Skip to main content
Top
Published in: World Journal of Surgery 12/2009

01-12-2009

Current Patterns of Prehospital Trauma Care in Kampala, Uganda and the Feasibility of a Lay-First-Responder Training Program

Published in: World Journal of Surgery | Issue 12/2009

Login to get access

Abstract

Background

Uganda currently has no organized prehospital emergency system. We sought to measure the current burden of injury seen by lay people in Kampala, Uganda and to determine the feasibility of a lay first-responder training program.

Methods

We conducted a cross-sectional survey of current prehospital care providers in Kampala: police officers, minibus taxi drivers, and Local Council officials, and collected data on types and frequencies of emergencies witnessed, barriers to aid provision, history of training, and current availability of first-aid supplies. A context-appropriate course on basic first-aid for trauma was designed and implemented. We measured changes in trainees’ fund of knowledge before and after training.

Results

A total of 309 lay people participated in the study, and during the previous 6 months saw 18 traumatic emergencies each; 39% saw an injury-related death. The most common injury mechanisms were road crashes, assault, and burns. In these cases, 90% of trainees provided some aid, most commonly lifting (82%) or transport (76%). Fifty-two percent of trainees had previous first-aid training, 44% had some access to equipment, and 32% had ever purchased a first-aid kit. Before training, participants answered 45% of test questions correctly (mean %) and this increased to 86% after training (p < 0.0001).

