Traumatic Injuries in Developing Countries

Stewart, Kerry Ann; Groen, Reinou S.; Kamara, Thaim B.; Farahzad, Mina; Samai, Mohamed; Cassidy, Laura D.; Kushner, Adam L.; Wren, Sherry M.

doi:10.1001/jamasurg.2013.1341

Cited by 65 publications

(46 citation statements)

References 23 publications

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“…Sierra Leone is a country situated on the West coast of Africa with a population of just over 7 million people. It is amongst the world’s poorest countries, ranked 179 out of 188 countries in the Human Development Index with a life expectancy of 53 years [8] with injury representing 7% of the burden of disease [9] and responsible for an estimated 325,000 deaths [10] . It is currently recovering from the worst Ebola epidemic on record during which 221 health care workers lost their lives [11] and medical and surgical services were severely disrupted across the country, including at the only adult tertiary referral centre [12] .…”

Section: Introductionmentioning

confidence: 99%

The burden of trauma presenting to the government referral hospital in Freetown, Sierra Leone: An observational study

Bundu

Lowsby

Vandy

et al. 2019

African Journal of Emergency Medicine

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Introduction Trauma accounts for a significant proportion of the global burden of disease, with highest mortality rates seen in Africa. This epidemic is predicted to increase with urbanisation and an aim of the Sustainable Development Goals is to reduce deaths and trauma caused by road accidents. Data available on urban trauma in Sierra Leone is limited. Methods We conducted a retrospective observational study of trauma and injury related presentations to the emergency centre (EC) of Connaught Hospital, the principal adult tertiary referral centre in Freetown, Sierra Leone between January and March 2016. Patient demographics are described with mechanism of injury. Additional data on length of stay and surgical procedures were recorded for admissions to the trauma ward. Results During the 3-month period, a total of 340 patients with injury presented to the EC, accounting for 11.6% of total attendances and 68% of adult surgical admissions. The majority were male (66%) and mean age was 26 years (IQR 15–40). The proportion of trauma presentations were higher in the evening and at weekends and 41% of patients were triaged as emergency or very urgent cases. Road traffic accidents were the most frequent cause of injury (55%) followed by falls (17%) and assaults (14%). Burns were more common in children. Head and lower limbs were the most commonly injured body parts and a minority of patients underwent surgical procedures. Median length of stay for adult patients was 4.5 days (IQR 2–11) and 7 days (IQR 4–14) for children. Discussion Injury accounts for a high burden of disease at Connaught Hospital and consumes a significant proportion of EC and hospital resources. Efforts should be directed towards strengthening the pre-hospital and emergency trauma systems with accurate, formal data collection as well as targeting injury prevention initiatives and improving road safety to reduce morbidity and mortality.

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Section: Introductionmentioning

confidence: 99%

The burden of trauma presenting to the government referral hospital in Freetown, Sierra Leone: An observational study

Bundu

Lowsby

Vandy

et al. 2019

African Journal of Emergency Medicine

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“…Additionally, it had been reported that road traffic injuries was the major source of injuries in patients presenting to the hospitals of some African countries such as Uganda, Ghana, and Tanzania ( 11 ). However, in another study from Sierra Leone, a mid-income West African country, fall, lacerations, and crush injuries were the first and second most common causes of injury, respectively ( 12 ). On the other hand, falls are among the life events that lead to injury and in serious cases disability or death ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Types and Causalities in Dead Patients Due to Traumatic Injuries

