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The History of presenting complaint in surgical disease Background: Advanced disease, associated illnesses and poor compliance of the patients can be seen as characteristics of performing medicine in subsaharan Africa. In order to find needs of the health sector to reduce morbidity and mortality we were trying to find out why our patients keep presenting late at the hospital. Method: 236 patients admitted to the Surgical Department at Zomba Central Hospital were asked to answer a questionnaire, regarding the history of the presenting complaint. Data about the duration of symptoms, the kind and institution (hospital, health center (H/C), traditional healer (T/H) of previous treatment given and problems in managing this situation were collected and analysed. Conclusion: Most patients included in the study were presenting at advanced stages of their disease but the majority of them prefered an official health facility to a T/H. Medical knowledge or experience of health workers in hospitals and H/C must be classified as unsatisfactory for two reasons: (1) the right diagnosis has never been made or made very late, and (2) symptoms of malignancy were treated with wrong medication in a high number. Improving the medical skills of the health workers might be the key factor for reducing morbidity and mortality in Malawi. |
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