The Burden of Motorcycle Crash Injuries on the Public Health System in Kisumu City, Kenya

Cholo, Wilberforce; Odero, Wilson; Ogendi, Japheths

doi:10.9745/ghsp-d-22-00197

Cited by 6 publications

(13 citation statements)

References 34 publications

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“…Head injury was the most common injury from our study cohort, which is at variance with most studies that reported long bone fractures as the most prevalent injury [ 9 , 16 , 17 ], but is in keeping with a recent study conducted in urban Kenya [ 19 ]. This pattern of injury burden may be a consequence of the preponderant motorcycle-car collision mechanism of injury and their association with traumatic brain injury from head-leading impacts [ 20 ].…”

Section: Discussionsupporting

confidence: 87%

“…Other authors have alluded to the association of late presentation with worse clinical outcomes while reporting additional predictors of mortality, which include older age of the patient, non-use of helmet, hypotension on admission, severe head injury, injury severity (major trauma), low Glasgow Coma Scale score, and need for intensive care unit admission [ 19 , 22 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Motorcycle Road Traffic Injuries in a Tertiary Hospital in Nigeria: A Reflection of the Trauma Care Crisis

Ezeme,

Oladeji,

Baiyewu

et al. 2023

Cureus

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Background: Motorcycle is a popular and growing form of intracity transportation in many Nigerian cities owing mainly to poorly developed transport systems. It contributes significantly to road traffic injuries (RTIs), which are a leading cause of death and disabilities in low- and middle-income countries. There is a lack of information on the quality of care received and the treatment outcome in patients with motorcycle RTIs in Ibadan and many cities in Nigeria. This study evaluated the characteristics of motorcycle-related RTIs, the quality of care received, and the outcome of the patients managed in a trauma reference center in Ibadan, Nigeria. Methods: This is a prospective cohort study. All patients involved in motorcycle road traffic crashes who presented to the emergency department of the University College Hospital, Ibadan, between August 2020 and May 2021, were included in the study. Data on patients’ demographics, history of the crash, injuries sustained, definitive care, and the outcome of in-hospital care were obtained from patients (and/or their carers) and the medical records. Results: A total of 156 patients were seen, out of which 74.4% were males. About 76.2% were less than 45 years with a mean age of 35.7 ± 16.3 years, and the peak age group was 18-44 years. About 37 (23.7%) patients were involved in motorcycle/motorcycle collisions, whereas 67 (42.9%) were involved in motorcycle/car collisions. Riders accounted for 59.6% (93), and although 62% (97) of the patients presented within six hours of the crash, only 10.9% (17) presented within one hour. About 48% received some form of prehospital care rendered by officials of the Federal Road Safety Corps, police officers, or passers-by, and none was attended by a dedicated emergency ambulance team. The head and the limbs were the most affected anatomical areas, while orthopedic and neurosurgical procedures were the most required emergency surgical interventions. About 66.7% were discharged home with only 21.2% of them fit to return to pre-trauma function at discharge, and the mortality rate was 17.3%. Patients who presented at 7-24 hours (AOR = 2.99; 95% CI = 1.04-8.62; p-value = 0.043) and >24 hours after the accident (AOR = 5.65; 95% CI = 1.64-19.53; p-value = 0.006) were 2.99 and 5.65 times, respectively, more likely to die from motorcycle-related accident compared to those who presented within the first six hours. Conclusion: This study identified the growing burden of disabilities and mortalities related to motorcycle RTIs. It highlights the lack of prehospital trauma care, which is a reflection of the deficiency of a national, regional, or jurisdictional trauma system and the critical need to develop a functional trauma system.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Motorcycle Road Traffic Injuries in a Tertiary Hospital in Nigeria: A Reflection of the Trauma Care Crisis

Ezeme,

Oladeji,

Baiyewu

et al. 2023

Cureus

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“…Fractures are reported to destroy the underlying microstructure frameworks that make bone hard and strong to support locomotor activity participation (Sheen et al, 2023). Fractures and spinal cord injuries have significant functional impairments, long-term disability, and morbidity for victims following commercial motorcycle road accidents (Cholo et al, 2023). Stretch, compression, and breaking through the nervous system may lead to a complete or incomplete nerve spinal cord injury with partial or complete loss of motor and sensory function below the level of injury according to the America Spinal Injury Association (ASIA) scale of assessment (Bennet & Emmady, 2020;Kirshblum et al, 2014).…”

Section: Biological Modelmentioning

confidence: 99%

“…Globally, commercial motorcycle road-related injuries are higher in low-and middle-income countries than in developed countries (Cholo et al, 2023). In African countries, especially South Africa and Malawi, the use of commercial motorcycles as a means of transport is linked to traumatic fractures of the long bones that negatively impact one's several aspects of life (Abbas et al, 2023;Singaram & Naidoo, 2019).…”

Section: Introductionmentioning

confidence: 99%

Physiotherapists’ Use of Outcome Measure Tools in the Assessment of Neuro-Musculoskeletal Injuries for Short-Term Functional Rehabilitation Domains to Minimize Impairments and Disability following Commercial Motorcycle Road-Related Accident, Eldoret, Kenya

