IMPORTANCE Despite the highest injury rates worldwide, formal medical care is not often sought after injuries in Sub-Saharan Africa. Unaffordable costs associated with trauma care might inhibit injured patients from seeking care. OBJECTIVES To (1) determine the injury epidemiology in Cameroon using populationrepresentative data, (2) identify the barriers to use of formal health care after injury, and (3) determine the association between use of care and economic outcomes after injury. DESIGN, SETTING, AND PARTICIPANTS This mixed-methods, cross-sectional study included a population-representative, community-based survey and nested qualitative semistructured interviews in the urban-rural Southwest Region of Cameroon. Three-stage cluster sampling was used to select target households.

Background. Morbidity and mortality linked to injury has become an increasingly important public health concern worldwide, especially in developing countries. Despite the potentially severe nature of torso injury, little is known about the population-based epidemiology of torso injury in sub-Saharan Africa. Objectives. To determine the incidence, identify common mechanisms, and assess the socioeconomic consequences of torso injury in Cameroon. Methods. We performed a torso injury sub-analysis of a larger descriptive cross-sectional community-based study on injury epidemiology in the preceding 12 months in the Southwest region of Cameroon. Sampling was done using the three-stage cluster sampling technique. The differences between groups were evaluated using χ 2 and adjusted Wald tests. Results. We identified 39 cases of torso injuries out of 8 065 participants, providing a yearly incidence estimate of 488 (95% confidence interval (CI) 356 -668) per 100 000 person-years. Road traffic injury was the most common mechanism of torso injury. The median (interquartile range (IQR)) cost of treatment for torso injury was USD58 (10 -137), over four times the median (IQR) cost for non-torso injury at USD12 (3 -43) (p=0.0004). About half of affected households (51%) reported being unable to afford necessities such as rent and food after injury v. 33% of households with members with non-torso injuries (p=0.018). Conclusion. Torso injuries have an incidence of 488/100 000 person-years, and road traffic injuries account for the majority of the injuries. Road traffic control measures and trauma care strengthening may reduce the impact of torso injuries and injuries in Cameroon.

ObjectivesTo establish the prevalence of self-reported vision impairment (VI) in Southwest Cameroon and describe associated care-seeking practices, functional limitations and economic hardships.DesignA three-stage clustered sampling household community-based survey.SettingThe Southwest region of Cameroon.Participants8046 individuals of all ages residing in the Southwest region of Cameroon.Primary and secondary outcome measuresPrevalence of self-reported VI, onset of vision loss, care-seeking practices, diagnosis and treatment, functional limitations, economic hardships on household, beliefs about surgical treatability of blindness and barriers to surgical care.ResultsThe estimated prevalence of self-reported VI in Southwest Cameroon was 0.87% (95% CI 0.62 to 1.21). Among participants aged ≥40 years, the prevalence increased to 2.61% (95% CI 1.74 to 3.90). Less than a quarter of affected participants reported difficulty working (20.5%) or trouble going to school (12.0%) as a result of their VI. Yet, over half (52%, n=43) of affected households experienced significant economic hardships due to the VI. Residing in an urban setting (aOR 1.16, 95% CI 1.04 to 1.30) and belonging to a higher socioeconomic status (aOR 1.13, 95% CI 1.02 to 1.26) were factors associated with the belief that certain types of blindness were surgically reversible. Formal care was not sought by 16.3% (n=8) of affected participants. Cataracts was the leading diagnosis among participants who did seek formal care (43.2%, n=16), although 93.8% of these cases were not surgically treated, primarily due to a lack of perceived need.ConclusionThe prevalence of individuals who report vision impairment in Southwest Cameroon is considerably lower than prior published estimates based on visual physical examinations. Routine community-level screening and cost financing schemes could improve detection of pre-clinical eye disease and the utilisation of surgical care. It could also pre-empt disability and economic hardships associated with advanced VI in the region.

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