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The prevalence of life-limiting illness at a Ugandan National Referral Hospital: a 1-day census of all admitted patients
  1. Amandua Jacinto1,
  2. Victoria Masembe2,
  3. Nazarius Mbona Tumwesigye2 and
  4. Richard Harding3
  1. 1Ugandan Ministry of Health, Kampala, Uganda
  2. 2Mulago Hospital, Kampala, Uganda
  3. 3Cicely Saunders Institute, King's College London, London, UK
  1. Correspondence to Dr Richard Harding, Cicely Saunders Institute, King's College London, Bessemer Road, London SE5 9PJ, UK; Richard.harding{at}


Background Although models of hospital-based palliative care are common in high-income countries, they are rare in low-income countries despite the high burden of progressive disease.

Aim To measure the proportion of all adult and child patients admitted with previously diagnosed active life-limiting disease, who therefore may be appropriate for palliative care provision, across all beds.

Design One-day 24 h census using chart review across every ward and department.

Setting/participants All admitted patients at a large tertiary referral hospital in sub-Saharan Africa.

Results Of 1763 reviewed patients, 663 (37.7%) had a diagnosed active life-limiting disease. Of these, 130 (19.6%) were children. The most prevalent diagnoses were HIV (41.7%), cancer (41.5%) and heart disease (9.2%). During the 24 h census period 19 patients died (population mortality rate 0.01%).

Conclusions In order to appropriately respond to need, hospital-based palliative care services in low-income settings must be of adequate size to respond to high prevalence of life-limiting illness, and to provide education and support to clinical colleagues managing all patients with life-limiting disease.

  • Hospital care
  • Cultural issues

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