Skip to main content
Top
Published in: BMC Emergency Medicine 1/2017

Open Access 01-12-2017 | Research article

Trauma burden in Tanzania: a one-day survey of all district and regional public hospitals

Authors: Hendry R. Sawe, Juma A. Mfinanga, Khalid R. Mbaya, Phillip M. Koka, Said S. Kilindimo, Michael S. Runyon, Victor G. Mwafongo, Lee A. Wallis, Teri A. Reynolds

Published in: BMC Emergency Medicine | Issue 1/2017

Login to get access

Abstract

Background

Trauma contributes significantly to the burden of disease and mortality throughout the world, but particularly in developing countries. In Tanzania, there is an enormous research gap on trauma; the limited data available reflects realities in cities and areas with moderately- to highly-resourced treatment centers. Our aim was to provide a description of the injury epidemiology across all of Tanzania. Our data will serve as a basis for future larger studies.

Methods

This is a subgroup analysis of a cross-sectional, prospective study of the clinical epidemiology of patients presenting at all public district and regional hospitals in Tanzania. The study was conducted between May 2012 and December 2012. A team of emergency doctors used a purpose-designed data collection sheet to gather the demographic and clinical information of all patients presenting during the day-site visit to each hospital. Descriptive statistics, including means, standard deviations, medians, and ranges are reported.

Results

A total of 5227 patients were seen in 24-h period in 105 (100% response rate) district (or designated district) and regional hospitals in mainland Tanzania. Of these patients, 508 (9.7%) presented with trauma-related complaints. Among patients with trauma-related complaints, 286 (56.3%) were male, and the overall median age of 30 (interquartile range of 22–35) years. Road traffic crash was the most common mechanism of injury, accounting for 227 (44.7%) complaints. Open wounds and bone fractures were the two most frequent diagnoses, with a combined 300 (59%) cases. Most of the patients - 325 (64%) - were discharged, 11 (2.2%) went to operating theatres and 4 (0.8%) of patients died while receiving care at the acute intake areas.

