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Croughs M, Nyakunga GB, Sakita FM, Kilonzo K, Mmbaga BT, Soentjens P. Incidence and predictors of severe altitude illness symptoms in Mt. Kilimanjaro hikers: a prospective cohort study. J Travel Med 2022; 29:6554584. [PMID: 35348739 DOI: 10.1093/jtm/taac044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Each year several Mt. Kilimanjaro hikers die due to altitude illness (AI) although urgent descent is technically easily possible. The objectives of this study were to determine the incidence and predictors of severe altitude illness (SAI) symptoms and of summit success in Mt. Kilimanjaro hikers, and the measures taken when AI symptoms develop. METHODS A prospective observational cohort study in Mt. Kilimanjaro hikers was conducted from December 2019 until March 2020. Participants were asked to complete a questionnaire at the entrance gate and one at the descend gate. A multivariate logistic regression was performed to study the relations between the variables. RESULTS A total of 1237 recreational hikers and 266 porters or guides were included. The incidence of severe symptoms was 8.6% in recreational hikers and 1.5% in porters and guides. One percent (1.1%) of hikers was hospitalized due to SAI. A history of SAI, young age, summit failure and lack of clear advice predicted the development of severe symptoms. Uhuru peak was reached by 87.9% of the hikers. Absence of severe symptoms, acetazolamide prophylaxis, climbing higher in daytime, young age and climbing in more days predicted summit success. The majority climbed further despite the presence of mild or severe symptoms. The only measure taken in case of mild symptoms that was associated with a lower incidence of severe symptoms was not climbing further. CONCLUSION The incidence of SAI symptoms in Mt. Kilimanjaro hikers was observed to be high. However, how hikers reacted during symptoms was not appropriate. Therefore, travel health counsellors should emphasize even more that hikers do not ascend higher until mild symptoms have resolved and that it is vital to descend immediately when severe symptoms develop. In addition, they can be informed on the measures, which improved summit success.
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Affiliation(s)
- Mieke Croughs
- Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp 2000, Belgium
| | - Gissela B Nyakunga
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi 3010, Tanzania.,Clinical Trial Unit, Kilimanjaro Clinical Research Institute (KCRI), Moshi 2236, Tanzania.,Faculty of Medicine, Kilimanjaro Christian Medical University College (KCMCUCO), Moshi 2240, Tanzania
| | - Francis M Sakita
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi 3010, Tanzania.,Clinical Trial Unit, Kilimanjaro Clinical Research Institute (KCRI), Moshi 2236, Tanzania.,Faculty of Medicine, Kilimanjaro Christian Medical University College (KCMCUCO), Moshi 2240, Tanzania
| | - Kajiru Kilonzo
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi 3010, Tanzania.,Clinical Trial Unit, Kilimanjaro Clinical Research Institute (KCRI), Moshi 2236, Tanzania.,Faculty of Medicine, Kilimanjaro Christian Medical University College (KCMCUCO), Moshi 2240, Tanzania
| | - Blandina T Mmbaga
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre (KCMC), Moshi 3010, Tanzania.,Clinical Trial Unit, Kilimanjaro Clinical Research Institute (KCRI), Moshi 2236, Tanzania.,Faculty of Medicine, Kilimanjaro Christian Medical University College (KCMCUCO), Moshi 2240, Tanzania
| | - Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine (ITM), Antwerp 2000, Belgium.,Department of Infectious Diseases, Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels 1120, Belgium
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