Patterns of injury at an Ethiopian referral hospital: Using an institutional trauma registry to inform injury prevention and systems strengthening

Laytin, Adam D.; Seyoum, Nebyou; Kassa, Seyoum; Juillard, Catherine; Dicker, Rochelle

doi:10.1016/j.afjem.2020.01.001

Cited by 14 publications

(11 citation statements)

References 28 publications

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“…In this study the mortality rate was 3.6%, this implies that a higher proportion of death is reported at the emergency department which is not comparable with the study that was reported from Tikur Anbessa specialized hospital (1.47%), Menelik hospital (1.5%), India (1%), Canada (1.2%), and Korea (0.6%) ( [15] , [16] , [17] , [18] ). However, the result is within the expected worldwide range (0.5%-6%) and much lower than the study conducted in Dilla hospital (6%), and sub-Saharan Africa (4.2%) ( 7 , 19 ).…”

Section: Discussioncontrasting

confidence: 75%

“…Road traffic injuries accounted for 30.7% of all injuries, which is greater than the 14.1% reported by Mekelle Public Hospital and, but far lower than the 36.5% reported by Menelik II Specialized Hospital, 49.1% Tikur Anbessa and Yekatit 12 hospital, 47.3% reported by Gedio Dilla Hospital and India 75% ( 9 , 16 , 32 , 29 , 17 ). RTA was the primary cause of mortality in this study (92.3%), which is greater than the study published in Ethiopian University Hospitals (52.2%) ( 19 ), and Saudi Arabia (60%) of patients died in road traffic accidents ( 33 ).…”

Section: Discussionmentioning

confidence: 70%

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Clinical profile and outcomes of trauma patients visiting the emergency department of a trauma center Addis Ababa, Ethiopia

Abebe

Boru²,

Belay³

et al. 2022

African Journal of Emergency Medicine

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Section: Discussioncontrasting

confidence: 75%

Section: Discussionmentioning

confidence: 70%

Clinical profile and outcomes of trauma patients visiting the emergency department of a trauma center Addis Ababa, Ethiopia

Abebe

Boru²,

Belay³

et al. 2022

African Journal of Emergency Medicine

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“…20 , 21 Another study was done in Minilik Specialized hospital that showed males (73.5%) were the most injured individuals. 22 The finding of the mentioned study coincides with my finding. The reason why males account for the larger proportion of road traffic injuries might be due to the nature of the job since most drivers were males and more exposed to the external environment.…”

Section: Discussionsupporting

confidence: 90%

Pattern of Orthopedic Injuries Related to Road Traffic Accidents Among Patients Managed at the Emergency Department in Black Lion Hospital, Addis Ababa, Ethiopia, 2021

Bezabih¹,

Tesfaye²,

Melaku³

et al. 2022

OAEM

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Background Studies showed that each year people lose their life on the road and many people are disabled. The majority of this disability was caused by orthopedic injury related to road traffic accidents. However, in the context of Ethiopia, studies ascribed to orthopedic injuries related to road traffic accidents are limited. The study aimed to assess the pattern of orthopedic injuries related to road traffic accidents among patients managed at the emergency department of Black Lion Hospital. Methods An institutional-based cross-sectional study was conducted on 354 victims of road traffic accidents with orthopedic injuries who were visiting the Emergency department of Black Lion Hospital. Patient charts were selected by systematic random sampling technique and the data was entered into Epi-data version 4.4.2.2 and exported to the static package for social science window version 26, and descriptive statistics were used for analysis. Results The study reveals that males were mostly injured persons (71.7%) with the age group of 13–24 were the most injured. Passenger car accounts 36.3% of causes of injury followed by motorbikes (27.4%) and lower limbs were the most common anatomic site of injuries (47.9). Of all injury types, a fracture is the most common one with 71.1%, especially lower limb fracture (42.1%). More than half victims (59.5%) had open wounds, and almost half of the study subjects (51.8%) experience Road traffic accidents while they are crossing or walking along the way. Conclusion Orthopedic injuries related to road traffic accidents are the main cause of death and disability in many individuals, especially in reproductive age groups. Therefore, policy-makers should be aware of different patterns of orthopedic injuries associated with a victim of road traffic accidents to have an appropriate and sustainable capacity to manage the orthopedic injuries.