Conclusions

Trauma-related complaints constitute a substantial burden among patients seeking care in acute intake areas of hospitals across Tanzania. There is a need to develop, implement and study systems that can support the improvement of trauma care and optimize outcomes of trauma patients.
Literature
2.
3.
go back to reference Mohan D. International journal of epidemiology. Int J Epidemiol. 2002;1:527–32.CrossRef Mohan D. International journal of epidemiology. Int J Epidemiol. 2002;1:527–32.CrossRef
4.
go back to reference Lopes MR, Oliveira MA, Pereira VOS, Lemos IPB, Auler JOC Jr, Michard F. Goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery: a pilot randomized controlled trial. Crit Care. 2007;11(5):R100.CrossRefPubMedPubMedCentral Lopes MR, Oliveira MA, Pereira VOS, Lemos IPB, Auler JOC Jr, Michard F. Goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery: a pilot randomized controlled trial. Crit Care. 2007;11(5):R100.CrossRefPubMedPubMedCentral
5.
go back to reference Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL. Measuring the Global Burden of Disease and Risk Factors, 1990–2001. In: Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ, editors. Global Burden of Disease and Risk Factors [Internet]. Washington (DC): World Bank; 2006 [cited 2013 Nov 24]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK11817/ Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL. Measuring the Global Burden of Disease and Risk Factors, 1990–2001. In: Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ, editors. Global Burden of Disease and Risk Factors [Internet]. Washington (DC): World Bank; 2006 [cited 2013 Nov 24]. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK11817/​
9.
go back to reference Grivna M, Barss P, Stanculescu C, Eid HO, Abu-Zidan FM. Child and youth traffic-related injuries: use of a trauma registry to identify priorities for prevention in the United Arab Emirates. Traffic Inj Prev. 2013;14(3):274–82.CrossRefPubMed Grivna M, Barss P, Stanculescu C, Eid HO, Abu-Zidan FM. Child and youth traffic-related injuries: use of a trauma registry to identify priorities for prevention in the United Arab Emirates. Traffic Inj Prev. 2013;14(3):274–82.CrossRefPubMed
10.
go back to reference Odero W, Garner P, Zwi A. Road traffic injuries in developing countries: a comprehensive review of epidemiological studies. Tropical Med Int Health. 1997 May;2(5):445–60.CrossRef Odero W, Garner P, Zwi A. Road traffic injuries in developing countries: a comprehensive review of epidemiological studies. Tropical Med Int Health. 1997 May;2(5):445–60.CrossRef
14.
go back to reference Christie N, Cairns S, Towner E, Ward H. How exposure information can enhance our understanding of child traffic “death leagues.”. Inj Prev. 2007 Apr;13(2):125–9.CrossRefPubMedPubMedCentral Christie N, Cairns S, Towner E, Ward H. How exposure information can enhance our understanding of child traffic “death leagues.”. Inj Prev. 2007 Apr;13(2):125–9.CrossRefPubMedPubMedCentral
16.
go back to reference Reynolds TA, Mfinanga JA, Sawe HR, Runyon MS, Mwafongo V. Emergency care capacity in Africa: a clinical and educational initiative in Tanzania. J Public Health Policy. 2012 Dec;33(S1):S126–37.CrossRefPubMedPubMedCentral Reynolds TA, Mfinanga JA, Sawe HR, Runyon MS, Mwafongo V. Emergency care capacity in Africa: a clinical and educational initiative in Tanzania. J Public Health Policy. 2012 Dec;33(S1):S126–37.CrossRefPubMedPubMedCentral
17.
go back to reference Nicks BA, Sawe HR, Juma AM, Reynolds TA. The state of emergency medicine in the United Republic of Tanzania. African Journal of Emergency Medicine. 2012 Sep;2(3):97–102.CrossRef Nicks BA, Sawe HR, Juma AM, Reynolds TA. The state of emergency medicine in the United Republic of Tanzania. African Journal of Emergency Medicine. 2012 Sep;2(3):97–102.CrossRef
18.
go back to reference Moshiro C, Heuch I, Åstrøm AN, Setel P, Hemed Y, Kvåle G. Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey. BMC Public Health. 2005 Jan 28;5(1):11.CrossRefPubMedPubMedCentral Moshiro C, Heuch I, Åstrøm AN, Setel P, Hemed Y, Kvåle G. Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey. BMC Public Health. 2005 Jan 28;5(1):11.CrossRefPubMedPubMedCentral
20.
go back to reference Chalya PL, Mabula JB. Dass RM, Mbelenge N, Ngayomela IH, Chandika AB, et al. injury characteristics and outcome of road traffic crash victims at Bugando medical Centre in northwestern Tanzania. J Trauma Manag Outcomes. 2012 Feb 9;6:1.CrossRefPubMedPubMedCentral Chalya PL, Mabula JB. Dass RM, Mbelenge N, Ngayomela IH, Chandika AB, et al. injury characteristics and outcome of road traffic crash victims at Bugando medical Centre in northwestern Tanzania. J Trauma Manag Outcomes. 2012 Feb 9;6:1.CrossRefPubMedPubMedCentral
21.
