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Published in: World Journal of Surgery 1/2016

01-01-2016 | Original Scientific Report

Vital Statistics: Estimating Injury Mortality in Kigali, Rwanda

Authors: Woon Cho Kim, Jean Claude Byiringiro, Georges Ntakiyiruta, Patrick Kyamanywa, Jean Jacques Irakiza, Jean Paul Mvukiyehe, Zeta Mutabazi, Jean Paul Vizir, Jean de la Croix Allen Ingabire, Steven Nshuti, Robert Riviello, Selwyn O. Rogers Jr., Sudha P. Jayaraman

Published in: World Journal of Surgery | Issue 1/2016

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Abstract

Background

Globally, injury deaths largely occur in low- and middle-income countries. No estimates of injury-associated mortality exist in Rwanda. This study aimed to describe the patterns of injury-related deaths in Kigali, Rwanda using existing data sources.

Methods

We created a database of all deaths reported by the main institutions providing emergency care in Kigali—four major hospitals, two divisions of the Rwanda National Police, and the National Emergency Medical Service—during 12 months (Jan–Dec 2012) and analyzed it for demographics, diagnoses, mechanism and type of injury, causes of death, and all-cause and cause-specific mortality rates.

Results

There were 2682 deaths, 57 % in men, 67 % in adults >18 year, and 16 % in children <5 year. All-cause mortality rate was 236/100,000; 35 % (927) were due to probable surgical causes. Injury-related deaths occurred in 22 % (593/2682). The most common injury mechanism was road traffic crash (cause-specific mortality rate of 20/100,000). Nearly half of all injury deaths occurred in the prehospital setting (47 %, n = 276) and 49 % of injury deaths at the university hospital occurred within 24 h of arrival. Being injured increased the odds of dying in the prehospital setting by 2.7 times (p < 0.0001).

