Fall injuries in Sub-Saharan Africa: analysis of prospective injury registry from 23 health facilities in Malawi and Tanzania

Abstract

Background Low-and middle-income countries account for over 80% of fall-related fatalities globally. However there is little emphasis on the issue and limited high quality data to understand the burden, and to inform preventive and management strategies. We characterise the burden of fall injuries in Malawi and Tanzania. Methods This multi-centre prospective descriptive study utilized trauma registry data from 10 hospitals in Malawi and 13 hospitals in Tanzania. The study included twelve months of data in Tanzania (October 2019 to September 2020), and eighteen months of data from Malawi (September 2018 to March 2020). We describe patient demographics, the causes, location, and nature of injuries, timing of arrival to hospital, and final disposition. Regression analyses were performed to determine risk factors for serious injuries. Results There were 93,178 trauma patients in the registries of both countries, of which 44,609 (47.9%) had fall related complaints. Fall injuries accounted for 55.3% and 17.4% of all trauma cases in Malawi and Tanzania respectively. Overall the median age was 16 years (Interquartile range (IQR) 8–31 years), and 62.8% were male. Most fall injuries (69.9%) occurred at home, were unintentional (98.1%), and were due to a ground level fall (74.9%). Nearly half of patients (47.9%) arrived at a facility using public transport, with median arrival time of 10 h (IQR 8–13 h) from initial injury. Extremities (87.0%) were the most commonly injured region, followed by head and neck (4.4%). Overall 3275 (7.4%) patients had potentially serious injuries. Age > 60 years was associated with two times odds of having serious injuries than those < 5 years, and those sustaining injury at work (adjusted Odds Ratio (aOR) 1.95 95% CI; 1.56–2.43) or recreational areas (aOR 3.47 95% CI; 2.93–4.10) had higher odds of serious injuries compared to those injured at home. Conclusions In these facilities in Sub-Saharan Africa, fall injuries accounted for a substantial fraction of all injuries. While most common in younger males, those aged 5–13 and over 60 years were more likely to have serious injuries. Most falls occurred at home, but serious injuries were more likely to occur at recreational and work areas. Future efforts should focus on preventive strategies to mitigate these injuries.

Edukasi dan Demonstrasi Rawat Luka Penanganan Cedera kepada Anak Usia Sekolah Menengah di SMA Kristen YBPK 1 Surabaya

“…Menurut hasil wawancara, cedera disekolah terjadi karena faktor lingkungan yang kurang baik seperti lapangan sekolah yang diaspal dan permukaan tidak rata jauh lebih beresiko untuk terjadinya cedera. Menurut Sawe et al (2023) bahwa korban cedera harus segera mendapatkan penanganan pertama yang benar dan tepat berupa rawat luka, untuk menimimalkan dampak buruk yang mungkin terjadi, seperti infeksi.Pengetahuan akan dasar-dasar penanganan pertama pada cedera sangat diperlukan. Tanpa pengetahuan dasar yang memadai, sering kali setiap orang menjadi panik dan tidak tahu harus berbuat apa dalam menghadapi kondisi darurat tersebut.…”

“…Hasil ini sejalan dengan penellitian yang dilakukan oleh Herlianita (2020) pada anak SMA dimana didapatkan pengaruh pendidikan kesehatan terhadap sikap dan praktik pada perawatan luka.Perawatan luka sangat penting untuk menghindari komplikasi seperti infeksi dan memperlama perawatan luka. Pertolongan yang tepat dapat mencegah menghindari prognosis yang buruk untuk kedepannya (Sawe et al, 2023;Xie et al, 2023). Bentuk edukasi yang diberikan meliputi jenis luka, penyebab luka dan perawatan luka.…”