Injury, Disability and Access to Care in Rwanda: Results of a Nationwide Cross‐Sectional Population Study

Petroze, Robin T.; Joharifard, Shahrzad; Groen, Reinou S.; Niyonkuru, Francine; Ntaganda, Edmond; Kushner, Adam L.; Guterbock, Thomas M.; Kyamanywa, Patrick; Calland, J. Forrest

doi:10.1007/s00268-014-2544-9

Cited by 39 publications

(35 citation statements)

References 34 publications

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“…This survey has been executed in Rwanda and Sierra Leone in 2011 and 2012, respectively [6,7] and in Nepal in 2014. In Sierra Leone, 3.98% respondents reported at least one burn [8] and in Rwanda 9% of all injuries were due to burns [9]. However, comparable data are not available in South Asia, which is home to one fifth of the world's population, approximately 1.7 billion people [10].…”

Section: Introductionmentioning

confidence: 99%

Burns in Nepal: A population based national assessment

Gupta

Mahmood

Gurung

et al. 2015

Burns

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Section: Introductionmentioning

confidence: 99%

Burns in Nepal: A population based national assessment

Gupta

Mahmood

Gurung

et al. 2015

Burns

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“…[11, 19, 20] A survey instrument was adapted from the World Health Organization’s community injury survey guidelines and the Surgeons OverSeas Assessment of Surgical Need (SOSAS). [19–21] The instrument was translated into Arabic, back translated to assure accuracy and piloted for utility and validity.…”

Section: Methodsmentioning

confidence: 99%

Burns in Baghdad from 2003 to 2014: Results of a randomized household cluster survey

Stewart

Lafta

Shatari

et al. 2016

Burns

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Purpose Civilians living amid conflict are at high-risk of burns. However, the epidemiology of burns among this vulnerable group is poorly understood, yet vital for health policy and relief planning. To address this gap, we aimed to determine the death and disability, healthcare needs and household financial consequences of burns in post-invasion Baghdad. Methods A two-stage, cluster randomized, community-based household survey was performed in May of 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about cause of household member death, households were interviewed regarding burn specifics, healthcare required, disability, relationship to conflict and resultant financial hardship. Results Nine-hundred households, totaling 5,148 individuals, were interviewed. There were 55 burns, which were 10% of all injuries reported. There were an estimated 2,340 serious burn injures (39 per 100,000 persons) in Baghdad in 2003. The frequency of serious burn injuries generally increased post-invasion to 8,780 burns in 2013 (117 per 100,000 persons). Eight burns (15%) were the direct result of conflict. Individuals aged over 45 years had more than twice the odds of burn injury than children aged less than 13 years (aOR 2.42; 95%CI 1.08 – 5.44). Nineteen burns (35%) involved ≥20% body surface area. Death (16% of burn injuries), disability (40%), household financial hardship (48%) and food insecurity (50%) were common after burn injury. Conclusion Civilian burn injury in Baghdad is epidemic, increasing in frequency and associated with household financial hardship. Challenges of healthcare provision during prolonged conflict were evidenced by a high mortality rate and likelihood of disability after burn injury. Ongoing conflict will directly and indirectly generate more burns, which mandates planning for burn prevention and care within local capacity development initiatives, as well as humanitarian assistance.

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“…7, 14, 15 A survey instrument was adapted from the World Health Organization's community injury survey guidelines and the Surgeons OverSeas Assessment of Surgical Need (SOSAS). 14-16 The instrument was translated into Arabic, back translated to assure accuracy and piloted for utility and validity.…”

Section: Methodsmentioning

confidence: 99%

Fall injuries in Baghdad from 2003 to 2014: Results of a randomised household cluster survey

Stewart

Lafta

Shatari

et al. 2016

Injury

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Introduction Falls incur nearly 35 million disability-adjusted life-years annually; 75% of which occur in low- and middle-income countries. The epidemiology of civilian injuries during conflict is relatively unknown, yet important for planning prevention initiatives, health policy and humanitarian assistance. This study aimed to determine the death and disability and household consequences of fall injuries in post-invasion Baghdad. Methods A two-stage, cluster randomized, community-based household survey was performed in May of 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about household member death, households were interviewed regarding injury specifics, healthcare required, disability, relatedness to conflict and resultant financial hardship. Results Nine hundred households totaling 5,148 individuals were interviewed. There were 138 fall injuries (25% of all injuries reported); fall was the most common mechanism of civilian injury in Baghdad. The rate of serious fall injuries increased from 78 to 466 per 100,000 persons in 2003 and 2013, respectively. Fall was the most common mechanism among the injured elderly (i.e. ≥65 years; 15/24 elderly unintentional injuries; 63%). However, 46 fall injuries were children aged <15 years (49% of unintentional injuries) and 77 were respondents aged 15 - 64 years (36%). Respondents who spent significant time within the home (i.e. unemployed, retired, homemaker) had three times greater odds of having suffered a fall injury than student referents (aOR 3.34; 95%CI 1.30 – 8.60). Almost 80% of fall injured were left with life-limiting disability. Affected households often borrowed substantial sums of money (34 households; 30% of affected households) and/or suffered food insecurity after a family member's fall (52; 46%). Conclusion Falls were the most common cause of civilian injury in Baghdad. In part due to the effect of prolonged insecurity on a fragile health system, many injuries resulted in life-limiting disabilities. In turn, households shouldered much of the burden after fall injury due to loss of income and/or medical expenditure, often resulting in food insecurity. Given ongoing conflict, civilian injury control initiatives, trauma care strengthening efforts and support for households of the injured is urgently needed.

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Injury, Disability and Access to Care in Rwanda: Results of a Nationwide Cross‐Sectional Population Study

Abstract: Determining accurate injury and disability burden is crucial to health system planning in low-income countries. SOSAS is a useful survey for determining injury epidemiology at the community level, which can in turn help to plan prevention efforts and optimize provision of care.

Cited by 39 publications

References 34 publications

Burns in Nepal: A population based national assessment

Burns in Nepal: A population based national assessment

Burns in Baghdad from 2003 to 2014: Results of a randomized household cluster survey

Fall injuries in Baghdad from 2003 to 2014: Results of a randomised household cluster survey

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