Causes of Injuries Resulting in a Visit to the Emergency Department of a Provincial General Hospital; Nyanza; Western Kenya

Background: There is increasing importance of trauma not only as a major cause of surgical admissions; but also a significant cause of morbidity; mortality and disability. Objective: To document injury-related visits and hospitalization in a provincial hospital; western Kenya. Methods: On-site review of records of all patients who visited emergency department (ED) from January 2002 through December 2003; and admissions of year 2003. Results: A total of 15365 patients visited the ED; of which 41(6319/15395) were injury cases. The leading causes of injury were assault (42); road traffic crashes (RTC) (28); unspecified soft tissue injury (STI) (11). Cut-wounds; dogbites; falls; burns and poisoning were infrequently reported (each 10). The age group 15-44 years formed the largest proportion (75). A total of 3253 patients were admitted in 2003; of which 1010 (31) were due to injuries. RTC were leading cause of hospitalization (49) followed by assault (16). Men were more likely to be hospitalized due to assault (OR=2.22; CI = 1.45 - 3.41) and not burns or poisoning (p0.01). There were 64 (6.3) injury-related deaths; mainly resulting from RTC (41.9); burns (19.4) and assault (16.1). Conclusions: This study provides considerable information on major causes of injuries; useful for epidemiological surveillance and injury prevention campaigns

Prevalence and Profile of Injuries in Khorixas District Hospital; Namibia

The aims of this study were to identify the demographic characteristics of injury victims and the types of injury cases seen and admitted for treatment in Khorixas District Hospital; Namibia. A descriptive retrospective survey of all injuries attended to and admitted in the hospital from January 2001 to December 2004 was done using document review of patients' medical records. A total of 331 injury cases (6.8 of all admissions) were admitted. The age group 20-29 years was the most commonly affected; with 18 injured. Injury was common among the males (76). The unemployed constituted 36 of all the injuries; followed by children/infants (19). Over two-thirds (68) of the injuries were unintentional. Cuts and stabs were the most common (24) type of injury among the injury cases admitted. Motor vehicle accidents accounted for 21 of all injuries admitted. Over a third (36) of all the injuries were alcohol related. Farmers (11) constitute the most affected group among the employed. Type of injury and occupation were significantly associated (?2=107.879; p 0.001). Mass propagation of anti-violence education is needed to reduce the high rate of intentional injuries among the injuries such as cuts/stabs; assaults; human bite and gunshot injuries

A Survey of Wound Care Knowledge in South Africa

Chronic wounds afflict millions worldwide; incurring significant health care costs and chronic suffering. Clinicians are often unsure about treatment; resulting in poor outcomes. Objective. To determine the scope of knowledge possessed by fifth-year medical students; general practitioners (GPs) and surgical registrars; concerning chronic wound management. Design. Cross-sectional study.Methods. Deans of eight South African medical schools received letters requesting information regarding time devoted to wound-care training. Knowledge-based questionnaires were distributed to final-year students at two universities; surgical registrars at four universities and GPs attending refresher courses. Results. Four medical schools replied; of whom only two offered formal teaching. 162 medical students; 45 GPs and 47 surgical registrars completed questionnaires. The overall median (25th - 75th percentiles) knowledge scores for registrars; GPs and students were 65(55 - 70); 55(45 - 65) and 45(35 - 50) respectively. Whereas the scores of registrars and GPs did not differ; the student scores were significantly less. Only 32of registrars and 18of GPs attained scores of 70or more. 96considered training to be inadequate. Interest in wound care was only mild to moderate; with more GPs than registrars requesting literature. Conclusions. Very little; if any; training on chronic wounds is offered in South Africa. The levels of knowledge cannot be considered adequate for successful treatment; nor for teaching to undergraduates. This preliminary study cannot reflect the attitudes and knowledge throughout the country. However; it is clear that there is a need for improved education about these conditions that have huge clinical and economic consequences

A prospective study of significant non-fatal injuries in small children in Cape Town : lessons for prevention

Paediatric trauma is the leading cause of death in the 5-14 year-old age group in South Africa and elsewhere in the world; with attendant considerable morbidity. This prospective study analyzed 100 consecutive children (under the age of 12 years old) presenting with injuries requiring admission to a trauma center inCapeTown. The most common cause of injuries were motor vehicle accidents (33) followed by falls (31); sports (8);poisoning (3); and bicycle accidents (2). Fourteen (14) children were injured non-accidentally. The majority of injured children were from poor socio-economic circumstances with a mean family income of 894R (130 USD) per month. Alcohol played a role in the etiology of at least 21of the injuries.Children are vulnerable to injuries in our society and there is presently too little direction on preventative aspects of these injuries

Injury Profile in KwaZulu-Natal; South Africa: Implications for Prevention

Background: Prevention and control of injuries require generating relevant information on the magnitude; characteristics and determinants of injuries. Objective: The objective of this study was to describe the characteristics of injuries and predict the severity of injury with other variables. Design: A cross - sectional descriptive study was conducted at the hospitals of KwaZulu - Natal. Information was gathered from a total of 428 injured patients randomly selected from hospital attendances. Multivariate logistic regression analysis was performed to identify the risk factors for severity of injury. Results: Over 60of injury victims were below the age of 30 years. The economically active group (21 - 60 years) also constituted about 60of injury victims. Over half of the victims reported that the scene of incidence was private house; yard and road. One fifth was transport related injury whereas majority was violence (50). Unintentional injury was 28.8. Most of the injuries were minor (42.3) to moderate (41.1) in severity. Odds Ratio for alcohol related violence was 11. Conclusion: In order to reduce injuries appropriate multisectoral interventions; broader policies and strategies; regulating transport and alcohol use; routine testing of alcohol to identify the problem-drinkers for rehabilitation. Interventions should also include health education and health promotion and law enforcement