Conclusions

Lay people witness many emergencies and deaths in Kampala, Uganda and provide much needed care but are ill-prepared to do so. A context-appropriate prehospital trauma care course can be developed and improve lay people’s knowledge of basic trauma care. The effectiveness of such a training program needs to be evaluated prospectively.
Literature
1.
go back to reference Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ (2006) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367(9524):1747–1757CrossRefPubMed Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ (2006) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367(9524):1747–1757CrossRefPubMed
2.
go back to reference Mathers CD, Loncar D (2030) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3(11):e442CrossRef Mathers CD, Loncar D (2030) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3(11):e442CrossRef
3.
go back to reference The global burden of disease: 2004 update. Geneva: WHO2008 The global burden of disease: 2004 update. Geneva: WHO2008
4.
go back to reference Hofman K, Primack A, Keusch G, Hrynkow S (2005) Addressing the growing burden of trauma and injury in low- and middle-income countries. Am J Public Health 95:13–17CrossRefPubMed Hofman K, Primack A, Keusch G, Hrynkow S (2005) Addressing the growing burden of trauma and injury in low- and middle-income countries. Am J Public Health 95:13–17CrossRefPubMed
5.
go back to reference Murray CJL, Lopez AD (1996) The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard University Press, Cambridge Murray CJL, Lopez AD (1996) The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard University Press, Cambridge
6.
go back to reference Murray CJL, Lopez AD (1996) Global health statistics: a compendium of incidence prevalence and mortality estimates for over 200 conditions. Harvard University Press, Cambridge Murray CJL, Lopez AD (1996) Global health statistics: a compendium of incidence prevalence and mortality estimates for over 200 conditions. Harvard University Press, Cambridge
7.
go back to reference Mock CN, Jurkovich GJ, nii-Amon-Kotei D, Arreola-Risa C, Maier RV (1998) Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma 44:804–814CrossRefPubMed Mock CN, Jurkovich GJ, nii-Amon-Kotei D, Arreola-Risa C, Maier RV (1998) Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma 44:804–814CrossRefPubMed
8.
go back to reference WHO (2004) World report on road traffic injury prevention. World Health Organization, Geneva WHO (2004) World report on road traffic injury prevention. World Health Organization, Geneva
9.
go back to reference Debas HT, Gosselin R, McCord C, Thind A (2006) Surgery. In: Jamison D, Breman J, Measham A, Alleyne G, Claeson M, Evans D et al (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York Debas HT, Gosselin R, McCord C, Thind A (2006) Surgery. In: Jamison D, Breman J, Measham A, Alleyne G, Claeson M, Evans D et al (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York
10.
go back to reference Mock C, Nguyen S, Quansah R, Arreola-Risa C, Viradia R, Joshipura M (2006) Evaluation of Trauma Care capabilities in four countries using the WHO-IATSIC Guidelines for Essential Trauma Care. World J Surg 30:946–956CrossRefPubMed Mock C, Nguyen S, Quansah R, Arreola-Risa C, Viradia R, Joshipura M (2006) Evaluation of Trauma Care capabilities in four countries using the WHO-IATSIC Guidelines for Essential Trauma Care. World J Surg 30:946–956CrossRefPubMed
11.
go back to reference Ministry of Health Epidemiology Unit C, Planning Unit (1996) Burden of disease, cost-effectiveness analysis and five year projections in thirteen districts of Uganda. Uganda Ministry of Health and United States Centers for Disease Control and Prevention, Entebbe, Uganda Ministry of Health Epidemiology Unit C, Planning Unit (1996) Burden of disease, cost-effectiveness analysis and five year projections in thirteen districts of Uganda. Uganda Ministry of Health and United States Centers for Disease Control and Prevention, Entebbe, Uganda
12.
go back to reference Kobusingye OC, Guwatudde D, Owor G, Lett RR (2002) Citywide trauma experience in Kampala, Uganda: a call for intervention. Inj Prev 8:133–136CrossRefPubMed Kobusingye OC, Guwatudde D, Owor G, Lett RR (2002) Citywide trauma experience in Kampala, Uganda: a call for intervention. Inj Prev 8:133–136CrossRefPubMed
13.
go back to reference Mock CN, nii-Amon-Kotei D, Maier RV (1997) Low utilization of formal medical services by injured persons in a developing nation: health service data underestimate the importance of trauma. J Trauma 42:504–513CrossRefPubMed Mock CN, nii-Amon-Kotei D, Maier RV (1997) Low utilization of formal medical services by injured persons in a developing nation: health service data underestimate the importance of trauma. J Trauma 42:504–513CrossRefPubMed
14.
15.
go back to reference Mock C, Lormand J, Goosen J, Joshipura M, Peden M (2004) Guidelines for essential trauma care. World Health Organization, Geneva Mock C, Lormand J, Goosen J, Joshipura M, Peden M (2004) Guidelines for essential trauma care. World Health Organization, Geneva
16.
go back to reference WHO (2005) Prehospital trauma care systems. World Health Organization, Geneva WHO (2005) Prehospital trauma care systems. World Health Organization, Geneva
17.
go back to reference Kobusingye O, Hyder A, Bishai B, Joshipura M, Romero Hicks E, Mock C (2006) Emergency medical services. In: Jamison D, Breman J, Measham A, Alleyne G, Claeson M, Evans D et al (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York Kobusingye O, Hyder A, Bishai B, Joshipura M, Romero Hicks E, Mock C (2006) Emergency medical services. In: Jamison D, Breman J, Measham A, Alleyne G, Claeson M, Evans D et al (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York
18.
go back to reference Mock CN, Tiska M, Adu-Ampofo M, Boakye G (2002) Improvements in prehospital trauma care in an African country with no formal emergency medical services. J Trauma 53:90–97CrossRefPubMed Mock CN, Tiska M, Adu-Ampofo M, Boakye G (2002) Improvements in prehospital trauma care in an African country with no formal emergency medical services. J Trauma 53:90–97CrossRefPubMed
19.
go back to reference Tiska MA, Adu-Ampofo M, Boakye G, Tuuli L, Mock CN (2004) A model of prehospital trauma training for lay persons devised in Africa. Emerg Med J 21:237–239CrossRefPubMed Tiska MA, Adu-Ampofo M, Boakye G, Tuuli L, Mock CN (2004) A model of prehospital trauma training for lay persons devised in Africa. Emerg Med J 21:237–239CrossRefPubMed
20.
go back to reference Husum H, Gilbert M, Wisborg T, Van Heng Y, Murad M (2003) Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. J Trauma 54:1188–1196CrossRefPubMed Husum H, Gilbert M, Wisborg T, Van Heng Y, Murad M (2003) Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. J Trauma 54:1188–1196CrossRefPubMed
22.
go back to reference Kobusingye O, Hyder A, Bishai B, Joshipura M, Romero Hicks E, Mock C (2006) Emergency medical systems. In: Jamison DT et al (eds) Disease control priorities in developing countries, 2nd edn. World Bank, Kobusingye O, Hyder A, Bishai B, Joshipura M, Romero Hicks E, Mock C (2006) Emergency medical systems. In: Jamison DT et al (eds) Disease control priorities in developing countries, 2nd edn. World Bank,
23.
go back to reference Husum H, Gilbert M, Wisborg T (2003) Training pre-hospital trauma care in low-income countries: the ‘Village University’ experience. Med Teach 25:142–148CrossRefPubMed Husum H, Gilbert M, Wisborg T (2003) Training pre-hospital trauma care in low-income countries: the ‘Village University’ experience. Med Teach 25:142–148CrossRefPubMed
Metadata
Title
Current Patterns of Prehospital Trauma Care in Kampala, Uganda and the Feasibility of a Lay-First-Responder Training Program
Publication date
01-12-2009
Published in
World Journal of Surgery / Issue 12/2009
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-009-0180-6

Other articles of this Issue 12/2009

World Journal of Surgery 12/2009 Go to the issue