Road traffic injuries in Yaoundé, Cameroon: A hospital-based pilot surveillance study.

Road traffic injuries (RTIs) are a major cause of death and disability worldwide. In Cameroon, like the rest of sub-Saharan Africa, more data on RTI patterns and outcomes are needed to improve treatment and prevention. This study analyses RTIs seen in the emergency room of the busiest trauma centre in Yaoundé, Cameroon.A prospective injury surveillance study was conducted in the emergency room of the Central Hospital of Yaoundé from April 15 to October 15, 2009. RTI patterns and relationships among demographic variables, road collision characteristics, injury severity, and outcomes were identified.A total of 1686 RTI victims were enrolled. The mean age was 31 years, and 73% were male. Eighty-eight percent of road collisions occurred on paved roads. The most common user categories were 'pedestrian' (34%) and 'motorcyclist' (29%). Pedestrians were more likely to be female (p<0.001), while motorcyclists were more likely to be male (p<0.001). Injuries most commonly involved the pelvis and extremities (43%). Motorcyclists were more likely than other road users to have serious injuries (RR=1.45; 95% CI: 1.25, 1.68). RTI victims of lower economic status were more likely to die than those of higher economic status.Vulnerable road users represent the majority of RTI victims in this surveillance study. The burden of RTI on hospitals in Cameroon is high and likely to increase. Data on RTI victims who present to trauma centres in low- and middle-income countries are essential to improving treatment and prevention

Road traffic injuries in Yaoundé, Cameroon: A hospital-based pilot surveillance study

©2014 Elsevier Ltd. All rights reserved. Background: Road traffic injuries (RTIs) are a major cause of death and disability worldwide. In Cameroon, like the rest of sub-Saharan Africa, more data on RTI patterns and outcomes are needed to improve treatment and prevention. This study analyses RTIs seen in the emergency room of the busiest trauma centre in Yaoundé , Cameroon.Methods: A prospective injury surveillance study was conducted in the emergency room of the Central Hospital of Yaoundé from April 15 to October 15, 2009. RTI patterns and relationships among demographic variables, road collision characteristics, injury severity, and outcomes were identified.Results: A total of 1686 RTI victims were enrolled. The mean age was 31 years, and 73% were male. Eighty-eight percent of road collisions occurred on paved roads. The most common user categories were pedestrian (34%) and motorcyclist (29%). Pedestrians were more likely to be female (p \u3c 0.001), while motorcyclists were more likely to be male (p \u3c 0.001). Injuries most commonly involved the pelvis and extremities (43%). Motorcyclists were more likely than other road users to have serious injuries (RR = 1.45; 95% CI: 1.25, 1.68). RTI victims of lower economic status were more likely to die than those of higher economic status.Discussion: Vulnerable road users represent the majority of RTI victims in this surveillance study. The burden of RTI on hospitals in Cameroon is high and likely to increase. Data on RTI victims who present to trauma centres in low- and middle-income countries are essential to improving treatment and prevention

Exploring data sources for road traffic injury in Cameroon: Collection and completeness of police records, newspaper reports, and a hospital trauma registry

© 2017 Elsevier Inc. Background Road traffic injury surveillance systems are a cornerstone of organized efforts at injury control. Although high-income countries rely on established trauma registries and police databases, in low- and middle-income countries, the data source that provides the best collection of road traffic injury events in specific low- and middle-income country contexts without mature surveillance systems is unclear. The objective of this study was to compare the information available on road traffic injuries in 3 data sources used for surveillance in the sub-Saharan African country of Cameroon, providing potential insight on data sources for road traffic injury surveillance in low- and middle-income countries. We assessed the number of events captured and the information available in Yaoundé, Cameroon, from 3 separate sources of data on road traffic injuries: trauma registry, police records, and newspapers. Methods Data were collected from a single-hospital trauma registry, police records, and the 6 most widely circulated newspapers in Yaoundé during a 6-month period in 2009. The number of road traffic injury events, mortality, and other variables included commonly in injury surveillance systems were recorded. We compared these sources using descriptive analysis. Results Hospital, police, and newspaper sources recorded 1,686, 273, and 480 road traffic injuries, respectively. The trauma registry provided the most complete data for the majority of variables explored; however, the newspaper data source captured 2, mass casualty, train crash events unrecorded in the other sources. Police data provided the most complete information on first responders to the scene, missing in only 7%. Conclusion Investing in the hospital-based trauma registry may yield the best surveillance for road traffic injuries in some low- and middle-income countries, such as Yaoundé, Cameroon; however, police and newspaper reports may serve as alternative data sources when specific information is needed

