Burden of infectious diseases in a West African tertiary hospital: a two-year retrospective study at CHNU de Fann, Senegal

Abstract

Introduction: Despite progress in prevention and treatment, infectious diseases remain a major cause of morbidity and mortality in West Africa. Hospital-level data are limited. This study aimed to assess the burden, clinical spectrum, and outcomes of infectious diseases at a referral hospital in Senegal.

Methodology: A retrospective study of all non-coronavirus disease 2019 (COVID-19) infectious disease admissions at the Centre Hospitalier National Universitaire (CHNU) de Fann from January 2021 to December 2022 was conducted. Sociodemographic, clinical, diagnostic, and outcome variables were recorded. Logistic regression identified factors independently associated with in-hospital mortality.

Results: A total of 1,098 patients (median age 42, 57.2% male) were included. Tuberculosis (TB; 21.8%), malaria (13%), and community-acquired pneumonia (9.2%) were the leading diagnoses. Human immunodeficiency virus (HIV) infection was present in 28.1% of patients, with 58.4% having opportunistic infections. Overall mortality was 25.0%. Independent predictors of death included HIV-positive status (OR: 2.1; 95% CI: 1.4–3.2), neurological involvement (OR: 1.7; 95% CI: 1.2–2.5), age > 60 years (OR: 1.9; 95% CI: 1.1–3.1), and sepsis (OR: 2.3; 95% CI: 1.5–3.6).

Conclusions: Infectious diseases remain a leading cause of hospitalization and death in Senegal. Improving early diagnostics, integrating TB/HIV services, and expanding access to fungal testing are crucial to improve outcomes in resource-limited hospital settings.