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1060 All-cause presentations to emergency facilities in low-income and low-middle income Sub-Saharan African countries: a systematic review
  1. Sarah Richardson1,
  2. Tonny Luggya2,
  3. Alasdair Gray1,
  4. Liz Grant3
  1. 1Royal Infirmary of Edinburgh
  2. 2Makerere University
  3. 3University of Edinburgh


Introduction Emergency conditions constitute a large proportion of the total global burden of disease and annual global deaths. All 10 leading causes of death in LMICs are conditions which are amenable to emergency care. Much of the research performed in the sub-Saharan African region focuses on single disease processes or particular causations, giving a skewed impression of disease burden. The lack of comprehensive information concerning emergency care delivery has stalled attempts to improve emergency care systems in LMICs.

Objective To understand the current evidence base available regarding the all-cause demographics, characteristics and epidemiology of patient presentations to an emergency setting within LMIC/LIC sub-Saharan African countries.

Methods A systematic search was conducted on 23rd January 2020 of PubMed, Embase, Global Health and Google Scholar for peer reviewed literature published in English from January 2000 to January 2020 describing all-cause presentations at facility-based emergency care in Sub-Saharan LIC or LMIC countries. Articles were screened at title and full text level.

Results 19227 articles were screened at title level, 43 were screened at full-text level. 21 articles fit the inclusion criteria. Of 41 LMIC/LIC sub-Saharan African countries included, 31 were unrepresented due to lack of published data. Overall data quality was poor. Only 1 study fulfilled the suggested minimum core data set for emergency care surveillance. Outcome data was lacking or only partially reported in a number of papers. Chief complaints and disease categorisation reporting lacked a unified approach or reporting system making comparisons both within and between countries extremely challenging.

Conclusion Despite considerable progress being made in recognising the need for integrated emergency care systems in all global regions, the data available to policy makers and system implementers remains sparse. This review demonstrates that critical investment is required to produce quality data from the current emergency systems in LMIC/LICs.

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