Epidemiology of injuries, outcomes, and hospital resource utilisation at a tertiary teaching hospital in Lusaka, Zambia

Seidenberg, Philip; Cerwensky, Kathryn; Brown, Rae Oranmore; Hammond, Emily E.; Mofu, Yona; Lungu, James; Mulla, Yakub; Biemba, Godfrey; Mowafi, Hani

doi:10.1016/j.afjem.2014.01.006

Cited by 32 publications

(63 citation statements)

References 25 publications

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“…A similar pattern was observed when comparing the Central Hospital Yaounde trauma registry with their administrative data [7,8]. However, the number of records collected annually in the Limbe trauma registry was inconsistent.…”

Section: Resultssupporting

confidence: 66%

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

et al. 2017

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IntroductionTrauma 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.Methods and findingsFrom 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.About 5,617 patients, aged from 0.5-95years (median age of 26 years), visited the LRH ED with an injury; 67% were male. Students (27%) were the most affected occupation category. Road traffic injuries (RTIs) (56%), assault (22%), and domestic injuries (13%) were the leading causes of injury. Two-thirds of RTIs were motorcycle-related. Working in transportation (AOR 4.42, p<0.001) and law enforcement (AOR 1.73, p = 0.004) were significant predictors of having a RTI. The trauma registry showed a significant improvement in completeness of all data (p<0.001) and it improved over time compared with previous administrative records. However, proportions of missing data still ranged from 0.5% to 8.2% and involved respiratory rate or Glasgow Coma scale.ConclusionsImplementation 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.

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Section: Resultssupporting

confidence: 66%

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

et al. 2017

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“…Manipulation of fractures under anaesthesia accounted for most such procedures, where children aged 0–15 years accounted for over two‐thirds of all such procedures in Malawi and between half and two‐thirds in Zambia. This high burden of trauma in young children is consistent with empirical studies from the region , although equally high burdens in girls as boys are not usually reported . The somewhat higher level of trauma surgery in adults in Zambia may reflect a more mobile population at greater risk of road traffic accidents .…”

Section: Discussionsupporting

confidence: 82%

Who accesses surgery at district level in sub‐Saharan Africa? Evidence from Malawi and Zambia

Gajewski

Dharamshi

Strader

et al. 2017

Tropical Med Int Health

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Women of reproductive (16-45 years) mainly undergoing Caesarean sections and children aged 0-15 years who accounted for two-thirds of trauma cases are the main patient populations undergoing surgery at district hospitals in Zambia and Malawi. Verification and analysis of routine hospital data, across 10-30% of districts countrywide, demonstrated the need to prioritise quality assurance in surgery and anaesthesia, and preventive interventions in children.

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“…The top 25 global EM articles for 2014 are listed in Table . The complete database of all 477 global EM articles for 2014, as well as full summaries and critical analyses of the top 25 global EM articles of 2014 can be found in Data Supplements S1 and S2 (available as supporting information in the online version of this article).…”

Section: Resultsmentioning

confidence: 99%

“…Seidenberg et al . report on a prospective observational study conducted at an urban teaching hospital in Lusaka, Zambia.…”

Section: Discussionmentioning

confidence: 99%

Global Emergency Medicine: A Review of the Literature From 2014

et al. 2015

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Objectives: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a worldwide audience of academics and clinical practitioners.Methods: This year 6,376 articles written in six languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. A total of 477 articles were deemed appropriate by at least one reviewer and approved by the editor for formal scoring of overall quality and importance.Results: Of the 477 articles that met our predetermined inclusion criteria, 63% were categorized as emergency care in resource-limited settings, 13% as EM development, and 23% as disaster and humanitarian response. Twenty-five articles received scores of 17.5 or higher and were selected for formal summary and critique. Inter-rater reliability for two reviewers using our scoring system was good, with an intraclass correlation coefficient of 0.657 (95% confidence interval = 0.589 to 0.713). Studies and reviews focusing on infectious diseases, trauma, and the diagnosis and treatment of diseases common in resource-limited settings represented the majority of articles selected for final review.Conclusions: In 2014, there were fewer total articles, but a slightly higher absolute number of articles screening in for formal scoring, when compared to the 2013 review. The number of EM development articles decreased, while the number of disaster and humanitarian response articles increased. As in prior years, the majority of articles focused on infectious diseases and trauma.ACADEMIC EMERGENCY MEDICINE 2015;22:976-984

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Epidemiology of injuries, outcomes, and hospital resource utilisation at a tertiary teaching hospital in Lusaka, Zambia

Cited by 32 publications

References 25 publications

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

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

Who accesses surgery at district level in sub‐Saharan Africa? Evidence from Malawi and Zambia

Global Emergency Medicine: A Review of the Literature From 2014

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