Road Traffic Accident Injuries in Kampala

ABSTRACT

The objectives of this study are To determine the circumstances related to road traffic injuries (RTIs); emergency and acute care; as well as outcomes in a hospital population. Setting: The casualty department of a 1200-bed teaching hospital in Kampala. Method: Information pertaining to age; categorical crash circumstances; activity when injury sustained; crash protection used; alcohol use; transport to hospital; pre-hospital treatment; and injury time were elicited from all admitted patients presenting with injuries due to road traffic crashes. A standardised form was used. Data were linked with the hospital's trauma registry which records injury severity and event location. Results: During the study period; 6432 patients were treated in the casualty department; of whom 1988 (30.9) were injury cases. There were 697 road traffic injuries; accounting for 35.1of all trauma; the largest single external cause; constituting 43.5(157/361) or RTI. Only 3.4(3/89) of cyclists reported wearing a helmet; no vehicle occupants reported using safety belts. Private transport to hospital was used by 78(284/361) of the victims. Mean time from injury to treatment was 155 minutes (range 15-1440; SD+/-224.2). Mortality two weeks after admission was 10.2(37/361) and a further 19.1(67/351) remained in hospital at two weeks. Conclusion: RTI is the largest single cause of severe injury in this population; with pedestrians; especially children and adolescents; the most affected group. Safety restraint and crash helmet use is rare. Alcohol is an important factor. Prevention and control efforts could focus on safety belt and crash helmet use; improved emergency services; trauma management training; and first-aid