Diagnosting vascular diseases in our community - patients complaints and doctors constraints

Abstract

Background: Contrary to previously held belief, vascular diseases are not rare in ou community. What is truly rare is our ability to pick up them when they present. Aims and Objectives: To study the cases of vascular diseases seen in our center, with a view to seeing how the diagnosis was made and how we can imrprove our diagnostic acumen. Design: Retrospective study. Settings: Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria, a tertiary institution, and Gabro Specialist Hospital, Nnewi Nigeria, a private hospital, both health establishments serving rural, semi-urban communities. Patients and Methods: Every patient who had a working diagnosis of any form of vascular disease, excluding trauma cases, from 1st June 2001 to 15th December 2004, was included in this study. Results: Two hundred and one pateints were identified. One hundred and three patients had varicose veins. Firty-four had deep vein thrombosis, 31 had peripheral arterial disease, 17 had different forms of vascular malformations and six had ancurysms. Most of the patients who were advised to do angiography or venography complained that they could not afford the hihg cost of the investigations in other centers. Our institution at that time did not have facilities for angiography. The diagnosis was made at post-mortem in two patients. Conclusions: With the exception of varicose veins, the index of suspicious for other vascular diseases is still very low in our community. In those patients in whom the diagnosis is highly suspected, diagnostic facilities are not readily available to confirm diagnosis or to asses the full extent of the disease. This is a big constraint. Patient's poverty and the absence of any form of social welfare package in our community is another big constraint. A high index insurance scheme will certainly reduce patients' complaints and doctors' constraints and improve the care of patients with vascular diseases in our community.