Table 4. Characteristics and diagnosis/therapy/cost for 35 patients referred during population survey 1.
Sex Age Main symptoms and findings
F 3 Coughing, 10,9 kg <3 percentile
M 3 Oedema. Hb 10,7. Thick drop+. Splenomegaly
F 30 Coughing, weight loss, pulmonary rales, acidfast bacilli ++++ in expectorate, bilateral x-ray
changes lung. HIV negative
M 64 Coughing, oedema. Tb neg
F
M
M
F
M
M
F
M
M
M
32 Coughing, fever. Treated for Tb 1 year ago,
expectorate negative, bilateral x-ray changes
lung, HIV positive
1 Weight loss, 7,7 kg = < 3 percentile, arm
circumference 14 cm, lung rales
14 Dyspnoe, palpitations. Accentuated heart
sounds. Enlarged heart on x-ray SR 40.
Improved symptoms/x-ray on follow-up
7 Coughing, weight loss, fever. Temp 38,3, Lung
rales, tachypnoe 40/min, Hb 9,3. Leukocytes
41000, 90% neutrophils. X-ray shadow one
lung. Cured on follow-up.
35 Weight loss, 42 kg. Treated for Tb for 8 months
until 6 months ago, still expectorate positive
then, could not afford further therapy. Now
unilateral fibrotic x-ray changes lung,
expectorate negative, HIV negative
24 Weight loss, 37 kg. Treated for Tb the last two
months. Now unilateral massive x-ray shadow
one lung, expectorate negative, HIV positive,
did not return after he was told this result.
1 Weight loss, but 10,9kg > 50-percentile. Thick
drop +
42 Weight loss, coughing. Treated for Tb for 2
months until 9 months ago. X-ray thorax 1
month ago negative, got Bactrim. Now
expectorate negative. Leukocytes 11000 with
45% lymphocytes. HIV-test ordered, but he did
not come back
35 Weight loss, coughing. Went to another doctor
and was lost to follow-up
3 Not gained weight last two years, 9,5 kg < 3
percentile, arm circumference 13 cm. Mother
dead when child 8 months old, grandmother
says he eats well. Leukocytes 11000, 66%
neutrophils. Got gentamycine 5 days ago
Diagnosis
Malnutrition,
URI
Malaria
Tuberculosis
Therapy/hospital
Nutritionist advice
Cost USD
15
Quinine, iron, vit A
Hospitalised. Anti-Tb
16
99
Diuretic. Hospitalised
soon after.
Bactrim
12
Malnutrition,
URI
Sequaele
rheumatic
fever
Pneumonia
Salbutamol, vitamins.
Nutritionist advice
Pc, furosemid,
captopril
10
Pc, quinine
21
Lung fibrosis,
posttuberculous
Ibuprophen, vit. B,
advice to stop smoking
19
Quinine, multivitamin
syrup
12
Heart failure
Aids
21
23
Aids
Malaria
Inconclusive.
May have Aids
Inconclusive.
May have Tb
Malnutrition
19
Hospitalisation offered, 13
but refused.
Multivitamins, Vit A,
chloroquine, vermox,
continue gentamycine.
Nutritionist advice
1
M 10 Congenital pes equino-varus with secondary
Leg deformity
contracture of knees and hips. Used arms as
“crutches” for locomotion. Had quit school
after two years, before that a cousin carried him
to school every day.
Aids, Tb
Father was offered 70
5
USD if they showed up
with a locally made
three wheel bicycle,
estimated to cost 140
USD, but they never
came.
Hospitalised. Pc
33
initially, then
tetracycline. Vit B
Hospitalised.
175
Ceftriaxon (after
resistance pattern).
Amputation below
knee offered but
refused, wound healed
after several months.
Referred to Tbresponsible doctor at
the hospital
Amoxicillin,
25
Vit A,
Nutritionist advice.
Hospitalisation
recommended, but
stepmother needed to
go home to her other
children.
Pc. Multivitamins,
15
Vermox. To be
revaccinated BCG.
Hospitalised. Anti-Tb 153
Tb
Hospitalised. Anti-Tb
Lymphoma?
Malaria
Hospitalised.
124
Cyclophosphamid i.v..
Prednisolone,
Largactil.
Quinine
Died after 4 weeks
Fansidar, multivitamin, 13
Vermox
M 70 Weight loss, couching, 30 kg, lung rales, x-ray
shadows both lungs. SR 27mm/h. Expectorate
negative.
