Epidemiology of injuries presenting to the national hospital in Kampala, Uganda: implications for research and policy

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Abstract

Background

Despite the growing burden of injuries in LMICs, there are still limited primary epidemiologic data to guide health policy and health system development. Understanding the epidemiology of injury in developing countries can help identify risk factors for injury and target interventions for prevention and treatment to decrease disability and mortality.

Aim

To estimate the epidemiology of the injury seen in patients presenting to the government hospital in Kampala, the capital city of Uganda.

Methods

A secondary analysis of a prospectively collected database collected by the Injury Control Centre-Uganda at the Mulago National Referral Hospital, Kampala, Uganda, 2004-2005.

Results

From 1 August 2004 to 12 August 2005, a total of 3,750 injury-related visits were recorded; a final sample of 3,481 records were analyzed. The majority of patients (62%) were treated in the casualty department and then discharged; 38% were admitted. Road traffic injuries (RTIs) were the most common causes of injury for all age groups in this sample, except for those under 5 years old, and accounted for 49% of total injuries. RTIs were also the most common cause of mortality in trauma patients. Within traffic injuries, more passengers (44%) and pedestrians (30%) were injured than drivers (27%). Other causes of trauma included blunt/penetrating injuries (25% of injuries) and falls (10%). Less than 5% of all patients arriving to the emergency department for injuries arrived by ambulance.

Conclusions

Road traffic injuries are by far the largest cause of both morbidity and mortality in Kampala. They are the most common cause of injury for all ages, except those younger than 5, and school-aged children comprise a large proportion of victims from these incidents. The integration of injury control programs with ongoing health initiatives is an urgent priority for health and development.

Related collections

Most cited references 18

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Road-traffic injuries: confronting disparities to address a global-health problem.

Shanthi Ameratunga, Martha Hijar, Robyn Norton (2006)

Evidence suggests that the present and projected global burden of road-traffic injuries is disproportionately borne by countries that can least afford to meet the health service, economic, and societal challenges posed. Although the evidence base on which these estimates are made remains somewhat precarious in view of the limited data systems in most low-income and middle-income countries (as per the classification on the World Bank website), these projections highlight the essential need to address road-traffic injuries as a public-health priority. Most well-evaluated effective interventions do not directly focus on efforts to protect vulnerable road users, such as motorcyclists and pedestrians. Yet, these groups comprise the majority of road-traffic victims in low-income and middle-income countries, and consequently, the majority of the road-traffic victims globally. Appropriately responding to these disparities in available evidence and prevention efforts is necessary if we are to comprehensively address this global-health dilemma.

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Advancement of global health: key messages from the Disease Control Priorities Project.

Ramanan Laxminarayan, Anne J Mills, Joel G Breman … (2006)

The Disease Control Priorities Project (DCPP), a joint project of the Fogarty International Center of the US National Institutes of Health, the WHO, and The World Bank, was launched in 2001 to identify policy changes and intervention strategies for the health problems of low-income and middle-income countries. Nearly 500 experts worldwide compiled and reviewed the scientific research on a broad range of diseases and conditions, the results of which are published this week. A major product of DCPP, Disease Control Priorities in Developing Countries, 2nd edition (DCP2), focuses on the assessment of the cost-effectiveness of health-improving strategies (or interventions) for the conditions responsible for the greatest burden of disease. DCP2 also examines crosscutting issues crucial to the delivery of quality health services, including the organisation, financial support, and capacity of health systems. Here, we summarise the key messages of the project.

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John K. Heath, Kentaro Hayashi, Christopher Thompson … (2007)

Women residing at domestic violence shelters (S group) were nearly 11 times more likely to report that their partner had hurt or killed pets than a comparison group of women who said they had not experienced intimate violence (NS group). Reports of threatened harm to pets were more than 4 times higher for the S group. Using the Conflict Tactics Scale, the authors demonstrated that severe physical violence was a significant predictor of pet abuse. The vast majority of shelter women described being emotionally close to their pets and distraught by the abuse family pets experienced. Children were often exposed to pet abuse, and most reported being distressed by these experiences. A substantial minority of S-group women reported that their concern for their pets' welfare prevented them from seeking shelter sooner. This seemed truer for women without children, who may have had stronger pet attachments. This obstacle to seeking safety should be addressed by domestic violence agencies.

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Author and article information

Contributors

: +1-650-8147638 , +1-415-2065818 , rhsia@post.harvard.edu,

Bio :

Dr. Renee Hsia is an emergency physician who has worked extensively in sub-Saharan Africa both clinically and for research, and is currently an Assistant Professor of Emergency Medicine at the University of California, San Francisco (UCSF). This relationship with the Mulago Hospital was first developed by Dr. Doruk Ozgediz, who was Assistant Professor of Surgery at UCSF, and spent over a year living in Uganda to help collect this data from the trauma registry. Mr. Milton Mutto was the executive director of the Injury Control Center- Uganda at the time, which was originally started under the aegis of Dr. Olive C. Kobusingye, who went from the ICC-U to the Regional Office for Africa at the World Health Organization, based in Harare, Zimbabwe. Drs. Sudha Jayaraman (UCSF) and Patrick Kyamanywa have spent significant periods of time in Kampala also helping analyze the data and develop this study.

Journal

Journal ID (nlm-ta): Int J Emerg Med

Title: International Journal of Emergency Medicine

Publisher: Springer-Verlag (London )

ISSN (Print): 1865-1372

ISSN (Electronic): 1865-1380

Publication date (Electronic): 20 July 2010

Publication date PMC-release: 20 July 2010

Publication date Collection: September 2010

Volume: 3

Issue: 3

Pages: 165-172

Affiliations

[1 ]Department of Emergency Medicine, University of California at San Francisco, 1001 Potrero Avenue, 1E21, San Francisco, CA 94110 USA

[2 ]Department of Surgery, University of Toronto, Hospital for Sick Children, Toronto, ON Canada

[3 ]Injury Control Center- Uganda, Kampala, Uganda

[4 ]Department of Surgery, University of California at San Francisco, San Francisco, CA USA

[5 ]Department of Surgery, Faculty of Medicine, National University of Rwanda, Butare, Rwanda

[6 ]Regional Office for Africa, World Health Organization, Harare, Zimbabwe

Author notes

The views expressed in this paper are those of the author(s) and not those of the editors, editorial board or publisher.

Article

Publisher ID: 200

DOI: 10.1007/s12245-010-0200-1

PMC ID: 2926872

PubMed ID: 21031040

SO-VID: 590ecfe1-cbe1-41a4-bf27-031a43b31e0e

History

Date received : 23 May 2009

Date accepted : 31 May 2010

Custom metadata

ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: trauma,uganda,injuries,developing country,road traffic

Data availability:

ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: trauma, uganda, injuries, developing country, road traffic

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