Respiratory diseases remain a leading cause of death worldwide, claiming around 10 million lives annually. The COVID-19 pandemic further intensified this global health challenge, particularly affecting both low- and high-income countries. This study investigated the occurrence and trends of respiratory conditions among patients attending the emergency department at Muhimbili National Hospital in Tanzania and explored whether hospital-based data could support early detection of outbreaks in settings with limited diagnostic resources. We analyzed two years of electronic health records from the Emergency Medical Department (EMD), including all patients who presented with respiratory complaints between 2020 and 2021. The analysis employed descriptive statistics and visual trend assessments to quantify the burden of disease and compare it to national COVID-19 case patterns. Of the 24,942 patients seen during the study period, respiratory conditions accounted for roughly one-quarter of visits, averaging 1,039 cases per month. Patients had a median age of 34.7 years (IQR 21.7–53.7), and 52% were male. Pneumonia (52%) and upper respiratory tract infections (31%) were most prevalent, followed by asthma (4.8%) and suspected COVID-19 (2.5%). Temporal analysis revealed four peaks in respiratory presentations, coinciding with the four waves of COVID-19 reported nationally. These results indicate a significant and fluctuating burden of respiratory illness in the hospital’s emergency department, mirroring national pandemic trends. The findings suggest that real-time monitoring of hospital presentations could serve as a practical tool for early warning of respiratory outbreaks and other public health emergencies in contexts where diagnostic testing is limited.