M 6 Osteomyelitis in left tibia, three open wounds
2-5 cm/diam, bone visible. On antiTb drugs last
2 months. SR 92mm/h . Culture showed
Proteus, resistant to most relevant drugs. X-ray
generalised inflammation, including epiphyses
Bronchopneumonia
M 60 Coughing, weight loss. Rales right lung.
Expectorate negative. X-ray massive shadow
right lung.
F 2 Weight loss, 5,9 kg < 3 percentile, arm
circumference 11,5 cm. Mother left when child
15 months old. Tachypnoe 50/min, neutrophilia
65%. X-ray small perihilar shadows bilaterally.
Tb?
F
Weight loss, periodic fever, weight not noted.
SR 65, neutrophilia 70%. BCG vaccinated.
Rales on both lungs. Tuberculin test negative.
M 22 Fever, coughing, weight loss. 47 kg, temp 38,8
and next day 38,1. Lung rales. Expectorate
+++. Malaria + in thick drop. X-ray massive
shadow half of left lung. HIV positive.
M 16 Weight loss, coughing, 37 kg. Anti-Tb
treatment for three months one year ago, and
for five months until one month ago,
expectorate positive at the end of both
treatments. Now expect +. X-ray shadows
scattered in both lungs. HIV negative
M 6 Weight loss, protruding abdomen. Palpable
masses in abdomen, opacities on ultrasound.
SR 68. Malaria ++ in thick drop. X-ray thorax
negative, urography inconclusive.
Bronchopneumonia
F
Malaria?
5
5
Fever at night one week, temp 37.5. 13.6 kg,
between 3 and 50 percentile. Thick drop
negative.
Osteomyelitis
tibia
Bronchopneumonia.
Malnutrition
162
2
F
3
M 2
Inflammation right knee and left ankle last 3
days. Sickle cell anaemia diagnosed one year
ago. Hb 8,5 g/dl.
Weight loss, diarrhoea, 8,6 kg < 3-percentile,
arm circumference 12 cm, temp 36,8-38,2.
Rhinitis
F
3
Weight loss, diarrhoea, 9,5 kg < 3-percentile,
arm circumference 13 cm.
F
2
Weight loss, diarrhoea, 6,8 kg < 3-percentile,
arm circumference 11 cm
F
13 Weight loss, periodic fever. Albuminuria from
early childhood. Now protein ++ in urine. SR
50. Malaria + in thick drop. Serum-creatinine
normal. Kidneys normal on ultrasound.
M 1 Weight loss, 4,5 kg, <3-percentile, arm
circumference 8,6 cm. Dehydrated, axillary and
inguinal glands. Mother died one month ago.
HIV positive
M 17 Completely deaf after fever disease for 1 week
6 months previously. Had quit secondary
school after that.
Sickle cell
Acetylsalicylic acid,
anaemia with
vermox, folic acid
joint symptoms
Malnutrition
Bactrim, chloroquine,
Vermox, Vit A,
Multivitamins.
Nutritionist advice
Malnutrition
Chloroquine, Vermox,
Vit A, Multivitamins.
Nutritionist advice
Malnutrition
Bactrim, Vermox, Vit
A, Multivitamins.
Nutritionist advice
Nephropathy. Bactrim
Malaria
13
HIV/Aids
Hospitalised.
Hydration, vitamins,
enriched milk
30
Referral to nearest
ENT-doctor 200 km
away
50
Quinine, Vit A,
multivitamins,
Vermox, griseofulvin,
nutritionist advice,
vaccinations
Quinine, Vit A,
multivitamins,
Vermox, nutritionist
advice, vaccinations
Gardenal, Vermox
15
Amoxicillin,
paracetamol, Vermox
14
M 6
Weight loss, 13,6 kg. Tinea capitis. Malaria +
in blood smear.
Deafness,
secondary to
infectious
disease
Malnutrition.
Malaria. Tinea
M 3
Weight loss, 10,9 kg <3-percentile, arm
circumference 13 cm. Malaria + in thick drop.
Malnutrition.
Malaria.
F
History of generalised epileptic fits from 3
months of age, psychomotor retardation.
Coughing, weight loss, fever last two weeks.
12,7 kg < 3-percentile. Temp 38,3, next day
38,5. Rales right lung, light splenomegaly.
Epilepsy
8
M 4
Pneumonia
7
9
17
25
13
12
12 referred patients had more ”innocent” diseases like upper respiratory infection (URI) and are not shown.
4 patients did not consult after referral
1
3