Injury control research has come a long way, but more needs to be done (original) (raw)
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Sustainable improvements in injury surveillance in Ghana
International Journal of Injury Control and Safety Promotion, 2010
Introduction-The mortuary is an important foundation for injury surveillance. However, mortuary data are incomplete in many developing countries. Methods-The KATH mortuary handles most injury deaths for Kumasi, Ghana. During 1994-5, many cases in KATH's mortuary logbooks had missing information deaths. A low-cost pilot program was adopted to improve recording of injury deaths. During 1996-9, 633 deaths/year were recorded. Results-Project sustainability assessment in 2006 showed that reporting was high, with 773 cases per year. Data quality was standard with similar percents of missing values for key variables compared with the pilot period. Supplemental data constituting 20% was obtained from the ICU, for which data recording in the mortuary was incomplete. Conclusion-Low-cost improvements can lead to improved mortuary reporting of injury deaths. Collation of data from multiple sources remains a problem at KATH. Improved organization and training could remedy the situation.
International Journal of Injury Control and Safety Promotion, 2014
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International Journal of Injury Control and Safety Promotion, 2011
To help bridge the obstacle of inadequate injury fatality data in low and medium income countries (LMICs) a simple cost effective system for mortuary surveillance of fatal injuries is being developed in consultation with the WHO. This will inform, direct and monitor injury prevention (IP) interventions and policies in LMICs. This article uses CDC's ‘attributes of a successful surveillance system’ to describe the process, the barriers and solutions in development of this mortuary data guideline. The consultative process utilised generated feedback from key stakeholders including forensic pathologists, Ministry of Health officials and injury prevention experts. An International Advisory Group was also convened to guide the guideline development. These assisted the adjustment of the proposed guideline to maximise flexibility, acceptability and stability; whilst minimising resource implications. Representativeness and the securing of government support perhaps remain the most significant challenges. Consultation with the advisory group and the wider stakeholders has been effective in developing a widely acceptable, user-friendly, low resource data form to gather useful data. Further strategies to overcome barriers need to be developed over the course of the pilot study and this should be done in consultation with the advisory group and stakeholders.
Injury related adult deaths in Addis Ababa, Ethiopia: analysis of data from verbal autopsy
BMC Public Health, 2020
Background Injury related deaths are causing huge impact on families and communities throughout the world. Reports show that developing countries are highly affected by injury deaths. Ethiopia is among the countries that are highly affected by injury deaths especially road traffic accident. Previous studies in Ethiopia concerning injury deaths were mostly based on hospital records. However, in the context of Ethiopia, where majority of the deaths are happening outside health facilities, hospital-based studies cannot give the exact proportion of injury deaths. This study aimed to assess the proportion and types of injury deaths in Addis Ababa and the distribution with different socio-demographic characteristics using data from verbal autopsy. Methods We used verbal autopsy data of Addis Ababa Mortality Surveillance Program. The basic source of data for Addis Ababa Mortality Surveillance is burial surveillance from all cemeteries of Addis Ababa. We analyzed causes of injury mortality ...
Global Health Action
Background: In Ethiopia, though all kinds of mortality due to external causes are an important component of overall mortality often not counted or documented on an individual basis. Objective: The aim of this study was to describe the patterns of mortality from external causes using verbal autopsy (VA) method at the Ethiopian HDSS Network sites. Methods: All deaths at Ethiopian HDSS sites were routinely registered and followed up with VA interviews. The VA forms comprised deaths up to 28 days, between four weeks and 14 years and 15 years and above. The cause of a death was ascertained based on an interview with next of families or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history and circumstances preceding death after 45 days mourning period. Two physician assigned probable causes of death as underlying, immediate and contributing factors independently using information in VA forms based on the WHO ICD-10 and VA code system. Disagreed cases sent to third physician for independent review and diagnosis. The final cause of death considered when two of the three physicians assigned underlying cause of death; otherwise, labeled as undetermined. Results: In the period from 2009 to 2013, a total of 9719 deaths were registered. Of the total deaths, 623 (6.4%) were from external causes. Of these, accidental drowning and submersion, 136 (21.8%), accidental fall, 113 (18.1%) and transport-related accidents, 112 (18.0%) were the topmost three leading external causes of deaths. About 436 (70.0%) of deaths were from the age group above 15 years old. Drowning and submersion and transport-related accidents were high in age group between 5 and 14 years old. Conclusion: In this study, external causes of death are significant public health problems and require attention as one of prior health agenda.
