Hospitalizations for communicable diseases in a developing country: prevalence and trends-Monastir, Tunisia, 2002-2013

- The crude prevalence of hospitalizations for communicable diseases (HCD) was 5.41 per 1000 inhabitants. This decreased from 2000 to 2013, and the in-hospital mortality was 1.43% of HCD. It was higher in adults aged ≥65 years than in the other age groups.
- Patients with tuberculosis had the highest median hospital length of stay (13 days (interquartile range 7-23 days)).
- Abdominal infections were the communicable diseases most often recorded in the university hospital in Monastir. Abdominal infections ranked second regarding the rate of hospitalization for communicable diseases for both sexes.
- Acute tubulo-interstitial nephritis was the predominant diagnosis among the 34 289 admissions (12%).

SummaryBackgroundIn spite of the epidemiological transition, communicable diseases remain a public health problem and represent a significant cause of morbidity and mortality worldwide, especially in developing countries. This study aimed to determine the crude and standardized prevalence rates of hospitalizations for communicable disease (HCD) and to assess trends in HCD by age and sex at a university hospital in Tunisia over a period of 12 years (2002-2013).MethodsAll cases of HCD from 2002 to 2013 in the university hospital departments were included. Data collected from the regional register of hospital morbidity were used. The discharge diagnoses were coded according to the International Classification of Diseases, 10th revision (ICD-10).ResultsHCD represented 17.45% of all hospitalizations during the study period (34 289/196 488; 95% confidence interval 17.28-17.62%). The median age at the time of admission was 31 years (interquartile range (IQR) 15-52 years). The median hospital length of stay (LOS) was 5 days (IQR 3-9 days). The crude prevalence rate (CPR) was 5.41 per 1000 inhabitants. The CPR was highest among patients aged ≥65 years. The four communicable disease categories that represented 70% of all HCD were abdominal infection, skin infection, genitourinary infection, and lower respiratory tract infection. The majority of HCD decreased over time; however, there was a significant increase in HIV diseases, tuberculosis, and viral hepatitis.ConclusionThis study provides evidence of the epidemiological transition, showing a decline in communicable diseases, which needs to be sustained and improved.