We identified risk factors for road traffic injuries among road users who received treatment at two major trauma hospitals in urban Gambia. The study includes pedestrians, bicyclists, motorcyclists, and drivers/passengers of cars and trucks. We examined distributions of injury by age, gender, collision vehicle types and vehicle category, and driver and environment factors. Two hundred and fifty-four patients were included in the study. Two-thirds were male and one-third female. Two-thirds (67%) of road traffic injuries involved pedestrians, bicyclists, and motorcyclists; and these were more common during weekdays (74%) than weekends. Nearly half (47%) of road traffic injuries involved pedestrians. One-third (34%) of injured patients were students (mean age of students was less than 14 years), more than half (51%) of whom were injured on the roadway as pedestrians. Head/skull injuries were common. Concussion/brain injuries were 3.5 times higher among pedestrians, bicyclists, and motorcyclists than vehicle occupants. Crashes involving pedestrians were more likely to involve young people (<25 years; aOR 6.36, 95% CI: 3.32–12.17) and involve being struck by a motor car (aOR 3.95, 95% CI: 2.09–7.47). Pedestrians contribute the largest proportion of hospitalizations in the Gambia. Young pedestrians are at particularly high risk. Prevention efforts should focus on not only vehicle and driver factors, but also protecting pedestrians, bicyclists, and motorcyclists.
Objectives. The objective of this study was to identify the types of pesticides in circulation at local markets in The Gambia and to determine the proportion of products that were sold as unlabeled pesticides. Methods. One hundred twenty-eight samples sold as pesticides were collected from four local markets throughout The Gambia. Pesticides in the samples were identified by gas chromatography with mass spectrometry (GC/MS). Findings. Of the 128 samples collected, 115 were unlabeled. Pesticide components in 111 of those unlabeled samples were identified. Approximately 28% of these samples that contained pesticides are banned or restricted in the United States, and about 16% was classified as hazardous by WHO. Conclusions. Based on results for 128 samples, a significant percentage of the pesticide products sold at local markets in The Gambia in 2005 are considered extremely hazardous.
Burn-related injuries are a significant burden in children, particularly in low- and middle-income countries (LMICs), where more than 90% of burn-related pediatric deaths occur. Lack of adult supervision of children is a major risk for pediatric burn injuries. The goal of this paper was to examine the general characteristics of burns and identify burn injury outcomes among adult-supervised children compared to those who were not supervised. The study examined burn injury and clinical characteristics among all burn patients admitted to two trauma hospitals in The Gambia, West Africa. At intake in the emergency room, the treating physician or nurse determined the need for admission based on body surface area burned (BSAB), depth of burn, and other clinical considerations such as co-occurring injuries and co-morbidities. During the study period of 1 April 2014 through 31 October 2016, 105 burn patients were admitted and data were collected by the treating physician for all of them. Information about supervision was only asked for children aged five years or less. More than half (51%) of the burn patients were children under 18 years, and 22% were under 5 years. Among children under five, most (86.4%) were supervised by an adult at the time of burn event. Of the 19 supervised children, 16 (84.2%) had body area surface burned (BSAB) of less than 20%. Two of the three children without adult supervision at the time of burn event had BSAB ≥ 20%. Overall, 59% of the patients had 20% + BSAB. Females (aOR = 1.25; 95% CI = 0.43–3.62), those burned in rural towns and villages (aOR = 2.29; 95% CI = 0.69–7.57), or burned by fire or flames (aOR = 1.47; 95% CI = 0.51–4.23) had increased odds of having a BSAB ≥ 20%, although these differences were not statistically significant. Children 0–5 years or 5–18 years (aOR = 0.04, 95% CI = 0.01–0.17; aOR = 0.07, 95% CI = 0.02–0.23, respectively) were less likely to have BSAB ≥ 20% than adults. Those burned in a rural location (aOR = 9.23, 95% CI = 2.30–37.12) or by fire or flames (aOR = 6.09, 95% CI = 1.55–23.97) were more likely to die. Children 0–5 years or 5–18 years (aOR = 0.2, 95% CI = 0.03–1.18; aOR = 0.38; 95% CI = 0.11–1.570, respectively) were less likely to die. Children constitute a significant proportion of admitted burn patients, and most of them were supervised at the time of the burn event. Supervised children (compared to unsupervised children) had less severe burns. Programs that focus on burn prevention at all levels including child supervision could increase awareness and reduce burns or their severity. Programs need to be designed and evaluated with focus on the child development stage and the leading causes of burns by age group.
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