherapy was extremely poor.
Key words: Incidence, Pattern, Respiratory disease, Tertiary health institution, Physiotherapy
Résumé
Contexte: Il existe plusieurs maladies respiratoires (MR) dans la population nigériane. Cependant, les rapports sur l’incidence et la participation du physiothérapeute dans les soins et la gestion des MR sont rares. Cette étude a étudié l’incidence, le schéma des MR et le renvoi pour les soins de physiothérapie dans deux hôpitaux d’enseignement nigérian.
Méthodologie: Une vérification rétrospective de 10 ans sur les MR a été menée dans deux hôpitaux d’enseignement de l’Université nigériane, Etat d’Osun, Sud-Ouest, Nigeria. Un total de 2637 dossiers de cas de patients atteints de MR de janvier 2005 à décembre 2014 a été examiné. Les types de MR, les données sociodémographiques, la durée de l’hospitalisation, le renvoi pour les soins de physiothérapie et le statut au point de décharge (mort ou vivant)] ont été enregistrés. Les données ont été résumées à l’aide de statistiques descriptives et de représentations graphiques.
Résultats: L’fréquence des MR a été de 12,4% dans les deux hôpitaux. La pneumonie et les infections de la trachée respiratoire (ITR) 1446 (54,8%), la tuberculose 460 (17,4%) et les maladies pulmonaires obstructives chroniques (MPOC) 296 (11,2%) étaient les formes prédominantes de MR. Plus de mâles que de femmes ont été affectés, en particulier les enfants dont les âges variaient entre 0 et 9 ans, représentant 58,2%. La pneumonie/ITR et la MPOC ont été les principales causes de décès, respectivement 42,1% et 23,3%. La majorité des patients, 77,9% ont été libérés au cours de la première semaine d’admission alors que seulement 4 (0,2%) de tous les cas de MR étaient référés pour la physiothérapie.
Conclusion: l’frequency des maladies respiratoires dans deux établissements de santé tertiaire dans le sud-ouest, du Nigeria à partir d’une évaluation de 10 ans était élevée. La pneumonie et la MPOC ont été les principales causes d’hospitalisation, tandis que les enfants masculins étaient plus vulnérables avec une mortalité élevée et le renvoi pour la physiothérapie était extrêmement médiocre.
Mots clés: Fréquence, Schéma, Maladie respiratoire, Institution de santé tertiaire, Physiothérapie
Correspondence: Dr. T.O. Awotidebe, Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria. Email: tidebet@yahoo.com
Referências
Murray CJL and Lopez AD. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge, Harvard University Press; 1996. v.1: The Global Burden of Disease and Injury Series.
British Thoracic Society. The burden of lung disease: a statistical report from the British Thoracic Society. 2nd ed. London: British Thoracic Society, 2006.
Wijesinghe M, Weatherall M, Perrin K, et al. International trends in asthma mortality rates in the 5- to 34-year age group: a call for closer surveillance. Chest, 2009; 135 (4):1045-1049.
Chawla J, Seear M, Zhang T, et al. Fifty years of pediatric asthma in developed countries: how reliable are the basic data sources? Pediatr Pulmonol, 2012; 47 (3):211-219.
Black RE, Morris SS and Bryce J. Where and why are 10 million children dying every year? Lancet, 2003; 361(9376):2226–2234.
Lozano M, Naghavi K and Foreman, E. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study, 2010. The Lancet, 2012; 380, 2095-2128.
Hubbard R. The burden of lung disease. Thorax. 2006 Jul; 61(7): 557–558. doi: 10.1136/thx.2006.066050. (Accessed 16/02/2013).
Speizer FE, Horton S, Batt J and Slutsky AS. Respiratory diseases of adults: Disease control priorities in developing countries. 2nd edition. Chapter 35.
Mathers CD, Boerma T and Ma Fat D. Global and regional causes of death. British Medical Bulletin, 2009; 92: 7–32 DOI:10.1093/bmb/ldp028. (Accessed 01/09/2014)
Laumbach RJ and Kipen HM. Respiratory health effects of air pollution: update on biomass smoke and traffic pollution. J Allergy Clin Immunol. 2012; 129(1): 3–13. doi: 10.1016/j.jaci.2011.11.021. (Accessed 21/04/2015).
Carter R, Holiday DB, Nwasuruba C, et al. 6-minute walk work for assessment of functional capacity in patients with COPD. Chest, 2003, 123(5):1408–1415.
Alison JA and McKeough ZJ. Exercise and Quality of Life in COPD. Handbook of Disease Burdens and Quality of Life Measures. 2nd Ed. Springer New York. pp 4119-4131, 2010.
Adedoyin RA and Adesoye AT. Incidence and pattern of cardiovascular disease in a Nigerian hospital. Trop Doc, 2005; 35: 104-106.
Rogerson SR, Gladstone M, Callaghan M, et al. HIV infection among paediatric in-patients in Blantyre, Malawi. Trans R Soc Trop Med Hyg. 2004; 98(9):544-552.
Desalu OO, Oluwafemi JA and Ojo O. Respiratory diseases morbidity and mortality among adults attending a tertiary hospital in Nigeria. J Bras Pneumol, 2009; 35(8):745-752.
Carey MA, Card JW, Voltz JW, et al. It’s all about sex: male-female differences in lung development and disease. Trends Endocrinol Metab. 2007; 18(8): 308–313. doi: 10.1016/j.tem.2007.08.003. (Accessed 12/04/2014)
Ibeh CC and Ele PU. Prevalence of cigarette smoking in young Nigerian females. Afr J Med Med Sci, 2003; 32:335–338.
Kumar V, Abbas A, Fausto N, Robbins and Cotran A. Pathological Basis of Disease. (15), p. 723. 2004.
Adedoyin RA, Erhabor GE, Olajide A and Anifowose OJ. Influence of self–reported socioeconomic status on lung function of adult Nigerians. Physiother, 2010; 96: 97 – 1.
Mohammed J, Adedoyin RA, Awotidebe TO and Onigbinde TA. Influence of parental socioeconomic status on lung function indices of children in Ile - Ife, Nigeria. J Nig Soc Physiother, 2012; 20: 67 – 72.
Fry AM, Shay DK, Holman RC, et al. Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States, 1988–2002. JAMA 2005; 294:2712–2719.
Papi A, Bellettato CM, Braccioni F, et al. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med 2006; 173:1114–1121.
Shaubel, D. . Neonatal characteristics as risk factors for preschool Asthma. J Asthma, 1996; 33(4), 255-264.
Menezes AM, Perez-Padilla R, Hallal PC, et al. Worldwide burden of COPD in high- and low-income countries. Part II. Burden of chronic obstructive lung disease in Latin America: the PLATINO study. Int J Tuberc Lung Dis. 2008; 12 (7):709-712.
Bott J, Blumenthal S, Buxton M, et al. Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient. Thorax, 2009; 64: (Suppl 1) i1–i51.
Waschki B, Kirsten A, Holz O, et al. Physical activity is the strongest predictor of all-cause mortality in patients with COPD: a prospective cohort study. Chest 2011; 140 (2) 331–342.
Holland AE, Hill CJ, Jones AY and McDonald CF. Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2012; 10. CD008250.
Ram FS, Picot J, Lightowler J and Wedzicha JA. Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2004; (1), CD004104.
Hopkinson NS, Tennant RC, Dayer MJ, et al. A prospective study of decline in fat free mass and skeletal muscle strength in chronic obstructive pulmonary disease. Respir Res, 2007; 8, 25.