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ACUTE APPENDICITIS IN A KENYAN RU IAL HOSPITAL
Abstract
Objectives: The literature on appendicitis in Africa is almost all derived from urban teaching
hospitals. As most of Africa's people are from rural areas, we sought to review our experience
from a rural hospital in Kenya.
Design: Retrospective chart review.
Setting: A rural Kenyan church hospital.
Subjects: One hundred and twelve cases of acute appendici .is presenting at Kijabe Hospital
over a five year period were reviewed.
Intervention: Appendicectomy.
Main outcome measures: Sex, age, pre-hospital delay, ope -ative findings, wound infection,
post-operative length of stay.
Results: The male to female ratio was 1.8:l. The median agt was 29 (4-71 years). Median prehospital
delays were one day (normal appendix), one and 3 half days (simple appendicitis),
three days (perforated appendix) and six and a half days (appendical abscess). Operative
findings were 14% normal appendix, 42% simple apptndicitis, 22% perforated, 21 %
abscess. Overall wound infection rate was 22% ; ranging from 11 % for simple appendicitis
to 46% for an appendiceal abscess. The mean post-opera tive length of stay was nine and a
half days.
Conclusions: Acute appendicitis in rural Kenya is similar to patterns reported in urban
African centres. The main difference from western data is the high complicated appendicitis
rate which is most likely related to prolonged pre-hospit~l delay.
hospitals. As most of Africa's people are from rural areas, we sought to review our experience
from a rural hospital in Kenya.
Design: Retrospective chart review.
Setting: A rural Kenyan church hospital.
Subjects: One hundred and twelve cases of acute appendici .is presenting at Kijabe Hospital
over a five year period were reviewed.
Intervention: Appendicectomy.
Main outcome measures: Sex, age, pre-hospital delay, ope -ative findings, wound infection,
post-operative length of stay.
Results: The male to female ratio was 1.8:l. The median agt was 29 (4-71 years). Median prehospital
delays were one day (normal appendix), one and 3 half days (simple appendicitis),
three days (perforated appendix) and six and a half days (appendical abscess). Operative
findings were 14% normal appendix, 42% simple apptndicitis, 22% perforated, 21 %
abscess. Overall wound infection rate was 22% ; ranging from 11 % for simple appendicitis
to 46% for an appendiceal abscess. The mean post-opera tive length of stay was nine and a
half days.
Conclusions: Acute appendicitis in rural Kenya is similar to patterns reported in urban
African centres. The main difference from western data is the high complicated appendicitis
rate which is most likely related to prolonged pre-hospit~l delay.
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