Conclusions

Injuries account for 22 % of deaths in Kigali with road traffic crashes being the most common cause. Injury deaths occurred largely in the prehospital setting and within the first 24 h of hospital arrival suggesting the need for investment in emergency infrastructure. Accurate documentation of the cause of death would help policy-makers make data-driven resource allocation decisions.
Literature
1.
go back to reference Lopez AD et al (2006) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367(9524):1747–1757PubMedCrossRef Lopez AD et al (2006) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 367(9524):1747–1757PubMedCrossRef
2.
go back to reference WHO (2005) Prehospital trauma care systems. World Health Organization, Geneva WHO (2005) Prehospital trauma care systems. World Health Organization, Geneva
3.
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
4.
go back to reference Nantulya VM, Reich MR (2003) Equity dimensions of road traffic injuries in low- and middle-income countries. Inj Control Saf Promot 10(1–2):13–20PubMedCrossRef Nantulya VM, Reich MR (2003) Equity dimensions of road traffic injuries in low- and middle-income countries. Inj Control Saf Promot 10(1–2):13–20PubMedCrossRef
5.
go back to reference Lozano R et al (2012) Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2095–2128PubMedCrossRef Lozano R et al (2012) Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2095–2128PubMedCrossRef
6.
go back to reference Bhalla K et al (2009) Building national estimates of the burden of road traffic injuries in developing countries from all available data sources: Iran. Inj Prev 15(3):150–156PubMedCrossRef Bhalla K et al (2009) Building national estimates of the burden of road traffic injuries in developing countries from all available data sources: Iran. Inj Prev 15(3):150–156PubMedCrossRef
7.
go back to reference Mathers CD et al. (2003) Global burden of disease in 2002: data sources, methods and results. Global Programme on Evidence for Health Policy Discussion Paper No. 54. World Health Organization, Geneva Mathers CD et al. (2003) Global burden of disease in 2002: data sources, methods and results. Global Programme on Evidence for Health Policy Discussion Paper No. 54. World Health Organization, Geneva
8.
go back to reference Jayaraman S et al (2011) Disparities in injury mortality between Uganda and the United States: comparative analysis of a neglected disease. World J Surg 35(3):505–511PubMedPubMedCentralCrossRef Jayaraman S et al (2011) Disparities in injury mortality between Uganda and the United States: comparative analysis of a neglected disease. World J Surg 35(3):505–511PubMedPubMedCentralCrossRef
10.
go back to reference Jayaraman S et al (2009) Current patterns of prehospital trauma care in Kampala, Uganda and the feasibility of a lay-first-responder training program. World J Surg 33(12):2512–2521PubMedCrossRef Jayaraman S et al (2009) Current patterns of prehospital trauma care in Kampala, Uganda and the feasibility of a lay-first-responder training program. World J Surg 33(12):2512–2521PubMedCrossRef
11.
go back to reference Jayaraman S et al (2009) First things first: effectiveness and scalability of a basic prehospital trauma care program for lay first-responders in Kampala, Uganda. PLoS One 4(9):e6955PubMedPubMedCentralCrossRef Jayaraman S et al (2009) First things first: effectiveness and scalability of a basic prehospital trauma care program for lay first-responders in Kampala, Uganda. PLoS One 4(9):e6955PubMedPubMedCentralCrossRef
12.
go back to reference Petroze RT et al (2012) Comprehensive national analysis of emergency and essential surgical capacity in Rwanda. Br J Surg 99(3):436–443PubMedCrossRef Petroze RT et al (2012) Comprehensive national analysis of emergency and essential surgical capacity in Rwanda. Br J Surg 99(3):436–443PubMedCrossRef
13.
go back to reference Nsereko E, Brysiewicz P (2010) Injury surveillance in a central hospital in Kigali, Rwanda. J Emerg Nurs 36(3):212–216PubMedCrossRef Nsereko E, Brysiewicz P (2010) Injury surveillance in a central hospital in Kigali, Rwanda. J Emerg Nurs 36(3):212–216PubMedCrossRef
14.
go back to reference Petroze RT et al (2013) Estimating operative disease prevalence in a low-income country: results of a nationwide population survey in Rwanda. Surgery 153(4):457–464PubMedCrossRef Petroze RT et al (2013) Estimating operative disease prevalence in a low-income country: results of a nationwide population survey in Rwanda. Surgery 153(4):457–464PubMedCrossRef
15.
go back to reference Petroze RT et al (2015) Injury, disability and access to care in Rwanda: results of a nationwide cross-sectional population study. World J Surg 39(1):62–69PubMedCrossRef Petroze RT et al (2015) Injury, disability and access to care in Rwanda: results of a nationwide cross-sectional population study. World J Surg 39(1):62–69PubMedCrossRef
16.
go back to reference National Institute of Statistics of Rwanda 2012 Population and Housing Census (Provisional Results) (2012). Kigali National Institute of Statistics of Rwanda 2012 Population and Housing Census (Provisional Results) (2012). Kigali
17.
go back to reference Chalya PL et al (2012) Injury characteristics and outcome of road traffic crash victims at Bugando Medical Centre in Northwestern Tanzania. J Trauma Manag Outcomes 6(1):1PubMedPubMedCentralCrossRef Chalya PL et al (2012) Injury characteristics and outcome of road traffic crash victims at Bugando Medical Centre in Northwestern Tanzania. J Trauma Manag Outcomes 6(1):1PubMedPubMedCentralCrossRef
18.
go back to reference Tran TM et al (2015) Distribution and characteristics of severe traumatic brain injury at mulago national referral hospital in Uganda. World Neurosurg 83(3):269–277PubMedCrossRef Tran TM et al (2015) Distribution and characteristics of severe traumatic brain injury at mulago national referral hospital in Uganda. World Neurosurg 83(3):269–277PubMedCrossRef
19.
go back to reference Meara JG et al (2015) Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 386:569–624PubMedCrossRef Meara JG et al (2015) Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 386:569–624PubMedCrossRef
20.
go back to reference Meara JG, Greenberg SL (2015) The Lancet Commission on Global Surgery Global surgery 2030: evidence and solutions for achieving health, welfare and economic development. Surgery 157(5):834–835PubMedCrossRef Meara JG, Greenberg SL (2015) The Lancet Commission on Global Surgery Global surgery 2030: evidence and solutions for achieving health, welfare and economic development. Surgery 157(5):834–835PubMedCrossRef
21.
go back to reference Mutasingwa DR, Aaro LE (2001) Injury registration in a developing country. A study based on patients’ records from four hospitals in Dar es Salaam, Tanzania. Cent Afr J Med 47(8):203–209PubMed Mutasingwa DR, Aaro LE (2001) Injury registration in a developing country. A study based on patients’ records from four hospitals in Dar es Salaam, Tanzania. Cent Afr J Med 47(8):203–209PubMed
22.
go back to reference Outwater AH, Campbell JC, Mgaya E (2011) Implementation of WHO/CDC guidelines for intentional injury death surveillance: a mixed-methods approach in Dar es Salaam, Tanzania. Homicide Stud 15(3):253–267PubMedPubMedCentralCrossRef Outwater AH, Campbell JC, Mgaya E (2011) Implementation of WHO/CDC guidelines for intentional injury death surveillance: a mixed-methods approach in Dar es Salaam, Tanzania. Homicide Stud 15(3):253–267PubMedPubMedCentralCrossRef
23.
go back to reference Cox JA et al (2010) Autopsy causes of death in HIV-positive individuals in sub-Saharan Africa and correlation with clinical diagnoses. AIDS Rev 12(4):183–194PubMed Cox JA et al (2010) Autopsy causes of death in HIV-positive individuals in sub-Saharan Africa and correlation with clinical diagnoses. AIDS Rev 12(4):183–194PubMed
Metadata
Title
Vital Statistics: Estimating Injury Mortality in Kigali, Rwanda
Authors
Woon Cho Kim
Jean Claude Byiringiro
Georges Ntakiyiruta
Patrick Kyamanywa
Jean Jacques Irakiza
Jean Paul Mvukiyehe
Zeta Mutabazi
Jean Paul Vizir
Jean de la Croix Allen Ingabire
Steven Nshuti
Robert Riviello
Selwyn O. Rogers Jr.
Sudha P. Jayaraman
Publication date
01-01-2016
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 1/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-3258-3

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