Trauma-Related Mortality among Adults in Rural Western Kenya: Characterising Deaths Using Data from a Health and Demographic Surveillance System

Odhiambo, Frank; Beynon, Caryl; Ogwang, Sheila; Hamel, Mary J.; Howland, Olivia; Eijk, Anna Maria van; Norton, Robyn; Nyaguara, Amek; Slutsker, Laurence; Laserson, Kayla F.; Cock, Kevin M. De; Phillips-Howard, Penelope A.

doi:10.1371/journal.pone.0079840

Cited by 23 publications

(36 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, despite broad decreases in age-standardised rates of injury burden, the pace of progress for these causes has been comparatively slow and ultimately has led to minimal changes in the proportion of overall burden due to injuries during the past 25 years. Prevention of injuries requires strong public safety policies, 53 but minimising mortality and long-term disability from injuries hinges upon having comprehensive trauma care systems54, 55 that provide timely, evidence-based care,56, 57, 58 including emergency surgical services 59, 60…”

Section: Discussionmentioning

confidence: 99%

Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Kassebaum¹,

Arora²,

Barber³

et al. 2016

The Lancet

1,735

937

View full text Add to dashboard Cite

SummaryBackgroundHealthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development.MethodsWe used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate.FindingsTotal global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9–3·0) for men and 3·5 years (3·4–3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78–0·92) and 1·2 years (1·1–1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violen...

show abstract

Section: Discussionmentioning

confidence: 99%

Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Kassebaum¹,

Arora²,

Barber³

et al. 2016

The Lancet

1,735

937

View full text Add to dashboard Cite

show abstract

“…al. who found that 4% of deaths were attributable to injuries [13]. While the global burden of injuries is on the decline [1], the burden of injuries in especially Sub-Saharan Africa remains high, possibly due to inadequate preventive measures, increased motorization and industrialization and weak health response [5].…”

Section: Discussionmentioning

confidence: 99%

“…A study conducted in an informal settlement in Nairobi also found assault to be the leading cause of injury fatality [27]. Additionaly, another study in Western Kenya found that assault was the leading cause of injury fatality in men [13]. The homicide rate in Africa is the second highest in the world at 10.9 per 100,000 after the America’s region [28].…”

Section: Discussionmentioning

confidence: 99%

Demographic profile and pattern of fatal injuries in Nairobi, Kenya, January–June 2014

2017

View full text Add to dashboard Cite

BackgroundViolence and Injuries are a significant global public health concern characterized by marked regional variation in incidence. Approximately five million people die from injuries each year, accounting 9% of all deaths worldwide. In Kenya, injuries are increasingly becoming a cause of hospital admissions and mortality where they account for 10% of all the deaths. The objective of this study was to determine the magnitude, demographic profile and pattern of fatal injuries in Nairobi.MethodsRetrospective review of death certificates from the Department of Civil Registration was done for deaths caused by injuries that occurred in Nairobi during the period, January to June 2014. Data was collected using a standardized form. Data entry, cleaning and analysis was done using Epi info version 7.0.ResultsA total of 11,443 records were reviewed. From this data, deaths resulting from injuries were 1,208 accounting for 10.6% of all recorded deaths. Majority of the deaths resulting from injuries occurred in persons aged 25 to 44 years (48.1%). Males accounted for 85% of all the injuries. The leading cause of injury was assault by blunt force at 30.5%, followed by road traffic injuries at 25.9% and fire arm injuries at 15%. Pre-hospital deaths accounted for 51.4% of all the deaths. Nineteen percent of the deaths resulting from injuries had autopsies performed on them.ConclusionOur study found that injuries are an important cause of fatality in Nairobi, accounting for one in ten deaths. There is need for multisectoral collaboration as some of the preventive measures that target the most prevalent injuries such as assault and road traffic injuries lie outside the health sector. There exists information gaps on the death certificates hence there is need to adequately capacity build both clinicians and death certifiers. There is also a need to revise the death certificates and to improve the pre-hospital care system for the injured persons.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3958-0) contains supplementary material, which is available to authorized users.

show abstract

“…Between 2003 and 2008, the proportion of deaths related to trauma in western Kenya increased from 2.5% to 5·9%, with road traffic accidents (RTA) the the leading cause 5. In the past, most Kenya public health programmes focused on communicable diseases.…”

Section: Introductionmentioning

confidence: 99%

Emergency and urgent care capacity in a resource-limited setting: an assessment of health facilities in western Kenya

et al. 2014

View full text Add to dashboard Cite

ObjectiveInjuries, trauma and non-communicable diseases are responsible for a rising proportion of death and disability in low-income and middle-income countries. Delivering effective emergency and urgent healthcare for these and other conditions in resource-limited settings is challenging. In this study, we sought to examine and characterise emergency and urgent care capacity in a resource-limited setting.MethodsWe conducted an assessment within all 30 primary and secondary hospitals and within a stratified random sampling of 30 dispensaries and health centres in western Kenya. The key informants were the most senior facility healthcare provider and manager available. Emergency physician researchers utilised a semistructured assessment tool, and data were analysed using descriptive statistics and thematic coding.ResultsNo lower level facilities and 30% of higher level facilities reported having a defined, organised approach to trauma. 43% of higher level facilities had access to an anaesthetist. The majority of lower level facilities had suture and wound care supplies and gloves but typically lacked other basic trauma supplies. For cardiac care, 50% of higher level facilities had morphine, but a minority had functioning ECG, sublingual nitroglycerine or a defibrillator. Only 20% of lower level facilities had glucometers, and only 33% of higher level facilities could care for diabetic emergencies. No facilities had sepsis clinical guidelines.ConclusionsLarge gaps in essential emergency care capabilities were identified at all facility levels in western Kenya. There are great opportunities for a universally deployed basic emergency care package, an advanced emergency care package and facility designation scheme, and a reliable prehospital care transportation and communications system in resource-limited settings.

show abstract

Trauma-Related Mortality among Adults in Rural Western Kenya: Characterising Deaths Using Data from a Health and Demographic Surveillance System

Cited by 23 publications

References 27 publications

Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Demographic profile and pattern of fatal injuries in Nairobi, Kenya, January–June 2014

Emergency and urgent care capacity in a resource-limited setting: an assessment of health facilities in western Kenya

Contact Info

Product

Resources

About