Objective: The study aimed at assessing the prevalence and management of infectious diseases, with main focus on malaria, HIV and TB, in a rural hospital in Western Tanzania.Design: Spot prevalence study.Methods: Information gathered from staff and patient notes on ward rounds and subsequent interviews of patients. Results: Of the 102 hospitalised patients included in the study 37/102 (36%) were diagnosed malaria, 15/102 (15%) with HIV/AIDS and 14/102 (14%) had TB. Out of the TB positive individuals, 50% had a coexisting HIV infection. HIV was more frequent among the female patients (16%) than the male patients (13%) and the peak age group for HIV-infection was 50-59 years old. Malaria was most frequent among children aged 0-5 years. 52% of hospitalised patients were treated for malaria without having the diagnosis verified by blood smear. The National first line antimalarial treatment was not used. 94% of hospitalised patients received medication. 60% of the patients were prescribed antibiotics, 35% received antimalarial medication, 8% followed the national guidelines for TB-treatment with Direct observational treatment (DOT).
Conclusion: The most frequent diagnoses of this hospital, malaria, HIV and TB must represent a considerable burden. The difficulties in managing these infections at a hospital with limited access to modern laboratory equipment and well-trained staff are revealed in this study. More resources are needed to ensure implementation of National Guidelines and to optimise the health provision at BDDH.