The role of Ugandan District Hospital orthopedic units in the care of vulnerable road users: a cross-sectional study

Abstract

BackgroundMusculoskeletal injuries are a common cause of morbidity after road traffic injury (RTI) in motorizing countries. District hospitals provide front-line orthopedic care in Uganda and other sub-Saharan African nations. Improving care at the district hospital level is an important component of the World Health Organization’s strategy for surgical and trauma systems strengthening, but the data necessary to inform RTI safety and care initiatives has previously been insufficient at the district hospital level. The objective of this study was to provide data on the patient population and patterns of musculoskeletal injury caused by RTI at Ugandan district hospitals.MethodsIn this cross-sectional study, all patients with musculoskeletal injuries identified on x-ray presenting to three Ugandan district hospitals from October 2013 to January 2014 were interviewed and examined to obtain data on patient demographics and injury context by road user category. This manuscript is a sub-group analysis of RTI victims from a broader dataset of all musculoskeletal injuries.ResultsVulnerable road users comprised 92 % of musculoskeletal RTI patients, with 49 % (95 % CI 41–57 %) pedestrians, 41 % (95 % CI 33–49 %) motorcyclists, and 2 % (95 % CI 0–4 %) cyclists. Commonly injured subgroups included student pedestrians (33 % (95 % CI 22–44 %) of pedestrians) and motorcyclists with less than a post-secondary education (74 % (95 % CI 63–85 %) of motorcyclists). The morning hours were the most common time of injury for all RTI patients (37 %%; 95 % CI 30–44 %) and motorcyclists (46 %; 95 % CI 34–58 %), while pedestrians were most commonly injured in the evening (32 %; 95 % CI 21–43 %).ConclusionsBy demonstrating commonly injured demographic groups and high frequency times of day for injury, this surveillance study of musculoskeletal RTI suggests targeted avenues for future road safety research in the districts of Uganda. Compared with previous studies from the capital of Uganda, these results suggest that Ugandan district hospitals care for a disproportionate share of vulnerable road users, a discrepancy which may pertain to other sub-Saharan African nations, as well. Strengthening district hospital orthopedic care should be considered a priority of strategies aimed at improving outcomes for these vulnerable groups.

The willingness of orthopaedic trauma patients in Uganda to accept financial loans following injury

“…The results from this study are comparable to several recent extremity fracture studies conducted in metropolitan and rural Ugandan communities with respect to patient demographics and treatment costs. [ 3 , 4 , 6 , 7 , 15 ] Therefore, we believe the sample to be representative of this population. [ 3 , 4 , 6 , 7 , 15 ] A recent study at a large publicly funded region hospital in Southwestern Uganda assessed the effect of surgical costs, for all types of surgical treatment, on impoverishment.…”

The pattern of orthopedic fractures and visceral injury in road traffic crash victims, Addis Ababa, Ethiopia

“…Males are almost three times more affected by orthopedic fractures compared to females [7]. Different studies found out frequently more affected by road traffic crashes than females [8][9][10][11][12][13][14]. The younger age groups are most commonly affected in orthopedic crash fractures [1,10,11,[15][16][17].…”

Major limb loss (MLL): an overview of etiology, outcomes, experiences and challenges faced by amputees and service providers in the post-conflict period in Northern Uganda

“…If so, this situation is likely to change quickly as high-speed modern roads are being built very rapidly, associated with post-war development and new investments. 18,19 Regional variations in the etiology of MLL have previously been reported in other African countries like Nigeria. These studies found that whereas diabetic complications were the main causes for amputation in some areas of the country, in others trauma was the most common cause.…”