Challenges in trauma management in a developing economy

Obalum, D C; Eyesan, S. U.; Kolawole, HF; Ogo, CN

doi:10.13172/2052-9627-1-3-903

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…34 The finding of predominance of fractures in our emergency orthopedic practice is also not surprising as the world health organization's record has it that injuries account for 16% of the global burden of diseases, with 90% of the total burden coming from low and middle-income countries. 35,36 Overall, majority of the patients who were seen in the out-patient clinics with fractures were females. This finding aligns with observations in the global epidemiology of fractures recorded more in females as evidenced in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Pattern of orthopaedic case presentations at the rivers state university teaching hospital: a ten-year review

2022

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Background: Pattern of diseases help institutions and governments to know the dominant disease conditions and how to allocate scarce resources. Knowledge of the pattern of orthopedic disease conditions seen and treated in the Rivers State university teaching hospital will help in guiding the repositioning effort of the department/discipline, especially in the light of the new status of the institution as a teaching hospital for teaching, service delivery and research. The aim of this study therefore was to determine the pattern of orthopedic cases seen in the surgery department of the Rivers State university teaching hospital from January 2010 to January 2019.Methods: A descriptive retrospective cross-sectional study was carried out at the emergency room, clinic, operating theatre, and wards of the surgery department of the Rivers State university teaching hospital, using hospital registers. The study was analyzed using the Microsoft excel spreadsheet.Results: There were 2854 orthopedic emergency room cases seen, comprising 621 fractures, 463 lumbar spondylosis/ spondylolisthesis, 392-foot ulcer/sepsis, 375 dislocations, 310 acute osteomyelitis, and 864 osteoarthritis with other conditions. The common orthopedic cases seen in the out-patient clinics in descending order of occurrence were lumbar spondylitis / spondylolisthesis (881), osteoarthritis (655), fractures (560), dislocations (227), etc.Conclusions: Trauma-related disease care constituted the bulk of work of the orthopedic surgeon in our environment in the emergency room, operating theatre and ward admissions, and younger males were more affected.

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Section: Discussionmentioning

confidence: 99%

Pattern of orthopaedic case presentations at the rivers state university teaching hospital: a ten-year review

2022

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“…The mode of evacuation is part of the pre-hospital time in the care of trauma patients. In countries south of the Sahara, the transport of trauma victims is mostly unmedicalized [18][19][20] . In our study, only 1.07% of victims were taken by ambulance to the hospital.…”

Section: Discussionmentioning

confidence: 99%

Injuries to the musculoskeletal system due to domestic accidents: Socio-demographic, lesional and therapeutic aspects

Diop,

Sarr,

Dembélé

et al. 2023

Int. J. Orthop. Sci.

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Introduction: Injuries due to domestic accidents have become a real public health problem that is often neglected in countries south of the Sahara. The objectives were to describe the characteristics of the accidents, the socio-demographic and lesion profile of the victims, and to evaluate the therapeutic management. Material and Methods: We conducted a retrospective and descriptive study over a period from January to December 2018, including all patients with domestic accidents received at the Orthopedics-Traumatology Department of Aristide Le Dantec Hospital in Dakar. Results: We collected 890 cases over one year, i.e., 24.47% of admissions with a sex ratio of 0.64. The mean age of our patients was 44.6 years with extremes of 9 and 95 years. The patients lived in Dakar-City in 61% of cases. Between 6 am and 6 pm, the time slot was 32.58% and 39.55% between 12 and 6 pm. Patients were admitted on weekdays (15.55%) and weekends (9.32%). Falls accounted for 39.7% of the accidents recorded. Fractures were found in 39.77%. The injuries were located in the pelvic limbs in 57%, the thoracic limbs in 33.26%, the trunk in 7.19%, and the head in 2.55% of cases. Of the patients who were received beyond the first 24 hours after the trauma in 44.27%. Most were brought to the emergency room by taxi 57% and only 1.07% by ambulance. The treatment was orthopedic in 38.2%, medical alone in 36.63%, and surgical in 25.16%. The patients were treated and followed in an ambulatory in 73.03%. Conclusion: Domestic accidents are important in admissions to Orthopedic and Traumatology emergencies. Measures must be undertaken for both diagnostic and therapeutic management.

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“…Improvements in critical care and imaging, including increased availability and quality of ultrasound and computed tomography, could facilitate non-operative management of trauma and help address limited operative capacity. For example, in response to an increased awareness about trauma and road accidents, 4,5,6,7,8 the Ministry of Health (MISAU) has established a call center and funded the first ambulances for a pre-hospital trauma system. In addition, MISAU has partnered with the Primary Trauma Care Foundation (PTCF) to offer contextually-appropriate trauma courses.…”

Section: Discussionmentioning

confidence: 99%

General surgical services at an urban teaching hospital in Mozambique

Snyder

Amado

Jacobe

et al. 2015

Journal of Surgical Research

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Background As surgery becomes incorporated into global health programs, it will be critical for clinicians to take into account already existing surgical care systems within low-income countries. In order to inform future efforts to expand the local system and systems in comparable regions of the developing world, we aimed to describe current patterns of surgical care at a major urban teaching hospital in Mozambique. Methods We performed a retrospective review of all general surgery patients treated between August 2012 and August 2013 at Hospital Central Maputo in Maputo, Mozambique. We reviewed emergency and elective surgical logbooks, inpatient discharge records, and death records to report case volume, disease etiology, and mortality. Results There were 1,598 operations (910 emergency, 688 elective) and 2,606 patient discharges during our study period. The most common emergent surgeries were for non-trauma laparotomy (22%) followed by all trauma procedures (18%), while the most common elective surgery was hernia repair (31%). The majority of lower extremity amputations were above knee (69%). The most common diagnostic categories for inpatients were infectious (31%), trauma (18%), hernia (12%), neoplasm (10%), and appendicitis (5%). The mortality rate was 5.6% (146 deaths), approximately half of which were related to sepsis. Conclusions Our data demonstrate the general surgery caseload of a large, academic, urban training and referral center in Mozambique. We describe resource limitations that impact operative capacity, trauma care, and management of amputations and cancer. These findings highlight challenges that are applicable to a broad range of global surgery efforts.

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Challenges in trauma management in a developing economy

Cited by 4 publications

References 23 publications

Pattern of orthopaedic case presentations at the rivers state university teaching hospital: a ten-year review

Pattern of orthopaedic case presentations at the rivers state university teaching hospital: a ten-year review

Injuries to the musculoskeletal system due to domestic accidents: Socio-demographic, lesional and therapeutic aspects

General surgical services at an urban teaching hospital in Mozambique

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