A PROBLEM MEMO
Lower respiratory illnesses (COPD, asthma, pneumonia, and pulmonary tuberculosis) are the second leading cause of death in rural Uganda, however underdiganosis and delayed diagnosis rates remain on average over 60%.
It's estimated that over 90% of respiratory diseases in Uganda occur in low-resources areas. At rural clinics, up to 58% of patients are present with respiratory illness symptoms. COPD, asthma, pneumonia, and pulmonary tuberculosis (TB) remain as the most common types of respiratory illness, with prevalences at 16.2%, 11.1%, 9.0%, and 7.2% respectively in rural areas.
COPD (Chronic obstructive pulmonary disease) = long-term lung disease that makes it hard to breath
Asthma = a condition that causes your airways to narrow
Pneumonia = an inflammation of your lungs' air sacs due to an infection
Pulmonary TB = a contagious bacterial infection that resides in the lower respiratory tract
80% of patients with COPD aren't being diagnosed, the same matter occurring to 98% of those with asthma. With pneumonia, the under diagnosis rate hovers around 29%, and only 65% of people with TB annually are detected, only half with a laboratory-confirmed diagnosis.
These prevalences and under diagnosis rates account for those over the age of twelve all across rural Uganda.
The majority (2/3) of the diagnosis is based on a physical exam whereby the doctor will listen to a patient's breathing through a stethoscope put to the chest. Often, certain diseases sound different from one another (i.e. pneumonia has a crackling noise vs COPD and asthma which have specific whistling sounds) and this difference can be heard by the human ear.
However, because humans are not perfect in distinguishing sounds, they also rely on other pieces of information including occupation, family history, and place of residence. Often times certain respiratory diseases may be more prevalent within specific demographics, which can help to prioritize one disease in the diagnostic process.
If available (although only at national level hospitals), a lab test may be performed including a sputum test or scanning the chest with an x-ray, however this component is often not performed as this equipment is not available in the lower healthcare systems (village team, II, III, and IV).