The burden of road traffic injuries in an emergency department in Addis Ababa, Ethiopia

Abstract

T he global burden of road traffic injuries (RTIs) is growing constantly, with approximately 1.2 million people killed and 20-50 million people injured each year. 1 This major public health problem disproportionately affects low-and middle-income countries (LMICs), and is likely to become a greater problem, with RTI-related deaths and injuries forecast to increase by 80% in LMICs between 2000 and 2020. 2 RTIs place an immense burden on health care systems, diverting financial and human resources and bed occupancy from other priorities. 3 Emergency medical services (EMS), a system of ambulances and emergency departments (EDs) at hospitals, provide critical care for injured or ill patients before they are integrated into other health services. 4 However, there are several challenges to delivering high quality EMS care in sub-Saharan Africa, including patient overload, poor integration with other health services, limited and inefficient services, poor clinical documentation, and a shortage of physicians and necessary supplies. [5][6][7] The epidemiology of conditions presenting to the EMS needs to be studied to make efficient use of the scarce existing human, material and financial resources. 8 Ethiopia, a country with a low small vehicle/population ratio, is considered one of the countries worst affected by RTIs. 9 This is due mainly to poor road safety plans and the failure of drivers to abide by the traffic rules. 10 While some studies have highlighted the general burden of RTIs in Ethiopia, the burden of RTIs on hospital EDs is still an under-researched area. A study conducted in the ED of Black Lion Hospital, Addis Ababa, showed that RTI injuries constituted 48% of all ED casualities. 11 The study did not capture certain aspects of the RTI burden, however, such as the severity of cases, patient outcomes and the RTI-related workload in other hospital departments.To address these gaps, our study highlights the overall burden of RTIs in the ED of the Zewditu Memorial Hospital, Addis Ababa. We report on 1) the annual trend in the number and proportion of ED admissions resulting from an RTI, 2) the demographic and clinical characteristics of RTI cases, 3) the RTI outcomes at the end of the ED encounter, and 4) the specific characteristics and outcomes of RTI cases involving a head injury over a 1-year period. The results of this study are expected to guide efforts to improve the preparedness of EDs and the hospital referral departments that manage RTI cases. METHODS Study designThis was a descriptive cross-sectional study using retrospectively collected routine hospital data. Study settingEthiopia is one of the most populated countries in sub-Saharan Africa, with 82 million inhabitants. The country comprises nine regions and two city administrations; 16% of its population resides in urban areas. 12 Addis Ababa, the capital city, is the largest city in Ethiopia, with an estimated population of 3.5 million, constituting a quarter of the urban population in the country. 13 The country is poor, with a per capita gross ...

Demographic and mortality analysis of hospitalized children at a referral hospital in Addis Ababa, Ethiopia

“…Improving pre-hospital emergency medical services (EMS) is emerging as a priority throughout low- and middle-income countries (LMIC) and has shown success at decreasing both mortality and long-term human and economic costs of illness and injury in other settings [ 16 – 18 ]. However, a coordinated EMS system in Ethiopia is not widely available [ 19 , 20 ]. While a coordinated EMS system has a theoretical chance of decreasing early mortality, we did not collect data on time of injury or beginning of illness to time of hospital presentation, nor did we track method of arrival to hospital.…”

Pattern and Outcome of Pediatric Traumatic Brain Injury at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: Observational Cross-Sectional Study

“…Burr hole and evacuation was done for four mild TBI cases. Irrigation and Emergency Medicine International debridement were done for mild (16) and moderate TBI (1) cases.…”

“…TBI accounted for 8.3% of the pediatric emergency department (ED) visits with mild severity according to the Western studies [9,10]. Several studies from developing countries documented TBI as a very common public health problem with milder severity and most notably following motor vehicle accidents [11][12][13][14][15][16][17]. Road traffic accidents (RTA) and falls from height were common reported pediatric TBI causes.…”

Demographic and mortality analysis of hospitalized children at a referral hospital in Addis Ababa, Ethiopia

“…Improving pre-hospital emergency medical services (EMS) is emerging as a priority throughout low-and middle-income countries (LMIC) and has shown success at decreasing both mortality and long-term human and economic costs of illness and injury in other settings [16][17][18]. However, a coordinated EMS system in Ethiopia is not widely available [19,20]. While a coordinated EMS system has a theoretical chance of decreasing early mortality, we did not collect data on time of injury or beginning of illness to time of hospital presentation, nor did we track method of arrival to hospital.…”