Epidemiology of Fatal Injuries reported in the mortuary of a tertiary care hospital
Millions of people who suffer injuries may require treatment not involving formal medical care, visits to the local area hospitals, emergency department or ABSTRACT Background: Injuries are an increasingly recognized global, preventable public health problem and are an important cause of mortality and morbidity in adult population. The major causes of injury related deaths may be intentional and unintentional. The major unintentional or "accidental" causes are road traffic accidents (RTAs), falls and drowning whereas the leading intentional causes are suicide and homicide. A robust Surveillance System for Injury Mortality is almost non-existent in our country due to which the data for the same is not available and haphazard. Keeping these factors in mind, the following study was under taken to identify the various epidemiological factors related to fatal injury cases. Methods: A record based retrospective study was conducted in the Department of Community Medicine, VSSIMAR, Burla, Odisha. The data were collected from the autopsy reports preserved at the Dept of FM & T, VSSIMSAR. Variables like age, sex, number of injury cause of death, place of death etc. were collected. Data were entered in Microsoft Excel and analysed using proportions and percentages. Results: The age group 25-44 years recorded the maximum number of deaths (37.49%). Males suffered the highest casualty accounting for 61.85% of deaths. Unintentional fatal injuries constituted 63.58% of deaths. The most number of fatal injuries resulting in deaths were RTAs (36.41%). Conclusions: The age group 25-44 years recorded maximum deaths. Males were the major death victims. RTAs constituted maximum of deaths among unintentional fatal injuries. Homicidal injuries constituted maximum of deaths due to intentional fatal injuries.
The objective of this study was to evaluate cases of brought in dead (BID) patients in the accident and emergency unit of Effia-Nkwanta Regional Hospital through a retrospective study of 3 years period. A retrospective descriptive study of BID cases from the death register and patients’ records of the accident and emergency unit of the hospital was carried out from January 2011 to December 2013. 31% (180/574) of BID cases were recorded over the study period with the age range from below 1 year to over 70 years. They were 58.5% male and 41.5% female with a ratio of 1.4:1. The majority of the BID cases (20.7%) were patients above 70 years and most cases (40.8%) have no known clinical condition associated with the death. The majority of the unexplained deaths were highest among young adults between the ages 30 and 40 years (22.6%). The highest cases of BID (20%) were seen in the month of December and majority of the cases (72.5%) lived within the metropolis. This study showed a concerning trend of BID cases in the hospital with a high prevalence among the elderly and unexplained death among the young adults. Hence there is an urgent need to upgrade hospitals in the area with the hope of relieving the burden off Effia-Nkwanta Regional Hospital and also a need to increase health promotion strategies among the people of the area so as to instill health seeking behavior in order to prevent avoidable deaths.
Timing of death at National Trauma Center, Abuja, Nigeria
East and Central African Journal of Surgery, 2018
Background: We aimed to analyse the burden and timing of trauma deaths over a 1-year period at a trauma centre in Nigeria. Methods: This was a retrospective review of in-hospital trauma deaths during the period of January to December 2015. Sociodemographic data, cause of injury, mode of presentation, time interval between presentation and death, injury diagnoses, treatment, and place of death were analysed. Results: There were 2230 trauma consultations during the study period; 85 were brought in dead from the scene. We analysed data from 103 of 121 in-hospital deaths. Patient ages ranged from 0 to 90 years, with a mean age of 31.1. The male-to-female ratio was 5:1. Following injury, 46.6% of the victims presented directly to our tertiary centre, while 53.4% were referred from other hospitals. Most of the injuries were from RTA. Isolated head injury was the predominant diagnosis (44.7%), followed by polytrauma (29%). Immediate deaths (exclusive of those brought in already dead) comprised 5.8% of cases; 37.9% were early deaths and 56.3% were late deaths. Conclusions: The timing of trauma deaths closely approximated the original trimodal description in North America about half a century ago even though advances in trauma care have resulted in changes from this pattern in developed countries. Regionalised integrated care including prehospital trauma services are recommended.