Epidemiology of accidents and injuries
Answers
Injuries are said to be the leading cause of death and a major source of disability amongst children and young adults in industrialized countries[1,2] and this is more so in the developing countries like Nigeria where increasing industrialization, high velocity vehicles, increasing ethno-religious clashes and recently widespread terrorist attacks have resulted in sudden, unexpected mass casualties presenting to secondary and/or tertiary health centers.[3] These are now competing favorably with under-nutrition and infections as causes of morbidity and mortality especially in children.
Rapid unplanned industrialization and urbanization especially in the developing countries has led to an unprecedented surge in the number of vehicles in these countries, invariably leading to an increase in morbidity and mortality from these high velocity means of transportation. World-wide, the number of road traffic accident fatalities is estimated at 1.2 million annually with the number of those injured being as high as 50 million.[4] It is estimated that by the year 2030, motor vehicle accidents, which currently rank 9th as a cause of disability-adjusted life- years (DALYs) in the world would be ranked 3rd[5] therefore, road traffic accidents are considered to be the new global epidemic. Developing countries especially sub-Saharan Africa accounts for more than 85% of all road traffic accident deaths world-wide.[6,7,8] More than 90% of the DALYs lost world-wide from road traffic accidents occur in developing countries.[9] South East Asia records the highest number of global road fatalities in the world. It is difficult to have true epidemiological figures of these accidents in Nigeria due to poor record keeping and unreported accidents. Trauma registries are non-existent and documentation of injuries inadequate.[10]
In Nigeria, the use of motorcycles as a means of commercial transportation has completely changed the type, prevalence and outcome of injuries resulting from road traffic accidents, contributing a major neglected public health problem.
Ethnic and religiously motivated crises, which are also said to have political undertones have been in existence for decades in Nigeria, as far back as the pre-colonial era.[11]
Terrorist attacks have been non-existent in Nigeria until very recently with the proliferation of a variety of terrorist groups. These days it is common place to have bombings orchestrated by these insurgents targeted at the public.
Records of injuries following the above events in developing countries are primarily based on hospital logs[12,13] and police records[14,15,16] both of which are relatively unreliable as these sources underestimate the total burden of these injuries.
These events are characteristics, which can be modified for a better outcome for the people and prompted this study to determine the epidemiology and trend of injuries that present to our Teaching Hospital with a view to developing injury surveillance initiatives in our center and Nigeria as a whole by identifying the causes of these injuries and implementing appropriate preventive measures on a routine basis.
Answer:
Injuries directly lead to 5 million deaths every year, accounting for 9% of all deaths worldwide. While knowledge of the pattern of injuries is essential to plan health interventions to reduce the incidence of injuries, these are not thoroughly described in Ghana. The aim of this study was to describe the epidemiology of injuries seen at the Accident centre of the Korle-Bu Teaching Hospital, Ghana’s main referral hospital
A retrospective review of two-year records of all patients who attended the Accident centre of the Korle-Bu Teaching Hospital from January 2016 to December 2017 was done. Data on the cause of injuries was the main focus of this review
A total of 17,860 patients’ records were included in the study. There were 12,116 (67.8%) males and 5,744 (32.2%) females. The ages of the patients seen during the period ranged from three (3) days to 101 years. The overall mean age was 27.9 (±18.2). Majority of the injuries resulted from road traffic accidents and falls, accounting for 39.1 and 19.7% respectively.
Road Traffic accidents (RTA), especially motorcycle related, are a significant cause of injuries in Ghana. Future studies should focus on interventions that can reduce the incidence of RTA’s to reduce the number of injuries that present to the Korle-Bu Teaching Hospital.