原创力文档hospital based palliative care in sub-saharan africa; a six month review from malawi基于医院的姑息治疗在撒哈拉以南非洲地区;.pdfVIP
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hospital based palliative care in sub-saharan africa; a six month review from malawi基于医院的姑息治疗在撒哈拉以南非洲地区;
Tapsfield and Jane Bates BMC Palliative Care 2011, 10:12
/1472-684X/10/12
RESEARCH ARTICLE Open Access
Hospital based palliative care in sub-Saharan
Africa; a six month review from Malawi
Julia B Tapsfield1* and M Jane Bates2*†
Abstract
Background: 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.
Methods: A retrospective review of case notes for all in-patients seen by Tiyanjane Clinic over a six month period
(April-Sept 2009) was undertaken.
Results: 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.
Conclusions: The palliat
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