et al. 2015

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Background:Trauma constitutes a major public health problem in our country and contributes significantly to unacceptably high morbidity and mortality.Objectives:This study aimed to evaluate the epidemiology of trauma in dead patients referred to Shahid Rajaee Trauma Hospital, Shiraz, Iran.Patients and Methods:In a cross-sectional study, all patients with trauma admitted to our center were enrolled between March 2011 and February 2012. Age, gender, months of referring, causalities, and injured body parts of the victims were extracted from the data registry and analyzed.Results:A total of 9113 patients, including 7163 (78.6%) males and 1950 (21.4%) females were evaluated. Among them, 479 patients (5.3%) had died. There was a significant difference between the age of alive and dead patients (35.70 ± 0.18 and 45.44 ± 1.01 years, respectively (P < 0.001)). In addition, dead men had significantly higher percentage than alive men (83.7% and 78.3%, respectively, P = 0.005). The highest percentages of men and women who referred to our center and died were in September. Crashing by car had the most frequency of dead (247 cases) in referred patients and motorcycle accident, stabbing, and falling related injuries with 67, 36 and 26 dead cases were in the next ranks. Thorax injury had the most frequency between dead patients (53.2% of all dead) and the intracranial injury and trauma to extremities altogether were in the next ranks, which constituted more than 18.8% of all dead.Conclusions:Our data demonstrated that car and motorcycle accidents are the most important cause of trauma and thorax trauma had the most frequency among dead patients. Epidemiological evaluations and preventive measures such as this study should be conducted to provide valuable data.

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“…4 While falls are common in LMICs, such a high incidence of fall injuries is not usually reported during peacetime (447 per 100,000 persons in 2013). 4, 14, 22 For comparison, the reported rate of serious fall injuries from other Middle Eastern countries that have not been affected by recent conflict (e.g. United Arab Emirates, Iran, Qatar) ranges from 64 – 237 per 100,000 persons, even among high-risk groups (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…7, 14, 15 A survey instrument was adapted from the World Health Organization's community injury survey guidelines and the Surgeons OverSeas Assessment of Surgical Need (SOSAS). 14-16 The instrument was translated into Arabic, back translated to assure accuracy and piloted for utility and validity. The final version was designated the Surgeons OverSeas Injury Survey (SOSINJ).…”

Section: Methodsmentioning

confidence: 99%

Fall injuries in Baghdad from 2003 to 2014: Results of a randomised household cluster survey

Stewart

Lafta

Shatari

et al. 2016

Injury

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Introduction Falls incur nearly 35 million disability-adjusted life-years annually; 75% of which occur in low- and middle-income countries. The epidemiology of civilian injuries during conflict is relatively unknown, yet important for planning prevention initiatives, health policy and humanitarian assistance. This study aimed to determine the death and disability and household consequences of fall injuries in post-invasion Baghdad. Methods A two-stage, cluster randomized, community-based household survey was performed in May of 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about household member death, households were interviewed regarding injury specifics, healthcare required, disability, relatedness to conflict and resultant financial hardship. Results Nine hundred households totaling 5,148 individuals were interviewed. There were 138 fall injuries (25% of all injuries reported); fall was the most common mechanism of civilian injury in Baghdad. The rate of serious fall injuries increased from 78 to 466 per 100,000 persons in 2003 and 2013, respectively. Fall was the most common mechanism among the injured elderly (i.e. ≥65 years; 15/24 elderly unintentional injuries; 63%). However, 46 fall injuries were children aged <15 years (49% of unintentional injuries) and 77 were respondents aged 15 - 64 years (36%). Respondents who spent significant time within the home (i.e. unemployed, retired, homemaker) had three times greater odds of having suffered a fall injury than student referents (aOR 3.34; 95%CI 1.30 – 8.60). Almost 80% of fall injured were left with life-limiting disability. Affected households often borrowed substantial sums of money (34 households; 30% of affected households) and/or suffered food insecurity after a family member's fall (52; 46%). Conclusion Falls were the most common cause of civilian injury in Baghdad. In part due to the effect of prolonged insecurity on a fragile health system, many injuries resulted in life-limiting disabilities. In turn, households shouldered much of the burden after fall injury due to loss of income and/or medical expenditure, often resulting in food insecurity. Given ongoing conflict, civilian injury control initiatives, trauma care strengthening efforts and support for households of the injured is urgently needed.

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Traumatic Injuries in Developing Countries

Cited by 65 publications

References 23 publications

The burden of trauma presenting to the government referral hospital in Freetown, Sierra Leone: An observational study

The burden of trauma presenting to the government referral hospital in Freetown, Sierra Leone: An observational study

Types and Causalities in Dead Patients Due to Traumatic Injuries

Fall injuries in Baghdad from 2003 to 2014: Results of a randomised household cluster survey

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