Road traffic accident clinical pattern and management outcomes at JUMC Emergency Department; Ethiopia

Background: Road Traffic Accident is an incident on a way or street open to public traffic. It becomes one of the most significant public health problems in the world especially in developing countries. In Ethiopia, it represents a significant risk for morbidity and mortality. It is also the major public health problem even though studies done on this topic in the study area is limited. Objective: To assess clinical pattern, associated factors and management outcomes among road traffic accident Victims attending emergency department of Jimma University Medical Center. Methods: Hospital based cross sectional study design was employed to review patients' chart visited the hospital from March to April 2021. A systematic random sampling technique was applied. The data were collected using pretested checklist and analyzed using SPSS version 26. Descriptive statistics and multivariate logistic regression were computed. Variables with P<0.05 were considered statistically significant. Results: About 49.6%) were pedestrians injured of which motorcycle accounted 42.9%. More than half of victims never got any type of prehospital care. On arrival, 38.7% were classified as Red of which 71.4% of them were managed surgically. About 84.9% of victims were discharged with improvement whereas12.6% were died. Victims with head injury (AOR= 16.61: 95% CI; 3.85, 71.71), time elapsed to reach nearby health facility (AOR= 3.30; 95 CI (1.13, 9.60), condition of patient at Emergency Department (AOR= 7.78; 95% CI: 2.33, 26.06), GCS at admission (AOR= 20.12; 95% CI: 7.23, 55.96) and days spent in hospital (AOR= 6.85; 95% CI 5.81, 8.06) were independent predictors of unfavorable outcome. Conclusion: Road Traffic Accident represents a significant risk for morbidity and mortality in Ethiopia, of which head injury and multiple sites injury increase injury severity. Targeted approaches to improving care of the injured victims may improve outcomes. Thus, the clinician should take into consideration the clinical presentation and give due attention to the identified contributing factors in its management.

The magnitude of sexual abuse and its physical effects among female children seen at Gandhi Memorial Hospital in Addis Ababa, Ethiopia

Background: Child sexual abuse is a form of abuse that involves sexual activity with a minor. A child does not possess the ability to consent to any form of sexual activity. Therefore, perpetrators who engage in sexual activity with a minor are committing the crime of sexual abuse. The definition of child sexual abuse does not need to include physical contact between a perpetrator and a child. The objective of this study was to assess the magnitude and associated physical consequences of sexual abuse among female children seen at Gandhi Memorial Hospital in Addis Ababa, Ethiopia. Method and Materials: This cross-sectional study identified and reviewed 1,500 reported cases of sexual abuse through hospital records at Gandhi Memorial Hospital (Addis Ababa, Ethiopia) between March 2016 and February 2017. These cases were all perpetrated against females and included both adults and children. From a total of 1,500 cases reviewed, 1,100 involved victims in the pediatric age group (under 18 years) who first presented to the hospital following sexual abuse. Of these 1,100 cases, 292 female children were selected. One study participant was selected for every three victims of child sexual abuse, until the required sample size was met. Data were collected from these 292 cases, and descriptive analysis was used to describe study findings. This analysis included frequencies, percentages, and standard deviations. The socio-demographic and educational status of study participants, as well as the physical findings of the victims on presentation, were analyzed, and presented numerically and as percentages of the total study population. Results: The majority of the victims were referred from Addis Ababa. Among the 292 selected cases, 221 (75.7%) were from Addis Ababa and the rest were from the surrounding areas. The majority of respondents (64.7%) were between 12 and 18 years of age, with a small percentage of respondents (5.8%) between 2 and 3 years of age. Most respondents (242 cases, 82.9%) had no previous history of sexual abuse, but the remaining 50 cases (17.1%) had a previous history of sexual abuse by the same or a different perpetuator. Conclusions: This study provides data, and thus evidence for policymakers and other stakeholders, to strive for an improvement in the security and protection of children, as well as education on the matter of child sexual abuse for parents and guardians. Those who could be involved in the implementation of intervention strategies may include parents, health professionals and pertinent personnel from the Ministry of Health and Ministry of Education. Above all, the data suggest a need for the victims to receive training on how to protect themselves from victimization