|Family Medicine, Stellenbosch University|
|Aim: To enumerate the reasons for encounter (RFE) and the diagnoses (pre-existing or new) of patients seen in Klipfontein sub-district of the Western Cape.
Design: Prospective, cross-sectional survey.
Methods: The International Classification of Primary Care -2 (ICPC-2) was used to code data collected over a 9-month period (Oct 09 to June 10) on five different days of the week from patients presenting at primary care facilities in the Klipfontein sub-district (Doctor Abdurahman, Heideveld, Hanover park and Gugulethu CHC). This study was part of a larger project that collected the same data in primary health facilities in other parts of the Western Cape, as well as the Northern Cape, North West and Limpopo Provinces.
Results: During the study, 1985 patients (male 697, female 1288) were seen and resulted in 4241 RFE and 3565 diagnoses.
The top twenty RFE in descending order of frequency were: cough, headache, appointments related to the cardiovascular system (mostly hypertension), visit for results related to cardiovascular system, backache, appointments related to the endocrine system (mostly diabetes), cardiovascular system follow up-unspecified, joint symptoms, localized abdominal pain, tiredness, pruritus, leg pain, sneezing, throat symptoms, dysuria, generalized body pain, vomiting, localized rash, diarrhoea, generalized rash
The top twenty diagnoses presented were uncomplicated hypertension, diabetes, arthritis, upper respiratory tract infections, asthma, tuberculosis, urinary tract infection, lower respiratory tract infection, allergic rhinitis, chronic obstructive pulmonary disease, gastroenteritis, complicated hypertension, ischemic heart disease, HIV/AIDS, fibromyalgia/muscle pain, epilepsy, high cholesterol, eczema, gastritis and heart failure.
This survey has identified the range of RFEs and diagnoses amongst patients attending ambulatory primary care in provincial health centres within the Klipfontein sub-district, Cape Town. Non-communicable chronic diseases and infectious diseases such as respiratory tract infections and gastroenteritis made up the majority of consultations. HIV/AIDS, TB, maternal and child health as well as trauma were all under represented relative to the burden of disease. Mental disorders were also poorly recognized relative to their expected prevalence. The findings have implications for district managers, guideline developers and those responsible for the training of primary care providers.
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