Prehospital Trauma Care Systems: Potential Role Toward Reducing Morbidities and Mortalities from Road Traffic Injuries in Nigeria

AbstractIntroductionRoad traffic injuries (RTIs) and attendant fatalities on Nigerian roads have been on an increasing trend over the past three decades. Mortality from RTIs in Nigeria is estimated to be 162 deaths/100,000 population. This study aims to compare and identify best prehospital trauma care practices in Nigeria and some other African countries where prehospital services operate.MethodsA review of secondary data, grey literature, and pertinent published articles using a conceptual framework to assess: (1) policies; (2) structures; (3) first responders; (4) communication facilities; (5) transport and ambulance facilities, and (6) roadside emergency trauma units.ResultsThere is no national prehospital trauma care system (PTCS) in Nigeria. The lack of a national emergency health policy is a factor in this absence. The Nigerian Federal Road Safety Corps (FRSC) mainly has been responsible for prehospital services. South Africa, Zambia, Kenya, and Ghana have improved prehospital services in Africa.ConclusionsCommercial drivers, laypersons, military, police, a centrally controlled communication network, and government ambulance services are feasible delivery models that can be incorporated into the Nigerian prehospital system. Prehospital trauma services have been useful in reducing morbidities and mortalities from traffic injuries, and appropriate implementation of this study's recommendations may reduce this burden in Nigeria.AdeloyeD. Prehospital trauma care systems: potential role toward reducing morbidities and mortalities from road traffic injuries in Nigeria. Prehosp Disaster Med. 2012;27(6):1-7.</jats:sec

Effect of Hedging-Integrated Rule Curves on the Performance of the Pong Reservoir (India) During Scenario-Neutral Climate Change Perturbations

This study has evaluated the effects of improved, hedging-integrated reservoir rule curves on the current and climate-change-perturbed future performances of the Pong reservoir, India. The Pong reservoir was formed by impounding the snow- and glacial-dominated Beas River in Himachal Pradesh. Simulated historic and climate-change runoff series by the HYSIM rainfall-runoff model formed the basis of the analysis. The climate perturbations used delta changes in temperature (from 0° to +2 °C) and rainfall (from −10 to +10 % of annual rainfall). Reservoir simulations were then carried out, forced with the simulated runoff scenarios, guided by rule curves derived by a coupled sequent peak algorithm and genetic algorithms optimiser. Reservoir performance was summarised in terms of reliability, resilience, vulnerability and sustainability. The results show that the historic vulnerability reduced from 61 % (no hedging) to 20 % (with hedging), i.e., better than the 25 % vulnerability often assumed tolerable for most water consumers. Climate change perturbations in the rainfall produced the expected outcomes for the runoff, with higher rainfall resulting in more runoff inflow and vice-versa. Reduced runoff caused the vulnerability to worsen to 66 % without hedging; this was improved to 26 % with hedging. The fact that improved operational practices involving hedging can effectively eliminate the impacts of water shortage caused by climate change is a significant outcome of this study

An estimate of the prevalence of epilepsy in Sub-Saharan Africa:A systematic analysis

Epilepsy is a leading serious neurological condition worldwide and has particularly significant physical, economic and social consequences in Sub–Saharan Africa. This paper aims to contribute to the understanding of epilepsy prevalence in this region and how this varies by age and sex so as to inform understanding of the disease characteristics as well as the development of infrastructure, services and policies

Food additives and their health implications on children in Africa: a systematic review

Objective: The safety of processed foods is an issue of public health importance, especially in Africa where there is unchecked rate at which many food industries turn out novel 'chemicals' aimed at increasing the acceptability of their products. This is particularly true for processed foods targeted at children, who remain the most vulnerable group. The aim of this review was to identify health implications of food additives on children in Africa based on findings from original research works. Methods: We conducted a parallel search of Medline, EMBASE and Global Health for relevant studies from 1970 to 2014. We included studies conducted among African populations reporting effects of food additives among children (under age 17 years). Data on health implications of food additives were extracted and reviewed. Results: Our search returned 479 studies, with only 4 studies meeting the selection criteria. Five countries were represented, namely Libya, Nigeria, Uganda, Tanzania and Sudan The total study population was 3326. All the studies were cross-sectional, and focused essentially on sugar as an important risk factor for the development of dental caries and/or erosion in children. Conclusions: Studies on important food additives such as preservatives, colouring agents, sweeteners, anti-caking agents and their effects on health of children are largely unavailable in Africa, although anecdotal reports are suggestive of their deleterious effects. To ensure evidenced-based decision making and public policies in this regard, there is a need for original research works

Estimating the incidence of colorectal cancer in Sub-Saharan Africa:A systematic analysis

Background Nearly two–thirds of annual mortality worldwide is attributable to non–communicable diseases (NCDs), with 70% estimated to occur in low– and middle–income countries (LMIC). Colorectal cancer (CRC) accounts for over 600 000 deaths annually, but data concerning cancer rates in LMIC is very poor. This study analyses the data available to produce an estimate of the incidence of colorectal cancer in Sub–Saharan Africa (SSA). Methods Data for this analysis came from two main sources: a systematic search of Medline, EMBASE and Global Health which found 15 published data sets, and an additional 42 unpublished data sets which were sourced from the IARC and individual cancer registries. Data for case rates by age and sex, as well as population denominators were extracted and analysed to produce an estimate of incidence. Results: The crude incidence of CRC in SSA for both sexes was found to be 4.04 per 100 000 population (4.38 for men and 3.69 for women). Incidence increased with age with the highest rates in Southern Africa, particularly in South Africa. The rates of CRC in SSA were much lower than those reported for high–income countries. Conclusion Few health services in SSA are equipped to provide timely diagnosis and treatment of cancer in SSA. In addition, data collection systems are weak, meaning that the available statistics may underestimate the burden of disease. In order to improve health care services it is vital that accurate measurements of disease burden are available to policy maker

Prevalence and factors associated with the use of antibiotics in non-bloody diarrhoea in children under 5 years of age in sub-Saharan Africa

Objectives To estimate the prevalence and determine the factors associated with the use of antibiotics in the management of non-bloody diarrhoea in children under 5 years of age in sub-Saharan Africa (SSA). Methods We conducted a meta-analysis of demographic and health survey data sets from 30 countries in SSA. Pooled prevalence estimates were calculated using random effects model. Χ2 tests were employed to determine the factors associated with the antibiotic use. Results The pooled prevalence of antibiotic use among cases of non-bloody diarrhoea in children under 5 years of age was 23.1% (95% CI 19.5 to 26.7). The use of antibiotics in children with non-bloody diarrhoea in SSA was associated with (p<0.05) the source of care, place of residence, wealth index, maternal education and breastfeeding status. Conclusion We found an unacceptably high use of antibiotics to treat episodes of non-bloody diarrhoea in children under the age of 5 in SSA