Characterising emergency centre encounters in Mbour, Senegal as emergent-emergency care, emergent-primary care or non-emergent

Abstract

IntroductionEmergency medicine is a relatively new specialty in Africa, with the first emergency medicine training programme only started in South Africa in 2004. Continued emergency centre development and preparedness relies on a better understanding of the quantity and category of emergency centre encounters within the various African regions.MethodsThis study was conducted over four, consecutive months in 2014 using a retrospective chart review, aimed to examine the types of visits made to one emergency centre at the Grande Mbour Hospital in Mbour, Senegal. The New York University Emergency Department Algorithm was used to classify emergency centre encounters. Each diagnosis included in this study was classified per the algorithm as non-emergent; emergent but primary care treatable; emergent with emergency centre care needed but avoidable/preventable; and emergent with emergency centre care needed and not avoidable/preventable. The algorithm also categorised diagnoses of injury, mental health problems, alcohol, or substance abuse.ResultsThis study included 1268 diagnoses from the emergency centre. The most common presentations in Mbour, Senegal were injuries, with 302 cases (33%), and from the category: emergent but primary care treatable, with 303 cases (33%). In total, 174 cases (19%) were classified as: non-emergent. While only 93 cases (10%) were considered: emergency care needed/preventable or avoidable, a substantial number (n = 218, 24%) were categorised as: emergent with emergency centre care needed and not avoidable/preventable.ConclusionThis study provides the first description of patients presenting for care in the emergency centre of Mbour’s hospital and demonstrates the wide range of illnesses and types of trauma that the emergency centre must accommodate while contending with the limited resources available in the area. Understanding the burden of disease will help prioritise resources appropriately.

The burden of trauma at a district hospital in the Western Cape Province of South Africa

“…Our data found that patients with intentional injuries were about three times more likely to be admitted or transferred to higher levels of care than patients with unintentional injuries. The high rate of admissions and transfers amongst trauma patients at Wesfleur Hospital (7.1%) was found to be either consistent with, or slightly lower than, prior studies at other sub-Saharan African district hospitals [44] , [45] , [50] . In addition, higher acuity trauma patients were about nine times more likely to be admitted or transferred.…”

“…Wesfleur Hospital was the only major health facility serving a population of about one-quarter million people, which may explain the relatively high absolute monthly case load of trauma. If the proportion of trauma cases is considered, Wesfleur Hospital’s proportion of trauma (19.1%) was relatively consistent with prior studies conducted at other sub-Saharan Africa district hospitals [23] , [43] , [44] , [45] , [46] . The high trauma caseload at Wesfleur Hospital, similar to other African settings, reinforces the need to strengthen capacity of the local trauma care system, especially given the severity of injuries at Wesfleur.…”

Insufficient Supply, Diagnostic Services, and Lack of Trained Personnel in Primary Hospitals in North-West Ethiopia Worsened Trauma Care: A Mixed-Method Study

“…7 The WHO has identified 14 essential trauma care services that health care facilities should provide as a minimum standard for trauma victims, 8 although many of the hospitals in low-resource countries have challenges in achieving this. 9,10 Despite the high trauma prevalence in low and middle-income countries, the emergency departments of these countries have unfavorable conditions to manage trauma victims. Though emergency service is available 24/7, trauma care is provided by general practitioners, not by professionals specifically trained in trauma care.…”