Epidemiology and outcomes of injuries in Kenya: A multisite surveillance study

Isaac Mandoh Botchey Jr., Yuen W. Hung, Abdulgafoor M Bachani, Fatima Paruk, Amber Mehmood, Hassan Saidi, Adnan A. Hyder

Research output: Contribution to journalArticle

Abstract

Background: Injury is a leading cause of disability and death worldwide, accounting for over 5 million deaths each year. The injury burden is higher in low- and middle-income countries where more than 90% of injury-related deaths occur. Despite this burden, the use of prospective trauma registries to describe injury epidemiology and outcomes is limited in low- and middle-income countries. Kenya lacks robust data to describe injury epidemiology and care. The objective of this study was to investigate the epidemiology and outcomes of injuries at 4 referral hospitals in Kenya using hospital-based trauma registries. Methods: From January 2014 to May 2015, all injured patients presenting to the casualty departments of Kenyatta National, Thika Level 5, Machakos Level 5, and Meru Level 5 Hospitals were enrolled prospectively. Data collected included demographic characteristics, type of prehospital care received, prehospital time, injury pattern, and outcomes. Results: A total of 14,237 patients were enrolled in our study. Patients were predominantly male (76.1%) and young (mean age 28 years). The most common mechanisms of injury were road traffic injuries (36.8%), falls (26.4%), and being struck/hit by a person or object (20.1%). Burn was the most common mechanism of injury in the age category under 5 years. Body regions commonly injured were lower extremity (35.1%), upper extremity (33.4%), and head (26.0%). The overall mortality rate was 2.4%. Significant predictors of mortality from multivariate analysis were Glasgow Coma Scale ≤12, estimated injury severity score ≥9, burns, and gunshot injuries. Conclusion: Hospital-based trauma registries can be important sources of data to study the epidemiology of injuries in low- and middle-income countries. Data from such trauma registries can highlight key needs and be used to design public health interventions and quality-of-care improvement programs.

Original languageEnglish (US)
JournalSurgery (United States)
DOIs
StateAccepted/In press - 2017

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Kenya
Epidemiology
Wounds and Injuries
Registries
Body Regions
Glasgow Coma Scale
Injury Severity Score
Mortality
Quality of Health Care
Information Storage and Retrieval
Quality Improvement
Burns
Upper Extremity

ASJC Scopus subject areas

  • Surgery

Cite this

Epidemiology and outcomes of injuries in Kenya : A multisite surveillance study. / Botchey Jr., Isaac Mandoh; Hung, Yuen W.; Bachani, Abdulgafoor M; Paruk, Fatima; Mehmood, Amber; Saidi, Hassan; Hyder, Adnan A.

In: Surgery (United States), 2017.

Research output: Contribution to journalArticle

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abstract = "Background: Injury is a leading cause of disability and death worldwide, accounting for over 5 million deaths each year. The injury burden is higher in low- and middle-income countries where more than 90{\%} of injury-related deaths occur. Despite this burden, the use of prospective trauma registries to describe injury epidemiology and outcomes is limited in low- and middle-income countries. Kenya lacks robust data to describe injury epidemiology and care. The objective of this study was to investigate the epidemiology and outcomes of injuries at 4 referral hospitals in Kenya using hospital-based trauma registries. Methods: From January 2014 to May 2015, all injured patients presenting to the casualty departments of Kenyatta National, Thika Level 5, Machakos Level 5, and Meru Level 5 Hospitals were enrolled prospectively. Data collected included demographic characteristics, type of prehospital care received, prehospital time, injury pattern, and outcomes. Results: A total of 14,237 patients were enrolled in our study. Patients were predominantly male (76.1{\%}) and young (mean age 28 years). The most common mechanisms of injury were road traffic injuries (36.8{\%}), falls (26.4{\%}), and being struck/hit by a person or object (20.1{\%}). Burn was the most common mechanism of injury in the age category under 5 years. Body regions commonly injured were lower extremity (35.1{\%}), upper extremity (33.4{\%}), and head (26.0{\%}). The overall mortality rate was 2.4{\%}. Significant predictors of mortality from multivariate analysis were Glasgow Coma Scale ≤12, estimated injury severity score ≥9, burns, and gunshot injuries. Conclusion: Hospital-based trauma registries can be important sources of data to study the epidemiology of injuries in low- and middle-income countries. Data from such trauma registries can highlight key needs and be used to design public health interventions and quality-of-care improvement programs.",
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