Otorhinolaryngology Services at Muhimbili National Hospital and Muhimbili Orthopedic Institute, Dar es Salaam, Tanzania

Abstract

Background: Epistaxis is the commonest ear, nose and throat emergency. It's mostly self-limited but it may be severe such that medical attention is sought and in such cases it may be life threatening. There is paucity of data on the prevalence and management options for epistaxis in Tanzania and at Muhimbili National Hospital (MNH) and Muhimbili Orthopedic Institute (MOI), no any published study has unveiled it despite being the commonly encountered emergency in our department. The aim of this study was thus to determine the prevalence, aetiology and treatment modalities of epistaxis among patients receiving otorhinolaryngology services at MNH and MOI.
Materials and Methods: A cross-sectional, hospital based study was done to 427 patients at Muhimbili National Hospital (MNH) and Muhimbili Orthopedic Institute (MOI). Data was collected using structured questionnaires from June to December 2015 and it was then analyzed using SPSS program.
Results: A total of 427 patients aged 1-82 years were recruited with majority of the patients being females (54.6%). The mean age at diagnosis was found to be 27±23 years.The prevalence of epistaxis was found to be lower among patients below 20 years (12.5%) of age and higher among patients over the age of 40years (34.9%). Prevalence of epistaxis was found to be higher among males (29.9%) compared to females (18 %). Majority of patients had anterior epistaxis (73%) whereas the remaining percentage was constituted by those with posterior epistaxis.Posterior epistaxis was more common among patients aged 21-40 years (40.7%) compared to patients aged 0-20 years (20%). 75% of the patients had epistaxis due to local etiologies while 25% was due systemic causes. Majority of patients with epistaxis had history of trauma (25%). Other reported aetiologies were malignancy of nasal and post-nasal space (22%) and hypertension (15%). Anterior nasal packing was the most commonly used method in management of patients with epistaxis compared to conventional posterior nasal packs. Fewer number of patients required surgery as the treatment modality where 3% of the patients undergone electro cauterization and only 1% required external carotid artery ligation.