Citywide trauma experience in Kampala, Uganda: a call for intervention

Abstract

Objectives: To describe injuries and their emergency care at five city hospitals. Setting: Data were collected between January and December 1998 from casualty departments of the five largest hospitals of Kampala city, Uganda, with bed capacity ranging from 60 to 1200. Methods: Registry forms were completed on trauma patients. All patients with injuries were eligible. Outcome at two weeks was determined for admitted patients. Results: Of the 4359 injury patients, 73% were males. Their mean age was 24.2 years, range 0.1-89, and a 5-95 centile of 5-50 years. Patients with injuries were 7% of all patients seen. Traffic crashes caused 50% of injuries, and were the leading cause for patients >10 years. Fifty eight per cent of injuries occurred on the road, 29% at home, and 4% in a public building. Falls, assaults, and burns were the main causes in homes. Fourteen per cent of injuries were intentional. Injuries were severe in 24% as determined with the Kampala trauma score. One third of patients were admitted; two thirds arrived at the hospital within 30 minutes of injury, and 92% were attended within 20 minutes of arrival. Conclusions: Injuries in Kampala are an important public health problem, predominantly in young adult males, mostly due to traffic. The majority of injuries are unintentional. Hospital response is rapid, but the majority of injuries are minor. Without pre-hospital care, it is likely that patients with serious injuries die before they access care. Preventive measures and a pre-hospital emergency service are urgently needed.

Hospital-based injury data from level III institution in Cameroon: Retrospective analysis of the present registration system

“…The resultant rate of 14.3 per 1000 population per year is three times that of the rate derived from hospital data in Kampala, Uganda (population 1,000,000) where 4515 cases of trauma were recorded during one year. 19 The magnitude of injury reflected in these restricted data from our institution give a compelling case for increased attention to improving efforts in the prevention and treatment of injury.…”

“…As found in other sub-Saharan African settings, road traffic injuries were the most frequently occurring injury documented and were more common amongst men. 19,21 Most studies published report a slightly higher road traffic injury frequency of around 50% of all injury cases. 7,19,[22][23][24] This difference may represent the semi-urban setting in which Limbe hospital is found, as compared to reports mostly from large urban centres.…”

“…19,21 Most studies published report a slightly higher road traffic injury frequency of around 50% of all injury cases. 7,19,[22][23][24] This difference may represent the semi-urban setting in which Limbe hospital is found, as compared to reports mostly from large urban centres. Motorcycle-related road traffic injuries were notably frequent, a trend which has also been found recently in Nigeria.…”

“…25,26 Of note, interpersonal violence was the second most frequent form of injury, at 23%, which is higher than reports from other countries from the same region. 19,20 Although useful, these findings must be interpreted with the existing limitations in mind. Firstly, in any hospital-based system, a strong selection bias is inherent, as care-seeking at hospitals has been shown to be limited to only a fraction of the injured persons in some populations.…”

Current Patterns of Prehospital Trauma Care in Kampala, Uganda and the Feasibility of a Lay‐First‐Responder Training Program

“…Previously published data on injury patterns in Kampala indicate that 58% of injuries occurred on the roads and 29% in or near the home [12]. Based on this injury distribution, trainees were sought from the police, minibus taxi drivers, and Local Council officials by convenience sampling to ensure that participants who were identified by their supervisors as most likely to engage in prehospital trauma care were recruited.…”