Altitude-Related Disorders on Mount Kilimanjaro, Tanzania: Two-Year Survey in a Local Referral Center

• Published in: Wilderness & environmental medicine Vol. 32; no. 1; pp. 36 - 40
• Main Authors: Dekker, Marieke C.J., Mremi, Alex, Kilonzo, Kajiru G., Nyakunga, Gissela, Sakita, Francis, Mvungi, Mark, Urasa, Sarah J., Masenga, Gileard, Howlett, William P.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Elsevier Inc 01.03.2021; SAGE Publications
• Subjects: Adolescent; Adult; Africa; Aged; Altitude; Altitude Sickness - epidemiology; Altitude Sickness - mortality; Brain Edema - etiology; Brain Edema - mortality; Data Collection; Female; high altitude cerebral edema; high altitude pulmonary edema; Humans; Kilimanjaro; Male; Middle Aged; morbidity; mortality; Mountaineering; Pulmonary Edema - etiology; Pulmonary Edema - mortality; Retrospective Studies; Tanzania - epidemiology; Wounds and Injuries - epidemiology; Wounds and Injuries - mortality; Wounds and Injuries - pathology; Young Adult; Tanzania; mortality; Kilimanjaro; morbidity; high altitude pulmonary edema; high altitude cerebral edema; Africa
• ISSN: 1080-6032; 1545-1534
• DOI: 10.1016/j.wem.2020.10.003

A significant number of climbers on Mount Kilimanjaro are affected by altitude-related disorders. The aim of this study was to determine the main causes of morbidity and mortality in a representative cohort of climbers based on local hospital records. We conducted a 2-y retrospective chart review of all patients presenting to the main referral hospital in the region after a climb on Mount Kilimanjaro, including all relevant records and referrals for postmortem studies. We identified 62 climbers who presented to the hospital: 47 inpatients and 15 outpatients. Fifty-six presented with high altitude illness, which included acute mountain sickness (n=8; 14%), high altitude pulmonary edema (HAPE) (n=30; 54%), high altitude cerebral edema (HACE) (n=7; 12%), and combined HAPE/HACE (n=11; 20%). The mean altitude of symptom onset ranged from 4600±750 m for HAPE to 5000±430 m for HAPE/HACE. The vast majority of inpatients (n=41; 87%) were improved on discharge. Twenty-one deceased climbers, most having died while climbing (n=17; 81%), underwent postmortem evaluation. Causes of death were HAPE (n=16; 76%), HAPE/HACE (n=3; 14%), trauma (1), and cardiopulmonary (1). HAPE was the main cause of death during climbing as well as for hospital admissions. The vast majority of climbers who presented to hospital made a full recovery.