GHO Medical Mission Metrics-Kamkaniba, Burkina Faso 2009

GHO Medical Mission Metrics - Kamkaniba, Burkina Faso July 31- August 5, 2009

Type of clinic Patients Seen
Dental 161 ( the majority had dental extractions)
Adult 444 (the majority had musculoskeletal dx)
Child 393 (the majority had malaria dx)

Total 995

Some patients were seen in both dental and medical clinics for different reasons.
Some patients had more than one diagnosis.

Diagnosis Number of Patients
Adult malaria 75
Child (infant to 17 y.o.) 249

Total 324 (diagnosis made with lab test)

63% of children seen in child clinics tested positive for malaria
17% of adults seen in adult clinic tested positive for malaria

Pneumonia 17
Bronchitis 12
Gastritis 45
Diarrhea 14
Enteritis 6
Musculoskeletal 139
Eye irritation 31
Cataracts 19
Conjunctivitis 6
Impetigo 24
Scabies/nonsp. Dermatitis 25
Fungal skin 15
TB skin 3 (many chronic ulcers also appear to be
mycobacterium related but were counted in
Wounds)
Otitis Media 18
Otitis Externa 8
Mastitis 1
Headache 43 (this dx was made in non malarious patients )
Pregnant 3
Worms 24 (made by description of worms in stool)
Seizure 5
URI, viral 7
Pharyngitis 2
STD 7 (dx made by presumptive sxs)
HIV 1 (dx made by lab test)
Malaise/anorexia 3
Goiter 5
UTI 39 (dx made by presumptive symptoms)
Abscess/ulcer/wound 38
Well patient/normal exam 39

Interesting observations:
249 positive tests for malaria in children

90% of positive malaria tests were done because parent reported fever in last 5 days.

.08% of positive malaria tests were done because of only triage temp>100.4

10% of positive tests were done because of worrisome physical exam by physician (with neg fever in last 5 days and neg temp in triage)

No malaria or bacterial illness was found in the 2 children with triage fever and no reported fever in last five days

20 children had bacterial diagnoses with negative malaria tests after parent reported fever in last 5 days

Conclusion:
Based upon these findings it is safe to directly triage children with reported fever in the last 5 days to malaria testing and physician evaluation without obtaining a temperature. Obtaining a temperature is process slowing and adds nothing to making good diagnostic decisions.

100% of medical patients (837) received de-worming medication and vitamins.

All pregnant women received Folic Acid supplements.

The 837 number is less than the total of 995 patients because dental patients were counted in the total patients seen but they did not receive vitamins or de-wormers. Many of the dental patients were also seen in medical clinic and received these medications there.

Medications Prescribed

Children’s liquid Adult tablet
Antibiotic 93 patients 160 patients

Pain /fever med 111 patients 252 patients

Malaria 233 patients 91 patients
(includes 16 children
who took chews or adult tabs)
Eye drops for 6 patients 46 patients
infex or irritation

Ear drops for infex 8 patients 3 patients

Oral antihistamine 8 patients 8 patients

Topical fungal medication 10 patients 7 patients

Cheryl Durstein-Decker MD FACEP
August 27, 2009