Epidemiology of adult trauma injuries in Malawi: results from a multisite trauma registry

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Epidemiology of adult trauma injuries in Malawi: results from a multisite trauma registry


JournalInjury Epidemiology
Article typeJournal research article – Clinical research
Publication date – Apr – 2022
Authors – Linda Chokotho, Kevin Croke, Meyhar Mohammed, Wakisa Mulwafu, Jonna Bertfelt, Saahil Karpe, Sveta Milusheva
KeywordsMalaw, Road trafc accidents, Trauma Care, Trauma registries
Open access – Yes
SpecialityTrauma surgery
World region Southern Africa
Country: Malawi
Language – English
Submitted to the One Surgery Index on May 2, 2022 at 9:19 pm
Abstract:

Background
Large-scale multisite trauma registries with broad geographic coverage in low-income countries are rare. This lack of systematic trauma data impedes effective policy responses.

Methods
All patients presenting with trauma at 10 hospitals in Malawi from September 2018 to March 2020 were enrolled in a prospective registry. Using data from 49,241 cases, we analyze prevalence, causes, and distribution of trauma in adult patients, and timeliness of transport to health facilities and treatment.

Results
Falls were the most common mechanism of injury overall, but road traffic crashes (RTCs) were the most common mechanism of serious injury, accounting for (48%) of trauma admissions. This pattern was consistent across all central and district hospitals, with only one hospital recording  55, Glasgow Coma Score < 12, and presentation at hospital on a weekend.

Conclusions
RTCs make up almost half of hospitalized trauma cases in this setting, are equally common in referral and district hospitals, and are an important predictor of injury severity. Pedestrians and cyclists are just as affected as those in vehicles. Many of those injured in vehicles do not take adequate safety precautions. Most trauma patients, including those with serious injuries, do not receive prompt medical attention. Greater attention to safety for both motorized and especially non-motorized road users, and more timely, higher quality emergency medical services, are important policy priorities for Malawi and other developing countries with high burdens of RTC trauma.

OSI Number – 21583

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