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“…South Africa, Malawi, Uganda, Cameroon, Kenya, Ghana, Rwanda, Tanzania, and Zambia [ 168 ] have established trauma registries. Botswana [ 165 ], Nigeria [ 164 ], Ethiopia [ 166 ], and Mozambique [ 79 , 167 ] have registries at different levels of implementation. Quality of data collection is a challenge in many countries [ 169 ].…”

Section: Future Directions and Recommendationsmentioning

confidence: 99%

Disparities in Access to Trauma Care in Sub-Saharan Africa: a Narrative Review

Alayande,

Chu,

Jumbam

et al. 2022

Curr Trauma Rep

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Purpose of Review Sub-Saharan Africa is a diverse context with a large burden of injury and trauma-related deaths. Relative to high-income contexts, most of the region is less mature in prehospital and facility-based trauma care, education and training, and trauma care quality assurance. The 2030 Agenda for Sustainable Development recognizes rising inequalities, both within and between countries as a deterrent to growth and development. While disparities in access to trauma care between the region and HICs are more commonly described, internal disparities are equally concerning. We performed a narrative review of internal disparities in trauma care access using a previously described conceptual model. Recent Findings A broad PubMed and EMBASE search from 2010 to 2021 restricted to 48 sub-Saharan African countries was performed. Records focused on disparities in access to trauma care were identified and mapped to de Jager’s four component framework. Search findings, input from contextual experts, comparisons based on other related research, and disaggregation of data helped inform the narrative. Only 21 studies were identified by formal search, with most focused on urban versus rural disparities in geographical access to trauma care. An additional 6 records were identified through citation searches and experts. Disparity in access to trauma care providers, detection of indications for trauma surgery, progression to trauma surgery, and quality care provision were thematically analyzed. No specific data on disparities in access to injury care for all four domains was available for more than half of the countries. From available data, socioeconomic status, geographical location, insurance, gender, and age were recognized disparity domains. South Africa has the most mature trauma systems. Across the region, high quality trauma care access is skewed towards the urban, insured, higher socioeconomic class adult. District hospitals are more poorly equipped and manned, and dedicated trauma centers, blood banks, and intensive care facilities are largely located within cities and in southern Africa. The largest geographical gaps in trauma care are presumably in central Africa, francophone West Africa, and conflict regions of East Africa. Disparities in trauma training opportunities, public–private disparities in provider availability, injury care provider migration, and several other factors contribute to this inequity. National trauma registries will play a role in internal inequity monitoring, and deliberate development implementation of National Surgical, Obstetrics, and Anesthesia plans will help address disparities. Human, systemic, and historical factors supporting these disparities including implicit and explicit bias must be clearly identified and addressed. Systems approaches, strategic trauma policy frameworks, and global and regional coalitions, as modelled by the Global Alliance for Care of the Injured and the Bellagio group, are key. Inequity in access can be reduced by prehospital initiatives, as used in Ghana, and community-based insurance, as modelled by Rwanda. Summary Sub-Saharan African countries have underdeveloped trauma systems. Consistent in the narrative is the rural-urban disparity in trauma care access and the disadvantage of the poor. Further research is needed in view of data disparity. Recognition of these disparities should drive creative equitable solutions and focused interventions, partnerships, accompaniment, and action.

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Patterns of injury at an Ethiopian referral hospital: Using an institutional trauma registry to inform injury prevention and systems strengthening

Cited by 14 publications

References 28 publications

Clinical profile and outcomes of trauma patients visiting the emergency department of a trauma center Addis Ababa, Ethiopia

Clinical profile and outcomes of trauma patients visiting the emergency department of a trauma center Addis Ababa, Ethiopia

Pattern of Orthopedic Injuries Related to Road Traffic Accidents Among Patients Managed at the Emergency Department in Black Lion Hospital, Addis Ababa, Ethiopia, 2021

Disparities in Access to Trauma Care in Sub-Saharan Africa: a Narrative Review

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