Hospital based palliative care in sub-Saharan Africa; a six month review from Malawi

<p>Abstract</p> <p>Background</p> <p>The World Health Organisation recognises the importance of palliative care in an African setting. Despite this services are often patchy and inconsistent, and many operate at health centre and/or community level. Few reports from hos...

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Main Authors: Jane Bates M, Tapsfield Julia B
Format: Article
Language:English
Published: BMC 2011-07-01
Series:BMC Palliative Care
Online Access:http://www.biomedcentral.com/1472-684X/10/12
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author Jane Bates M
Tapsfield Julia B
author_facet Jane Bates M
Tapsfield Julia B
author_sort Jane Bates M
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>The World Health Organisation recognises the importance of palliative care in an African setting. Despite this services are often patchy and inconsistent, and many operate at health centre and/or community level. Few reports from hospital based palliative care services in sub-Saharan Africa exist in the current literature. As part of its activities Tiyanjane Clinic has been providing hospital based palliative care to patients at Queen Elizabeth Central Hospital, a large government tertiary referral institution, in the Southern region of Malawi since 2003, caring for patients with HIV, cancer and other non-malignant palliative diagnoses.</p> <p>Methods</p> <p>A retrospective review of case notes for all in-patients seen by Tiyanjane Clinic over a six month period (April-Sept 2009) was undertaken.</p> <p>Results</p> <p>A total of 177 patients were seen, for whom 137 case notes were available (77%). 58% of patients were male, 42% female. The average age of patients was 39.1 years (range 15-92 years). 54% of patients were HIV positive, with 34% on ARV drugs at the time of care. 42% of patients had HIV related diagnoses, including AIDS defining malignancies, 48% had (non AIDS related) cancers and 9% had other palliative diagnoses. The mean age of patients with HIV related diagnoses was 34 years, for cancer patients it was 48 years. Pain was the most commonly reported symptom (74%), with 56% of patients requiring oral morphine. The mean daily dose of morphine was 30 mg/day (range 9-100 mg). 65% of patients were discharged home, 26% of patients died during admission.</p> <p>Conclusions</p> <p>The palliative care population in this setting is relatively young, especially among patients with HIV related diagnoses. HIV and cancer are the main diagnostic groups. Pain is the most commonly reported symptom, with oral morphine frequently required. Health workers require access to and knowledge of oral morphine in order to provide appropriate assistance to patients under their care.</p>
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spelling doaj.art-fab0268a82034ea4a8e49f734aaec7de2022-12-22T01:45:04ZengBMCBMC Palliative Care1472-684X2011-07-011011210.1186/1472-684X-10-12Hospital based palliative care in sub-Saharan Africa; a six month review from MalawiJane Bates MTapsfield Julia B<p>Abstract</p> <p>Background</p> <p>The World Health Organisation recognises the importance of palliative care in an African setting. Despite this services are often patchy and inconsistent, and many operate at health centre and/or community level. Few reports from hospital based palliative care services in sub-Saharan Africa exist in the current literature. As part of its activities Tiyanjane Clinic has been providing hospital based palliative care to patients at Queen Elizabeth Central Hospital, a large government tertiary referral institution, in the Southern region of Malawi since 2003, caring for patients with HIV, cancer and other non-malignant palliative diagnoses.</p> <p>Methods</p> <p>A retrospective review of case notes for all in-patients seen by Tiyanjane Clinic over a six month period (April-Sept 2009) was undertaken.</p> <p>Results</p> <p>A total of 177 patients were seen, for whom 137 case notes were available (77%). 58% of patients were male, 42% female. The average age of patients was 39.1 years (range 15-92 years). 54% of patients were HIV positive, with 34% on ARV drugs at the time of care. 42% of patients had HIV related diagnoses, including AIDS defining malignancies, 48% had (non AIDS related) cancers and 9% had other palliative diagnoses. The mean age of patients with HIV related diagnoses was 34 years, for cancer patients it was 48 years. Pain was the most commonly reported symptom (74%), with 56% of patients requiring oral morphine. The mean daily dose of morphine was 30 mg/day (range 9-100 mg). 65% of patients were discharged home, 26% of patients died during admission.</p> <p>Conclusions</p> <p>The palliative care population in this setting is relatively young, especially among patients with HIV related diagnoses. HIV and cancer are the main diagnostic groups. Pain is the most commonly reported symptom, with oral morphine frequently required. Health workers require access to and knowledge of oral morphine in order to provide appropriate assistance to patients under their care.</p>http://www.biomedcentral.com/1472-684X/10/12
spellingShingle Jane Bates M
Tapsfield Julia B
Hospital based palliative care in sub-Saharan Africa; a six month review from Malawi
BMC Palliative Care
title Hospital based palliative care in sub-Saharan Africa; a six month review from Malawi
title_full Hospital based palliative care in sub-Saharan Africa; a six month review from Malawi
title_fullStr Hospital based palliative care in sub-Saharan Africa; a six month review from Malawi
title_full_unstemmed Hospital based palliative care in sub-Saharan Africa; a six month review from Malawi
title_short Hospital based palliative care in sub-Saharan Africa; a six month review from Malawi
title_sort hospital based palliative care in sub saharan africa a six month review from malawi
url http://www.biomedcentral.com/1472-684X/10/12
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