Indications and Outcome of Flexible Bronchoscopy at Muhimbili National Hospital in Dar es Salaam, Tanzania

Abstract

Background: A flexible bronchoscopy is an essential tool that is globally used for the diagnosis and treatment of Broncho-pulmonary diseases. However the indication and outcome of flexible bronchoscopy has not been widely documented in majority of low resource settings.
Objective: To determine the indications and outcome of flexible bronchoscopy (FB) at Muhimbili National Hospital (MNH).
Methodology: A cross sectional analytical study was conducted for a period of 12months. Details involving indications and outcome of flexible bronchoscopy includes; bronchoscopy findings, therapeutic value, diagnostic yield, and early procedural related complications together with their demographic data were documented after each procedure followed by analysis using SPSS version 25.
Results: Among 151 patients underwent flexible bronchoscopy 76(50.30%) were male and 75(49.70%) were female. The median age of 58 years with IQR (43, 65). Among the indications of flexible bronchoscopy, Cough and hemoptysis were the leading by 124(82.10%) and 38(25.20%) respectively. On the other hand hyperemic mucosa 47(31.10%) and endobronchial mass 32(21.20%) constituted the majority of the bronchoscopy findings. The overall diagnostic yield was 34.3% and procedural related complications was 18.54%. Among the indications for flexible bronchoscopy, the hemoptysis was associated with procedure related complications by 48(31.6%) OR (95%CI),2.779 (2.339-3.219) p<.020. Among sampling technique of flexible bronchoscopy, the endobronchial biopsy and bronchi alveolar lavage (BAL) sampling technique were associated with procedure related complications by 60(39.5%), OR (95%CI), 4.393 (3.957-4.829) p <.001 and 22(14.70%),OR (95%CI) 1.870 (1.656-2.084) p<.005 respectively .
Conclusion: We have demonstrated that flexible bronchoscopy is a safe and reliable procedure in diagnosis of respiratory maladies including Mycobacterium tuberculosis (MTB) at Muhimbili National Hospital.