Clinical features in the diagnosis of peptic ulcer in Malawian adults

The predictive value of clinical features in the diagnosis of peptic ulcer diseases was studied in 104 Malawian adults (mean age 36 years) with epigastric pain who were consecutively investigated by fiber-optic endoscopy. In 40 patients with peptic ulcer and 64 with a normal investigation; clinical features with a positive predictive value greater than 50 percent included: male subject; farming occupation; cigarette smoking; alcohol consumption; episodic pain; vomiting and hematemesis. The triad of smoking plus episodic pain plus nocturnal pain gave a predictive value of 90 percent. Attention in the history to these clinical features should allow a more accurate clinical diagnosis of peptic ulcer in patients presenting with epigastric pain

Medical admissions to Kamuzu Central Hospital; Lilongwe; Malawi in 1986: comparison with admissions to Queen Elizabeth Central Hospital; Blantyre in 1973

A retrospective survey was carried out on adult medical admissions to Kamuzu Central Hospital; Lilongwe; Malawi during the period January to December 1986; and results compared with those obtained in Queen Elizabeth Central Hospital; Blantyre in 1973. There were 4700 admissions which was more than twice the number seen in Blantyre. However; the age distribution; the pattern of disease and the overall hospital mortality were similar. Infections (malaria; pneumonia; tuberculosis; gastroenteritis/dysentery and meningitis) were the most common cause of admission; and the major causes of death were still tuberculosis; pneumonia and meningitis. Smoking related diseases were uncommon; and there was no documented case of ischaemic heart disease. The reasons for the importance of periodic surveys; such as the present study; are discussed