Analysis of prospective trauma registry data in francophone Africa: A pilot study from cameroon

© 2014 Socie;acuteacute Internationale de Chirurgie. Introduction: Injury rates in sub-Saharan Africa are among the highest in the world, but prospective, registry-based reports from Cameroon are limited. We aimed to create a prospective trauma registry to expand the data elements collected on injury at a busy tertiary center in Yaoundé Cameroon. Methods: Details of the injury context, presentation, care, cost, and disposition from the emergency department (ED) were gathered over a 6-month period, by trained research assistants using a structured questionnaire. Bivariate and multivariate models were built to explore variable relationships and outcomes. Results: There were 2,855 injured patients in 6 months, comprising almost half of all ED visits. Mean age was 30 years; 73 % were male. Injury mechanism was road traffic injury in 59 %, fall in 7 %, penetrating trauma in 6 %, and animal bites in 4 %. Of these, 1,974 (69 %) were discharged home, 517 (18 %) taken to the operating room, and 14 (1 %) to the intensive care unit. The body areas most severely injured were pelvis and extremity in 43 %, head in 30 %, chest in 4 %, and abdomen in 3 %. The estimated injury severity score (eISS) was \u3c9 in 60 %, 9-24 in 35 %, and \u3e25 in 2 %. Mortality was 0.7 %. In the multivariate analysis, independent predictors of mortality were eISS ≥9 and Glasgow Coma Score ≤12. Road traffic injury was an independent predictor for the need to have surgery. Trauma registry results were presented to the Ministry of Health in Cameroon, prompting the formation of a National Injury Committee. Conclusions: Injuries comprise a significant proportion of ED visits and utilization of surgical services in Yaounde; A prospective approach allows for more extensive information. Thorough data from a prospective trauma registry can be used successfully to advocate for policy towards prevention and treatment of injuries

Epidemiology and cost of pediatric injury in Yaoundé, Cameroon: a prospective study

© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Unintentional injury is the leading cause of death among children aged 10–19 years and over 95% of injury deaths occur in low- and middle-income countries (LMICs). As patterns of injury in the pediatric population may differ from those in adults, risks specific to children in LMICs need to be identified for effective injury prevention and treatment. This study explores patterns of pediatric injury epidemiology and cost in Yaoundé, Cameroon to inform injury prevention and resource allocation. Methods: Pediatric (age \u3c 20 years) trauma patient data were collected at the emergency department (ED) of Central Hospital of Yaoundé (CHY) from April through October 2009. Univariate, bivariate, and multivariate analyses were used to explore injury patterns and relationships between variables. Regression analyses were conducted to identify predictors of receiving surgical care. Results: Children comprised 19% (544) of trauma cases. About 54% suffered road traffic injuries (RTIs), which mostly affected the limbs and pelvis (37.3%). Half the RTI victims were pedestrians. Transportation to CHY was primarily by taxi or bus (69.4%) and a preponderance (71.1%) of the severely and profoundly injured patients used this method of transport. Major or minor surgical intervention was necessary for 17.9% and 20.8% of patients, respectively. Patients with an estimated injury severity score ≥ 9 (33.2%) were more likely to need surgery (p \u3c 0.01). The median ED cost of pediatric trauma care was USD12.71 [IQR 12.71, 23.30]. Conclusions: Injury is an important child health problem that requires adequate attention and funding. Policies, surgical capacity building, and health systems strengthening efforts are necessary to address the high burden of pediatric injuries in Cameroon. Pediatric injury prevention efforts in Cameroon should target pedestrian RTIs, falls, and burns and consider school-based interventions

Analysis of prospective trauma registry data in Francophone Africa: a pilot study from Cameroon.

