The disease profile of poverty: morbidity and mortality in northern Uganda in the context of war, population displacement and HIV/AIDS

The disease profile of poverty: morbidity and mortality in northern Uganda in the context of war, population displacement and HIV/AIDS

The population of Gulu District (northern Uganda) has been severely incapacitated by war, epidemics and social disruption. This study is aimed at describing disease patterns and trends in this area through a retrospective analysis of discharge records for 155 205 in-patients of Lacor Hospital in the...

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Bibliographic Details
Published in:Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 99; no. 3; pp. 226 - 233
Main Authors: Accorsi, S., Fabiani, M., Nattabi, B., Corrado, B., Iriso, R., Ayella, E.O., Pido, B., Onek, P.A., Ogwang, M., Declich, S.
Format: Journal Article
Language:English
Published: Oxford Elsevier Ltd 01-03-2005
Royal Society of Tropical Medicine and Hygiene
Elsevier
Subjects:
Acquired Immunodeficiency Syndrome - epidemiology
Acquired Immunodeficiency Syndrome - mortality
Adolescent
Adult
Age Distribution
Aged
Biological and medical sciences
Child
Child, Preschool
Communicable Diseases - epidemiology
Communicable Diseases - mortality
Cost of Illness
Disease burden
Disease Outbreaks
Epidemics
Female
General aspects
Hospitalization - trends
Human viral diseases
Humans
Infant
Infectious diseases
Length of Stay
Malaria - epidemiology
Malaria - mortality
Medical sciences
Middle Aged
Morbidity
Nutrition Disorders - epidemiology
Nutrition Disorders - mortality
Pneumonia - epidemiology
Pneumonia - mortality
Population displacement
Poverty
Retrospective Studies
Tuberculosis - epidemiology
Tuberculosis - mortality
Uganda
Uganda - epidemiology
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
War
Warfare
Wounds and Injuries - epidemiology
Wounds and Injuries - mortality
Uganda
Africa
Epidemics
War
Uganda
Poverty
Population displacement
Disease burden
Immunopathology
Mortality
AIDS
Immune deficiency
Epidemiology
Morbidity
Infection
Viral disease
Population migration
Tropical medicine
Public health
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Description
Summary:The population of Gulu District (northern Uganda) has been severely incapacitated by war, epidemics and social disruption. This study is aimed at describing disease patterns and trends in this area through a retrospective analysis of discharge records for 155 205 in-patients of Lacor Hospital in the period 1992–2002. The burden of infectious diseases in childhood is overwhelming, with malaria accounting for the steepest increase in admissions. Admissions for war-related injuries and malnutrition fluctuated with the intensity of the war and the severity of famine. Emerging and re-emerging infections, such as HIV/AIDS, tuberculosis and Ebola, accounted for a heavy disease burden; however, there has been a trend for admissions related to HIV/AIDS and tuberculosis to decrease since the implementation of community-based services. Vulnerable groups (infants, children and women) accounted for 79.8% of admissions. Long-term war, population displacement, the collapse of social structures and the breakdown of the health system place people at a much greater risk of persistent, emerging and re-emerging infectious diseases, malnutrition and war-related injuries, shaping the ‘disease profile of poverty’. Most of the disease burden results from infectious diseases of childhood, whose occurrence could be dramatically reduced by low-cost and effective preventive and curative interventions.
Bibliography:istex:E46137057CFABA4C84497B6BC4165FECC8073567
ark:/67375/HXZ-0F967TBT-2
This manuscript is dedicated to Dr Matthew Lukwiya, Medical Superintendent of Lacor Hospital, who died of Ebola in December 2000 and who substantially contributed to the development of the hospital-based system for data collection, analysis and dissemination, in the continuous effort to find new ways of helping his people of north Uganda.
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ISSN:0035-9203
1878-3503
DOI:10.1016/j.trstmh.2004.09.008