A morbidity survey of South African primary care
Date
2012-03
Authors
Mash, Bob
Fairall, Lara
Adejayan, Olubunmi
Ikpefan, Omozuanvbo
Kumari, Jyoti
Mathee, Shaheed
Okun, Ronit
Yogolelo, Willy
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science (PLoS)
Abstract
Background: Recent studies have described the burden of disease in South Africa. However these studies do not tell us
which of these conditions commonly present to primary care providers, how these conditions may present and how
providers make sense of them in terms of their diagnoses. Clinical nurse practitioners are the main primary care providers
and need to be better prepared for this role. This study aimed to determine the range and prevalence of reasons for
encounter and diagnoses found among ambulatory patients attending public sector primary care facilities in South Africa.
Methodology/Principal Findings: The study was a multi-centre prospective cross-sectional survey of consultations in
primary care in four provinces of South Africa: Western Cape, Limpopo, Northern Cape and North West. Consultations were
coded prior to analysis by using the International Classification of Primary Care-Version 2 in terms of reasons for encounter
(REF) and diagnoses. Altogether 18856 consultations were included in the survey and generated 31451 reasons for
encounter (RFE) and 24561 diagnoses. Women accounted for 12526 (66.6%) and men 6288 (33.4%). Nurses saw 16238
(86.1%) and doctors 2612 (13.9%) of patients. The top 80 RFE and top 25 diagnoses are reported and ongoing care for
hypertension was the commonest RFE and diagnosis. The 20 commonest RFE and diagnoses by age group are also
reported.
Conclusions/Significance: Ambulatory primary care is dominated by non-communicable chronic diseases. HIV/AIDS and TB
are common, but not to the extent predicted by the burden of disease. Pneumonia and gastroenteritis are commonly seen
especially in children. Women’s health issues such as family planning and pregnancy related visits are also common. Injuries
are not as common as expected from the burden of disease. Primary care providers did not recognise mental health
problems. The results should guide the future training and assessment of primary care providers.
Description
Publication of this article was funded by the Stellenbosch University Open Access Fund.
The original publication is available at www.plosone.org/
Bibliography
The original publication is available at www.plosone.org/
Bibliography
Keywords
Citation
Mash, B. et al. 2012. A morbidity survey of South African primary Care. PLoSOne, doi:10.1371/journal.pone.0032358.