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Anaesthesia in Malawi: complications and deaths

D Hansen1, S C Gausi, M Merikebu

  • 1Lilongwe Central Hospital, Malawi.

Tropical Doctor
|July 21, 2000
PubMed

Insights

Anesthesia complications and deaths in Malawi are significantly higher than in developed nations. Improving training and blood donation programs can reduce avoidable anesthesia mortality.

Area of Science:

  • Anesthesiology
  • Public Health
  • Global Health

Background:

  • Anesthesia-associated complications and mortality present a significant challenge in low-resource settings.
  • Malawi faces a high burden of anesthesia-related adverse events, necessitating urgent investigation.

Purpose of the Study:

  • To prospectively analyze anesthesia-associated complications and deaths in Malawi.
  • To identify the primary causes and contributing factors to anesthesia mortality.
  • To determine the avoidable mortality rate (AMR) and recommend interventions.

Main Methods:

  • Prospective analysis of 3022 anesthetics administered over a 6-month period.
  • Detailed recording and classification of all anesthesia-associated complications and deaths.
  • Categorization of avoidable factors into anesthetic, surgical, and administrative.

Main Results:

  • 51 complications and 14 deaths were reported, with hypotension (due to sepsis or blood loss) being the leading cause (53% complications, 71% deaths).
  • Intubating difficulties accounted for 25% of complications and 14% of deaths.
  • The overall avoidable mortality rate was 1:275, with anesthetic AMR at 1:504, primarily due to poor fluid and airway management.

Conclusions:

  • The anesthetic AMR in Malawi is substantially higher (6-100 times) than in developed countries.
  • Poor fluid and airway management are key avoidable factors in anesthetic mortality.
  • Enhanced training for anesthetists and improved blood donation programs are crucial for reducing anesthetic AMR in Malawi.

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