ICPC-2-defined pattern of illnesses in a practice-based research network in an urban region in West Africa

BACKGROUND: In optimising the health of individuals, families and communities, attention should be focused on the clinical processes at medical facilities based in the community. Networks of general and family practices offer this unique opportunity. In establishing the burden of diseases in a community, the traditional classification used is the International Classification of Diseases. This study uses the International Classification of Primary Care. The aim of the study was to document the pattern of illnesses presenting in general/family physician practices in a city in Nigeria. METHOD: A nine-item interviewer-administered questionnaire containing closed-ended questions was administered to 881 patients presenting at 67 private general/family practice clinics/hospitals in 15 local government areas of urban Lagos by trained general practitioners, using the ICPC-2 pager, which asks for socio-demographic information, reasons for the presentation, and the provisional diagnosis within a 24-hour period. RESULTS: Children younger than five years accounted for 20.4% of those presenting, while 25- to 39-year-olds accounted for 44.4%. Geriatric patients (60 years and older) comprised 3.0%. Social classes 1 to 4 accounted for 36.8% of the patients, while social classes 5 to 8 accounted for 43.2%. Of all the patients, 18.7% earned less than 1 US$/day. The seven topmost reasons for visiting the medical practice/clinic/hospital were: General and unspecified 23.1%; pregnancy, child bearing and family planning 13.9%; respiratory problems 10.9%; problems related to the digestive system 9.6%; musculoskeletal 5.6%; Skin 4.4%; and neurological problems 4.2%. CONCLUSION: The skills of general/family practitioners in West Africa and on the rest of the continent should concentrate on general and unspecified illnesses, routine and emergency maternal and child care, and problems related to the respiratory, digestive, musculoskeletal, skin and neurological systems.