Cawich, Shamir O.; Irvine, Roger; Ramphal, Paul
Author Affiliation, Ana.
Epidemiology of spontaneous pneumothoraces in Jamaica
The Internet Journal of Thoracic and Cardiovascular Surgery
Date of Publication
There has been no report on the prevalence of spontaneous pneumothoraces in developing Caribbean nations. We performed a retrospective survey of all tertiary level hospitals serving Kingston, the capital of Jamaica over five years from January 1997 to December 2001. All patients treated for spontaneous pneumothoraces were identified and their records were retrospectively examined. There were 81 patients treated for spontaneous pneumothoraces over the study period. Spontaneous pneumothorax affects 1.96/100,000 persons yearly in Jamaica, with a 3:1 male preponderance. Secondary spontaneous pneumothorax (SSP) occurs in 0.56/100,000 persons yearly in this setting (0.36 in males and 0.19 in females). The commoner underlying disorders causing SSP were COPD (47.8%), Tuberculosis (26.1%), Asthma (13%), Pneumocysitis Carinii Pneumonia (4.4%), granulomatous lung disease (4.4%) and endometriosis (4.4%). The incidence of primary spontaneous pneumothorax (PSP) in Jamaica was 1.40/100,000 persons yearly (1.16 in males and 0.24 in females). The majority of patients (58/81, 72%) were current smokers of cigarettes and/or cannabis, and there was a significantly higher incidence of current smoking among males with PSP (83% vs 33%; X2 = 16.67; p <0.001). There was a significant predilection for the right hemi-thorax to be affected (52/81, 64%) compared to the left hemithorax (28/81, 34%) and bilateral disease (1/81, 4.4%). There were 13 patients (16%) with recurrent pneumothoraces. Nine were ipsilateral, all on the right and 4 were contra lateral recurrences. Spontaneous pneumothoraces are potentially dangerous conditions. The incidence in Jamaica is relatively low. Emergency room physicians must remain aware of this problem and maintain a high level of suspicion in order to optimize diagnosis and therapy.....