The pattern of symptoms in patients receiving home based care in Bangwe, Malawi : a descriptive study

Cameron Bowie¹ , Linda Kalilane² , Paul Cleary³ and Claire Bowie⁴

¹Department of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi

²Johns Hopkins Research Project, College of Medicine, Blantyre, Malawi

³Department of Public Health, University of Liverpool, UK

⁴Salvation Army Bangwe Project, Blantyre, Malawi

author email corresponding author email

BMC Palliative Care 2006, 5:1doi:10.1186/1472-684X-5-1


Published:	10 February 2006

Abstract

Background

Home based care of HIV/AIDS patients is a health need recommended but not often available in Africa. Population based assessment helps to identify unmet health needs to plan services. Careful assessment and follow up of patients receiving home based care in a defined population of Bangwe, Malawi provides details of the frequency and severity of common symptoms.

Methods

Mortality and the incidence, duration and severity of common symptoms of patients in a defined population receiving home based care were measured over an eighteen month period.

Results

358 patients, of whom 199 died, were studied. A third of patients died within 4 months of being first seen. About half the patients were unable to care for themselves on first assessment. Half were malnourished with a Body Mass Index (BMI) < 18.5 kg/m². Most patients had a mixture of symptoms at presentation. These symptoms responded to treatment usually within a fortnight. However a small proportion (5%) of patients suffered repeated episodes often as many as 6–9 times a year. Incidence rates are estimated.

Conclusion

Symptoms which are alleviated by simple treatments are common. The patients in whom symptoms recur need a responsive home based care service. Population based estimates of incidence and duration of disease and the visit work load allow an assessment of home based care needs in an urban setting in Africa.