The Burden of Hypertension and Diabetes in an Emergency Department in Northern Tanzania.

Published online

Journal Article

Introduction: Little is known about the burden of hypertension and diabetes on emergency department (ED) utilization and hospitalizations in sub-Saharan Africa. Methods: A retrospective review of adult ED patients in northern Tanzania was performed from September 2017 through March 2018. Hypertension was defined as documented diagnosis of hypertension or blood pressure ≥ 140/90 mm Hg. Diabetes was defined as documented diagnosis of diabetes mellitus or random glucose ≥ 200 mg/dL. Results: Of 3961 adult ED patients, 1359 (34.3%) had hypertension, 518 (13.1%) had diabetes, and 273 (6.9%) had both. Both hypertension (OR 1.42, 95% CI 1.23-1.63, P<.001) and diabetes (OR 2.05, 95% CI 1.66-2.54, P<.001) were associated with increased odds of admission. Of 2418 hospital admissions, 694 (28.7%) were for complications of hypertension or diabetes. Of 499 patients admitted for hypertensive complications, the most common admission diagnoses were: heart failure (163 patients, 32.7%); stroke (147 patients, 29.5%); and severe hypertension (139 patients, 27.9%). Of 278 patients admitted for diabetic complications, the most common admission diagnoses were: hyperglycemia (158 patients, 56.9%); infection (60 patients, 21.6%); and stroke (28 patients, 10.1%). Conclusions: The burden of hypertension and diabetes in a Tanzanian ED is high, and the ED may serve as an opportune location for case identification and linkage-to-care interventions. Given the large proportion of Africans with undiagnosed hypertension and diabetes, an ED-based screening program would likely identify many new cases of these diseases. The high burden of hypertension- and diabetes-related hospitalizations highlights the urgent need for improvements in primary preventative care in Tanzania.

Full Text

Duke Authors

Cited Authors

  • Hertz, JT; Sakita, FM; Manavalan, P; Madut, DB; Thielman, NM; Mmbaga, BT; Staton, CA; Galson, SW

Published Date

  • 2019

Published In

Volume / Issue

  • 29 / 4

Start / End Page

  • 559 - 566

PubMed ID

  • 31641323

Pubmed Central ID

  • 31641323

Electronic International Standard Serial Number (EISSN)

  • 1945-0826

Digital Object Identifier (DOI)

  • 10.18865/ed.29.4.559

Language

  • eng

Conference Location

  • United States