IntroductionInjuries represent a significant cause of morbidity and mortality worldwide and road traffic crashes accounts for a significant proportion of these injuries. Tanzania is among the countries with high rates of road traffic crashes. The aim of this study was to determine the pattern, associated factors and management of road traffic injury patients in Tanzania.MethodsA cross-sectional study of patients involved in motor traffic crashes and attended in six public hospitals of Tanzania mainland between April 2014 and September 2014.ResultsA total of 4675 road traffic injury patients were seen in studied hospitals, 76.6% were males. Majority (70.2%) were between 18 - 45 years age group. Motorcycles were the leading cause of road traffic crashes (53.4%), and drivers (38.3%) accounted for majority of victims. Fractures accounted for 34.1%, and injuries were severe in 2.2% as determined by the Kampala trauma score II (KTS II). Majorities 57.4% were admitted and 2.2% died at the casualty. Factors associated with mortality were; using police vehicles to hospital (P = 0.000), receiving medical attention within 2 to 10 hours after injury (P = 0.000), 18 - 45 years age group (P = 0.019), not using helmet (P = 0.007), severe injuries (P = 0.000) and sustaining multiple injury (P = 0.000).ConclusionRoad traffic Injuries in Tanzania are an important public health problem, predominantly in adult males, mostly due to motorcycle crashes. It is therefore important to reinforce preventive measures and pre-hospital emergency service is urgently needed.
Objective: To examine the medical referral pattern of patients received at the Muhimbili National Hospital (MNH) in order to inform the process of strengthening the referral system. Methods: The study design was a prospective study conducted at MNH during a 10-week study period from January to March 2004. The study sample consisted of patients referred to MNH Results: Of the 11,412 patients seen, 72.5% were self-referrals. More than 70% of the patients seen required admission, though not necessarily at tertiary level. Only 0.8% came from outside the Dar es Salaam region. More than 70% of the patients seen required admission. Surgical services were required by 66.8% of patients, with obstetric conditions being most prominent (24.6% of all patients). For those who were formally referred from other health services, lack of expertise and equipment were the most common reasons given for referral (96.3%). Conclusion: Efforts to improve referral systems in low-income countries require that the primary and secondary level hospitals services be strengthened and increased so as to limit inappropriate use of national referral hospitals.
After completion of TTT, there was a significant improvement in trauma resuscitation knowledge, based on results from a validated questionnaire. Trauma team performance was excellent when assessed with a novel trauma simulation assessment tool. Participants were very supportive of the course.
Nine patients with chronic osteomyelitis, three with problems due to diagnosis, three with dilemmas regarding treatment and three with other complications are presented. It is suggested that although the diagnosis of osteomyelitis in most cases is straightforward, presentation might sometimes be similar to other conditions, which can lead to a dilemma in the diagnosis. Because of the formidable complications, which may be difficult to manage and the difficulty in guaranteeing permanent cure, the best approach is prevention by judicious treatment of acute haematogenous osteomyelitis and of open fractures.Résumé Présentation de 9 malades atteints d'ostéomy-élite chronique: trois avec des problèmes diagnostiques, trois avec des difficultés thérapeutiques et trois avec les plusieurs autres complications. Il apparait que bien que le diagnostic d'ostéomyélite soit dans la plupart des cas avancé facilement l'aspect peut parfois être trompeur, avec des hésitations diagnostiques. À cause des complications redoutables qui peuvent être difficiles à traiter et la difficulté d'obtenir une guérison, il faut insister sur la prévention par le traitement correct de l'ostéomyélite aigue hématogène et des fractures ouvertes. IntroductionThe diagnosis of chronic osteomyelitis spells a challenge, not only for the patient but also for the attending surgeon, due to the fact that treatment may not be effective because of the high recurrence rates and also due to potential complications. In the majority of patients diagnosis is usually straightforward; however, in some patients, different conditions may present with similar clinical features. This may pose a serious diagnostic problem because some of these conditions may be malignant.The improvement in both socio-economic status and health care delivery in developed countries has substantially decreased the prevalence of chronic osteomyelitis in their communities. However, unfortunately, in developing countries the situation is different. The incidence of acute haematogenous osteomyelitis is not only high but is either misdiagnosed or under-treated [5]. Apart from this, the increase in trauma, notably from road traffic accidents has resulted in an increase in open fractures and their complications [4]. These factors have meant that the prevalence of chronic osteomyelitis remains high; thus, posing a major orthopaedic challenge not only because of the high prevalence but also due to the difficulty in achieving a definitive cure and preventing serious complications.The aim of this study was to illustrate some of the challenges in the diagnosis and management of chronic osteomyelitis, particularly for the timing of surgery and possible options following bone loss due to destruction. Patients and methodsNine patients with chronic osteomyelitis are presented. Three of the patients had diagnostic problems; three with treatment dilemmas and three with complications. Diagnostic challengesThree young patients presented to us with a history of swelling of an extremity. There was no histo...
IntroductionWork related injuries are common, and the mining industry accounts for a significant proportion of these injuries. Tanzania is among the countries with high rates of mining injuries, nevertheless pre-hospital care is almost non existant and health care service deliveries are poor. This study sought to identify factors associated with injuries and fatalities among miners in Mererani, Tanzania.MethodsA Cross - Sectional study of miners who sustained injuries and seen at Mererani health centre between January 2009 and May 2012.ResultsIn the selected period 248 injury patients were seen. All were males, and 54% were between 18 - 30 years age-group. Almost all (98.7%) didn’t use protective gears at work, and worked for more than 12 hours daily. Falling rocks were the leading cause of injury (18.2%), and majority sustained multiple injuries (33%). Of the patients seen, 41.3% died. The following were more likely to die than others; Primary education (p = 0.04), Less than 5 years work experience (p = 0.000), unintentional injuries (p = 0.000), fall injuries (p = 0.000) and sustaining multiple injuries (p = 0.000).ConclusionThe burden of injuries and fatalities demonstrated in this study, point to the need for implementation and monitoring of the use of safety equipment and operating procedures of the mines by government and other regulatory authorities. Initiation of pre hospital care at the mines and improved emergency medical service delivery at health centers in Tanzania.
A prospective randomised study was carried out on 86 patients with first, second and third degree open fractures in order to compare the effect of isotonic saline, distilled water and boiled water as irrigating fluids. The standard management consisted of emergency surgical toilet, use of broad spectrum antibiotics and fracture immobilization. The results show that the outcome was not affected by the type of irrigating fluid used.
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