Title of article :
Injury patterns of patients presenting to a non-governmental hospital in Western Uganda
Author/Authors :
Brown, Heather A. University of South Carolina - Prisma Health Midlands - Department of Emergency Medicine - Columbia - SC , USA , Skaggs, Joshua University of South Carolina - Prisma Health Midlands - Department of Emergency Medicine - Columbia - SC , USA , Brady, Caroline University of South Carolina - Prisma Health Midlands - Department of Emergency Medicine - Columbia - SC , USA , Tumusiime, Vincent Masindi Kitara Medical Center - Outpatient Department - Kijunjubwa Rd - Masindi, Uganda , White , Austin S. Morristown-Hamblen Healthcare System - Department of Emergency Medicine - Morristown - TN , USA
Abstract :
Injury is a leading cause of morbidity and mortality globally and disproportionately affects low-income countries. While most injury data comes from tertiary care centers in urban settings, the purpose of this study was to describe the characteristics and severity of injury in rural Uganda and the associated treatment patterns and delays in care.
Methods
This is a retrospective cohort study of a trauma registry that was implemented at Masindi-Kitara Medical Center (MKMC), a rural hospital in Western Uganda. Demographic information, injury characteristics, modified Kampala Trauma Scores (M-KTS), and treatment modalities over a 12 month period were retrospectively collected from paper-based registry forms completed for all injury patients presenting to MKMC.
Results
A total of 350 patients were entered into the trauma registry. Most patients were male (71.2%) with a median age of 26.5 years. Motorcycle crashes were the most prevalent mechanism of injury (42.3%) with the majority being unhelmeted (83.3%). Soft tissue injury was the most common diagnosis (44.9%). Patients were frequently treated in the outpatient department and then discharged (54.8%). Patients requiring admission or transfer (M-KTS = 11.57 or 11.67) tended to have a lower M-KTS than discharged patients (M-KTS = 12.75). Analgesics (74.6%) and antibiotics (52.9%) were the most common treatments administered. For those patients requiring admission (29.4%), only one in-hospital death was documented. Thirty-nine percent of patients reported a delay in seeking care, most frequently due to lack of transportation (31.5%) with a median time of delay of 11 h.
Conclusion
Road traffic injuries were the leading cause of injury in Masindi, with a high proportion of injuries associated with unhelmeted motorcycle crashes. Future opportunities to prevent injury and improve care may be seen through improved prehospital care, enforcement of helmet laws, increased access to neurosurgical services, and enactment of hospital quality improvement measures.
Keywords :
Road traffic injury , Injury epidemiology , Global health , Uganda , Trauma registry
Journal title :
African Journal of Emergency Medicine