Muia,

Masinde,

Imbwaga

2024

AJERNET

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Bed immobilization remains a core intervention to stabilize neuro-musculoskeletal injuries following commercial motorcycle-related road traffic accidents. Despite timely operative and conservative management, most patients remain handicapped, requiring short- and long-term physical therapy. That calls for physiotherapists to assess and make use of outcome measure tools to determine the level of impairments and disability and make informed decisions when developing management goals. The objective of the study was to determine short-term functional rehabilitation domains, the use of outcome measure tools, and physiotherapy interventions used to minimize impairments and disability following a commercial motorcycle road-related accident in Eldoret, Kenya. Biopsychosocial theory guided the study. A prospective cohort study was adopted. Purposive sampling was used for the selection of 79 participants for 6 months between March 2021 and July 2021 in level 5 hospitals in Eldoret, Kenya. The target population included post-operative patients in both male and female orthopedics wards, physiotherapists, and social workers in the orthopedic department of Moi Teaching and Referral Hospital. The study population was 150 patients. A self-administered, structured questionnaire was used. The data collected was entered and analyzed with SPSS 20. The findings of this study revealed that forty-four percent (44%) of total participants were bedridden for fracture immobilization and spinal cord injuries for more than 3 days before and after orthopedic and neurological surgery. The majority (100%) of the participants had been referred for physiotherapy rehabilitation. All 100 participants were assessed with different outcome measure tools for neuro-musculoskeletal injuries to determine the level of physical function. Forty-three percent (43%) had lost functional abilities of the upper extremity (19 males, 15 females). Fifty-one-point nine percent (51.9%) had lost physical function due to lower extremity fractures (39% (26 males, 15 females) and 24% (15 males, 4 females) with spinal cord injuries. Four participants (5%) reported lost days to school, and 94.9% reported lost days to income-generating activities (27 females, 48 males). The majority (100%) of the participants pre- and post-operatively were assessed with standardized outcome measure tools that remain significant for prompt best evidence-based physiotherapy practices. Pain (100%) and impaired physical functions (100%) were the main rehabilitation domains that posed the biggest challenge to patients’ post-trauma. Multicomponent physiotherapy interventions ranging from stretching, strengthening, breathing exercises, bed positioning, mobility and transfers, balance and coordination, and gait training tailored to patients’ physical function levels, prevention of muscle atrophy and strength, and joint stiffness were core. This study recommended short-term physiotherapy rehabilitation on early bed mobilization and ambulation for patients, which remains core for the restoration of physical functional levels and a return formula to socioeconomic status.

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“…In United States of America, 81% of motorcycle road related injuries contribute to the five top categories of impairments namely; traumatic brain injury (TBI), other multiple trauma, TBI with fracture and amputation, other orthopedic, and hip/knee joint replacement (Hoseinian et al, 2019), that require injury diagnosis, medical and in-and outpatient rehabilitation cost (Baptistella et al, 2020). In low-and middle-income countries more than 1.35 million people die with more than 50 million reported to have suffered from long life disability due to road traffic accidents including motorcycle traffic injuries annually (Ahmed et al, 2023;Cholo et al, 2023;Khalaf et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Socio-demographics, Causes of Injuries, and Rehabilitation Injury Categories in a Commercial Motorcycle Road-Related Orthopedics and Neurological Surgery Cohort in Eldoret, Kenya

Muia,

Imbwaga

2024

AJERNET

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Commercial motorcycle road related orthopedics and neurological injuries are one of the major causes of short- and long-term consequences requiring timely interdisciplinary referrals and in-patient physiotherapy rehabilitation together with out-patient follow-ups, to maintain and improve physical and functional level of patients. Spinal cord injuries and fractures of the vertebra and lower extremities remain one of the causes of mortality, impairments and disability to the riders, passengers and pedestrians. The objective of the study was to explore socio-demographic characteristics, causes of injuries, rehabilitation injury categories following commercial motorcycle road-related orthopedics and neurological surgery, Eldoret, Kenya. In this prospective cohort study, purposive sampling was adopted to select a sample size of 79 participants for a 6 months period of March 2021-July 2022 in 5 level hospitals, Eldoret, Kenya. The data was entered and analyzed with SPSS 20. The findings show that, from the patients’ bio-data during the study period, 79 out 150 were admitted with commercial motorcycle road-related orthopedics and neurological injuries for surgery with a prevalence rate 53%. All (100%) participants from socioeconmic backgrounds used commerical motorcycles as means of public transport. Male participants constituted to 62% and 38% females with a ratio of male to female of 4.9:3. Majority (94%) of participants were aged between 18 to 44 years with 62% aged between 18-34 years. Sixty-six per cent (66%) were admitted to orthopedics while 34% in neurological wards. All (100%) of the participants reported physical impairments and functional limitations with reduced independence level following commercial motorcycle road-related orthopedics and neurological injuries. All (100%) were referred for post-operative physiotherapy by orthopedics and neurological surgeons. More than half (62%) participants did not intend to continue with outpatient and follow-up physiotherapy rehabilitation. Majority (78%) paid their hospital health bills out of pocket with 51% coming from needy socio-economic class. However, 75% of the participants had requested for a waiver from a social worker. Based on the findings, the study concludes that interdisciplinary referral for post-operative physiotherapy by orthopedics and neurological surgeons were excellent. As a result, there is need for out-patient post-operative physiotherapy follow-ups and sensitization of NHIF registration and uptake by workers in informal sectors.

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The Burden of Motorcycle Crash Injuries on the Public Health System in Kisumu City, Kenya

Cited by 6 publications

References 34 publications

Motorcycle Road Traffic Injuries in a Tertiary Hospital in Nigeria: A Reflection of the Trauma Care Crisis

Motorcycle Road Traffic Injuries in a Tertiary Hospital in Nigeria: A Reflection of the Trauma Care Crisis

Physiotherapists’ Use of Outcome Measure Tools in the Assessment of Neuro-Musculoskeletal Injuries for Short-Term Functional Rehabilitation Domains to Minimize Impairments and Disability following Commercial Motorcycle Road-Related Accident, Eldoret, Kenya

Socio-demographics, Causes of Injuries, and Rehabilitation Injury Categories in a Commercial Motorcycle Road-Related Orthopedics and Neurological Surgery Cohort in Eldoret, Kenya

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