Epidemiology of acute intestinal obstruction in Uasin Gishu county, Kenya

Abstract

Background: Acute Intestinal Obstruction (AIO) is a common life threatening emergency in all general hospitals all over the world. This study provides a population based incidence of acute intestinal obstruction derived from hospital data within a period of seven years preceding the year of the study (2008/9). Inpatient records can provide a fairly accurate data on the incidence of acute intestinal obstruction since almost all the cases are admitted in hospitals. Objectives: This study aims at determining the incidence and other epidemiological characteristics of AIO in Uasin Gishu County based on the hospital records and the national population census. Methods: The study was conducted in twelve hospitals (six within Uasin Gishu County) and six from the surrounding counties. Patient records for seven years preceding the period of study (2008) were retrieved and demographic information of the disease and treatment outcome (mortality) were analyzed against the projected population for the seven year period covered by the study (2001-2007). The population projections (the denominators) were based on Kenya population census and housing survey, 1999. Results: There were 444 cases of AIO from Uasin Gishu County during the seven year period of the study (2001- 2007). There were 319 males (71.8%) and 125 females (28.1%) (male/female ratio =2.6/1). The mean age was 31.4 years and the median age was 29 years. The population of Uasin Gishu County (1999 census) on which the population growth projections was based was 622,705. Mean annual incidence for the seven year period was 8.8 per 100,000 persons and this was significantly related to age and gender (p-values = 0.0001). Recovery (survival) rate was 93.5% and mortality (case fatality) rate was 6.5%. Mortality rate was not significantly related to age and gender (p-value>0.05). Conclusion: The observed annual incidence of acute intestinal obstruction in Uasin Gishu County was very low compared to available global data. Our findings could be a pointer to the general burden of AIO in Kenya (given the similarity of Uasin Gishu County and rest of the country in relation to demography, infrastructure and the state of health care services). The incidence increased exponentially with age. A prospective population based study on incidence could shed more light and confirm the low incidence found in this study.