go back to reference Ml M, Mc N, Mt L. Road Traffic Accidents in Tanzania: A Ten Year Epidemiological Appraisal. East and Central African Journal of Surgery. 7(1):23–6. Ml M, Mc N, Mt L. Road Traffic Accidents in Tanzania: A Ten Year Epidemiological Appraisal. East and Central African Journal of Surgery. 7(1):23–6.
22.
go back to reference Casey ER, Muro F, Thielman NM, Maya E, Ossmann EW, Hocker MB, et al. Analysis of traumatic injuries presenting to a referral hospital emergency Department in Moshi, Tanzania. Int J Emerg Med. 2012 Jun 8;5(1):28.CrossRefPubMedPubMedCentral Casey ER, Muro F, Thielman NM, Maya E, Ossmann EW, Hocker MB, et al. Analysis of traumatic injuries presenting to a referral hospital emergency Department in Moshi, Tanzania. Int J Emerg Med. 2012 Jun 8;5(1):28.CrossRefPubMedPubMedCentral
23.
go back to reference Tanzania TBST. | demographic and health survey 2010. Tanzania bureau of. Statistics. 2010; Tanzania TBST. | demographic and health survey 2010. Tanzania bureau of. Statistics. 2010;
24.
go back to reference Kuzma K, Lim AG, Kepha B, Nalitolela NE, Reynolds TA. The Tanzanian trauma patients’ prehospital experience: a qualitative interview-based study. BMJ Open. 2015 Apr 1;5(4):e006921.CrossRefPubMedPubMedCentral Kuzma K, Lim AG, Kepha B, Nalitolela NE, Reynolds TA. The Tanzanian trauma patients’ prehospital experience: a qualitative interview-based study. BMJ Open. 2015 Apr 1;5(4):e006921.CrossRefPubMedPubMedCentral
27.
go back to reference Seidenberg P, Cerwensky K, Brown RO, Hammond E, Mofu Y, Lungu J, et al. Epidemiology of injuries, outcomes, and hospital resource utilisation at a tertiary teaching hospital in Lusaka, Zambia. African Journal of Emergency Medicine. 2014 Sep 1;4(3):115–22.CrossRef Seidenberg P, Cerwensky K, Brown RO, Hammond E, Mofu Y, Lungu J, et al. Epidemiology of injuries, outcomes, and hospital resource utilisation at a tertiary teaching hospital in Lusaka, Zambia. African Journal of Emergency Medicine. 2014 Sep 1;4(3):115–22.CrossRef
28.
go back to reference MOI. Muhimbili Orthopaedic Institute (MOI). The Muhimbili Orthopaedic Institute (MOI). MOI. Muhimbili Orthopaedic Institute (MOI). The Muhimbili Orthopaedic Institute (MOI).
29.
go back to reference Bardosh K, Sambo M, Sikana L, Hampson K, Welburn SC. Eliminating rabies in Tanzania? Local understandings and responses to mass dog vaccination in Kilombero and Ulanga districts. PLoS Negl Trop Dis. 2014 Jun;8(6):e2935.CrossRefPubMedPubMedCentral Bardosh K, Sambo M, Sikana L, Hampson K, Welburn SC. Eliminating rabies in Tanzania? Local understandings and responses to mass dog vaccination in Kilombero and Ulanga districts. PLoS Negl Trop Dis. 2014 Jun;8(6):e2935.CrossRefPubMedPubMedCentral
30.
go back to reference Bayreuther J, Wagener S, Woodford M, Edwards A, Lecky F, Bouamra O, et al. Paediatric trauma: injury pattern and mortality in the UK. Arch Dis Child Educ Pract Ed. 2009 Apr;94(2):37–41.CrossRefPubMed Bayreuther J, Wagener S, Woodford M, Edwards A, Lecky F, Bouamra O, et al. Paediatric trauma: injury pattern and mortality in the UK. Arch Dis Child Educ Pract Ed. 2009 Apr;94(2):37–41.CrossRefPubMed
32.
go back to reference Outwater AH, Ismail H, Mgalilwa L, Justin Temu M, Mbembati NA. Burns in Tanzania: morbidity and mortality, causes and risk factors: a review. Int J Burns Trauma. 2013 Jan 24;3(1):18–29.PubMedPubMedCentral Outwater AH, Ismail H, Mgalilwa L, Justin Temu M, Mbembati NA. Burns in Tanzania: morbidity and mortality, causes and risk factors: a review. Int J Burns Trauma. 2013 Jan 24;3(1):18–29.PubMedPubMedCentral
33.
go back to reference Mishra B. Sinha (Mishra) ND, Sukhla S, Sinha a. Epidemiological study of road traffic accident cases from western Nepal. Indian J Community Med. 2010 Jan;35(1):115–21.CrossRefPubMedPubMedCentral Mishra B. Sinha (Mishra) ND, Sukhla S, Sinha a. Epidemiological study of road traffic accident cases from western Nepal. Indian J Community Med. 2010 Jan;35(1):115–21.CrossRefPubMedPubMedCentral
34.
go back to reference Patel A, Krebs E, Andrade L, Rulisa S, Vissoci JRN, Staton CA. The epidemiology of road traffic injury hotspots in Kigali, Rwanda from police data. BMC Public Health. 2016 Aug 2;16:697.CrossRefPubMedPubMedCentral Patel A, Krebs E, Andrade L, Rulisa S, Vissoci JRN, Staton CA. The epidemiology of road traffic injury hotspots in Kigali, Rwanda from police data. BMC Public Health. 2016 Aug 2;16:697.CrossRefPubMedPubMedCentral
35.
36.
Metadata
Title
Trauma burden in Tanzania: a one-day survey of all district and regional public hospitals
Authors
Hendry R. Sawe
Juma A. Mfinanga
Khalid R. Mbaya
Phillip M. Koka
Said S. Kilindimo
Michael S. Runyon
Victor G. Mwafongo
Lee A. Wallis
Teri A. Reynolds
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2017
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-017-0141-6

Other articles of this Issue 1/2017

BMC Emergency Medicine 1/2017 Go to the issue