Causes, outcomes and diagnosis of acute breathlessness hospital admissions in Malawi: protocol for a multicentre prospective cohort study.

Autor:	Spencer SA; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi.; Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi., Malowa F; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., McCarty D; Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi.; The Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi., Joekes E; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK., Phulusa J; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Chinoko B; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Kaimba S; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Keyala L; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Mandala P; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Mkandawire M; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Mlongoti M; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Mnesa B; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Mukatipa A; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Mijumbi R; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Nyirenda M; Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi.; The Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi., Sawe HR; Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Henrion M; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Augustine DX; Royal United Hospitals Bath NHS Foundation Trust, Bath, England, UK., Oxborough D; Liverpool Centre for Cardiovascular Sciences, Liverpool John Moores University, Liverpool, England, UK., Worrall E; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK., Limbani F; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi., Dark P; Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, England, UK., Gordon SB; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Southern Region, Malawi.; Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi., Rylance J; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK., Morton B; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Jazyk:	angličtina
Zdroj:	Wellcome open research [Wellcome Open Res] 2024 Apr 17; Vol. 9, pp. 205. Date of Electronic Publication: 2024 Apr 17 (Print Publication: 2024).
DOI:	10.12688/wellcomeopenres.21041.1
Abstrakt:	Background: Hospital admission due to breathlessness carries a significant burden to patients and healthcare systems, particularly impacting people in low-income countries. Prompt appropriate treatment is vital to improve outcomes, but this relies on accurate diagnostic tests which are of limited availability in resource-constrained settings. We will provide an accurate description of acute breathlessness presentations in a multicentre prospective cohort study in Malawi, a low resource setting in Southern Africa, and explore approaches to strengthen diagnostic capacity. Objectives: Primary objective: Delineate between causes of breathlessness among adults admitted to hospital in Malawi and report disease prevalence. Secondary objectives : Determine patient outcomes, including mortality and hospital readmission 90 days after admission; determine the diagnostic accuracy of biomarkers to differentiate between heart failure and respiratory infections (such as pneumonia) including brain natriuretic peptides, procalcitonin and C-reactive protein. Methods: This is a prospective longitudinal cohort study of adults (≥18 years) admitted to hospital with breathlessness across two hospitals: 1) Queen Elizabeth Central Hospital, Blantyre, Malawi; 2) Chiradzulu District Hospital, Chiradzulu, Malawi. Patients will be consecutively recruited within 24 hours of emergency presentation and followed-up until 90 days from hospital admission. We will conduct enhanced diagnostic tests with robust quality assurance and quality control to determine estimates of disease pathology. Diagnostic case definitions were selected following a systematic literature search. Discussion: This study will provide detailed epidemiological description of adult hospital admissions due to breathlessness in low-income settings, which is currently poorly understood. We will delineate between causes using established case definitions and conduct nested diagnostic evaluation. The results have the potential to facilitate development of interventions targeted to strengthen diagnostic capacity, enable prompt and appropriate treatment, and ultimately improve both patient care and outcomes. Competing Interests: No competing interests were disclosed. (Copyright: © 2024 Spencer SA et al.)
Databáze:	MEDLINE
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