IntroductionInjury rates in sub-Saharan Africa are among the highest in the world, but prospective, registry-based reports from Cameroon are limited. We aimed to create a prospective trauma registry to expand the data elements collected on injury at a busy tertiary center in Yaoundé Cameroon.MethodsDetails of the injury context, presentation, care, cost, and disposition from the emergency department (ED) were gathered over a 6-month period, by trained research assistants using a structured questionnaire. Bivariate and multivariate models were built to explore variable relationships and outcomes.ResultsThere were 2,855 injured patients in 6 months, comprising almost half of all ED visits. Mean age was 30 years; 73 % were male. Injury mechanism was road traffic injury in 59 %, fall in 7 %, penetrating trauma in 6 %, and animal bites in 4 %. Of these, 1,974 (69 %) were discharged home, 517 (18 %) taken to the operating room, and 14 (1 %) to the intensive care unit. The body areas most severely injured were pelvis and extremity in 43 %, head in 30 %, chest in 4 %, and abdomen in 3 %. The estimated injury severity score (eISS) was <9 in 60 %, 9-24 in 35 %, and >25 in 2 %. Mortality was 0.7 %. In the multivariate analysis, independent predictors of mortality were eISS ≥9 and Glasgow Coma Score ≤12. Road traffic injury was an independent predictor for the need to have surgery. Trauma registry results were presented to the Ministry of Health in Cameroon, prompting the formation of a National Injury Committee.ConclusionsInjuries comprise a significant proportion of ED visits and utilization of surgical services in Yaoundé. A prospective approach allows for more extensive information. Thorough data from a prospective trauma registry can be used successfully to advocate for policy towards prevention and treatment of injuries

Informing prehospital care planning using pilot trauma registry data in Yaoundé, Cameroon

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Introduction: About 54% of deaths in low- and middle-income countries (LMICs) are attributable to lack of prehospital care. The single largest contributor to the disability-adjusted life years due to poor prehospital care is injury. Despite having disproportionately high injury burdens, most LMIC trauma systems have little prehospital organization. An understanding of existing prehospital care patterns in LMICs is warranted as a precursor to strengthening prehospital systems. Methods: In this retrospective pilot study, we collected demographic and injury characteristics, therapeutic itinerary, and transport data of patients that were captured by the trauma registry at the Central Hospital of Yaoundé (CHY) from April 15, 2009 to October 15, 2009. Bivariate and multivariate regression analyses were used to explore relationships between care-seeking behavior, method of transport, and predictor variables. Results: The mean age was 30.2 years (95% CI [29.7, 30.7]) and 73% were male. Therapeutic itinerary was available for 97.5% of patients (N = 2855). Nearly 18.7% of patients sought care elsewhere before CHY and 82% of such visits were at district hospitals or health clinics. Moderately (OR 1.336, p = 0.009) and severely (OR 1.605, p = 0.007) injured patients were more likely to seek care elsewhere before CHY and were less likely to be discharged home after their emergency ward visit as opposed to being admitted to the hospital for further treatment (OR 0.462, p \u3c 0.001). Commercial vehicles provided most prehospital transport (65%), while police or ambulance transported few injured patients (7%). Conclusions: Possible areas for prehospital trauma care strengthening include training lay commercial vehicle drivers in trauma care and formalizing triage, referral, and communication protocols for prehospital care to optimize timely transfer and care while minimizing secondary injury to patients