Research Article: Key findings from a prospective trauma registry at a regional hospital in Southwest Cameroon

Date Published: July 19, 2017

Publisher: Public Library of Science

Author(s): Alain Chichom-Mefire, Obieze C. Nwanna-Nzewunwa, Vincent Verla Siysi, Isabelle Feldhaus, Rochelle Dicker, Catherine Juillard, Robert D Winfield.

http://doi.org/10.1371/journal.pone.0180784

Abstract

Trauma is a leading cause of morbidity and mortality worldwide. Data characterizing the burden of trauma in Cameroon is limited. Regular, prospective injury surveillance can address the shortcomings of existing hospital administrative logs and medical records. This study aims to characterize trauma as seen at the emergency department (ED) of Limbe Regional Hospital (LRH) and assess the completeness of data obtained by a trauma registry.

From January 2008 to October 2013, we prospectively captured data on injured patients using a strategically designed, context-relevant trauma registry instrument. Indicators around patient demographics, injury characteristics, delays in accessing care, and treatment outcomes were recorded. Descriptive, bivariate, and multivariate statistical analyses were conducted.

Implementation of a context-appropriate trauma registry in resource-constrained settings is feasible. Providing valuable, high-quality data, the trauma registry can inform trauma care quality improvement efforts and policy development. Study findings indicate the need for injury prevention interventions and policies that will prioritize high-risks groups, such as those aged 20–29 years, and those in occupations requiring frequent road travel. The high incidence of motorcycle-related injuries is concerning and calls for a proactive solution.

Partial Text

Trauma, a leading cause of morbidity and mortality worldwide, accounts for about 10% of the global burden of disease and over five million deaths annually [1][2]. Low- and Middle-Income Countries (LMICs) are disproportionately affected by trauma, with about 90% of injury-related mortality occurring in these settings [3]. The incidence and burden of trauma in LMICs is growing due to poor road infrastructure, weak road safety policies and other factors [4,5]. In Cameroon, the burden of road traffic injuries (RTIs) continues to increase, rising from the 11th to the 8th leading cause of disability-adjusted life years (DALYs) between 1990 and 2010 [6].

Limbe Regional Hospital encounters a high trauma volume, which is chiefly due to traffic injuries and assault. Patients were predominantly young (10 to 39 years old), male, and residents of Limbe municipality presenting with mild injuries at one or two anatomical locations. Most patients arrived at the emergency department within an hour of being injured. These visits most often led to formal discharge.

This study shows that the implementation of a locally-developed trauma registry is feasible and sustainable, providing valuable, higher quality data to inform our understanding of injury as well as trauma care and systems in this setting. The high prevalence of motorcycle-related injuries raises concerns and the need for a proactive approach towards reducing the incidence of these injuries. Improving road safety and infrastructure, provision of safer public transportation systems, and the formulation and implementation of policies to ensure road and passenger safety will be critical to reducing the risk and occurrence of trauma in the region.

 

Source:

http://doi.org/10.1371/journal.pone.0180784

 

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