Prevalence of Acute Mountain Sickness among Finnish Trekkers on Mount Kilimanjaro, Tanzania: An Observational Study

Abstract

The aim of this study was to evaluate the prevalence of acute mountain sickness (AMS) among trekkers on Mount Kilimanjaro during the winter season of 2006-2007. A A total of 130 Finnish trekkers at Marungu route were asked to complete daily a Lake Louise self-report and clinical assessment score questionnaire with the help of a trainee Finnish guide during their trek to Kilimanjaro. A Lake Louise questionnaire score>or=3 indicated AMS. Altogether 112 mountaineers or travelers [54 men, 58 women, mean age 51+/-10 (SD) years] were studied. Fifty-nine travelers (53%) reached Gillman's Point or Uhuru Peak. The incidence of AMS among Finnish Kilimanjaro trekkers was 75%. The most common high altitude symptoms were headache, followed by sleeping problems and fatigue or weakness. The incidence of AMS is high among trekkers climbing Mount Kilimanjaro.The main reason for this seems to be rapid ascent. Kilimanjaro treks normally have a fixed timetable, and for commercial reasons there is little opportunity to spend extra days for acclimatization in the camps. Some contributing factors are preventable, so we recommend an educational program for all the trekking agencies that guide on this peak and, in particular, the Tanzania-based guiding agencies, which, typically, are driving these very fast ascent rates.

Acute mountain sickness

“…Furthermore, the AMS symptoms were demonstrated to decrease together with acclimatization for 2 days. The symptoms subside about 5 days after high altitude stays [27,28].…”

Recognising and mitigating the risk of altitude-related illness

“…[2] Indeed, consensus statements in the wilderness medical literature indicate that ascents of <7 days carry very high risks. [10] In contrast to this lies the commercial imperative: every day on Kilimanjaro incurs additional guiding, porter, camping, national park and rescue fees, all of which create a perverse incentive to hurry, imposed by the almighty dollar.…”

“…Kilimanjaro is of particular relevance, as it has a very high incidence of altitude-related illnesses. [2][3][4][5] Regardless of the details of the Zulu tragedy, a great number of southern Africans undertake treks on Kilimanjaro each year. We have a responsibility to improve understanding and access to medically sound advice for prospective adventurers, and to encourage tour operators to plan and market adventure activities that mitigate the risks to participants.…”

Acute mountain sickness, two cases and their treatment in the field

“…Remedying the situation requires radical actions such as interrupting When climbing the altitudes over 3000 m, the current re commendations are to ascend only 300-600 m per day and to have an acclimatization day for every 600-1200 m of altitude gained [1,5], so that the body can adapt to the al titude. In practice, travelers and climbers usually ascend considerably faster than commended [3]. Slight symptoms of AMS may become more serious if the symptoms and warning signs are ignored.…”

“…If this process fails, due to too rapid ascent rate or susceptibility of the climber, one or a combination of three illnesses may result: acute mountain sickness (AMS), high altitude cerebral edema (HACE) or high altitude pulmonary edema (HAPE). AMS is the most common of these problems affecting 25% of those who ascend the al titudes of 1850 to 2750 m [2], 42 % of people at altitudes of 3000 m [1], and as many as 75% at Mount Kiliman jaro (5984 m) where the most common reason for high prevalence for AMS is the rapid ascent [3]. AMS usually develops after 1-3 days of sojourn at high altitude.…”