Skip to main content

Advertisement

SpringerLink
Log in

Analysis of Prospective Trauma Registry Data in Francophone Africa: A Pilot Study from Cameroon

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

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 <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.

Conclusions

Injuries 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Nantulya V, Reich M (2002) The neglected epidemic: road traffic injuries in developing countries. BMJ 324:1139–1141

    Article  PubMed  PubMed Central  Google Scholar 

  2. Department of Injuries and Violence Prevention WHO (2002) The injury chart book: a graphical overview of the global burden of injuries. World Health Organization, Geneva

    Google Scholar 

  3. Bowley DM, Khavandi A, Boffard KD et al (2002) The malignant epidemic–changing patterns of trauma. S Afr Med J 92(10):798–802

    PubMed  Google Scholar 

  4. Norman R, Matzopoulos R, Groenewald P et al (2007) The high burden of injuries in South Africa. Bull World Health Organ 85(9):695–702

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hofman K, Primack A, Keusch G et al (2005) Addressing the growing burden of trauma and injury in low- and middle-income countries. Am J Public Health 95(1):13–17

    Article  PubMed  PubMed Central  Google Scholar 

  6. World Health Organization (2004) Statistical Annex of the World Health Report 2004. World Health Organization, Department of Measurement and Health Information

    Google Scholar 

  7. World Health Organization (2004) Mortality and health status: causes of death. World Health Organization

  8. Mefire AC, Pagbe JJ, Fokou M et al (2010) Analysis of epidemiology, lesions, treatment and outcome of 354 consecutive cases of blunt and penetrating trauma to the chest in an African setting. S Afr J Surg 48(3):90–93

    PubMed  Google Scholar 

  9. Bahebeck J, Atangana R, Mboudou E et al (2005) Incidence, case-fatality rate and clinical pattern of firearm injuries in two cities where arm owning is forbidden. Injury 36(6):714–717

    Article  PubMed  Google Scholar 

  10. Bahebeck J, Masso-Misse P, Essomba A et al (2005) Abdominal gunshot wound: description of 86 cases in Cameroon. Med Trop (Mars) 65(6):554–558

    CAS  Google Scholar 

  11. Essomba A, Masso-Misse P, Tchembe R et al (1997) Blunt trauma of the liver. An analysis of a series of 29 cases. J Chir (Paris) 134(4):154–157

    CAS  Google Scholar 

  12. Juillard C, Etoundi Mballa GA, Bilounga Ndongo C et al Patterns of injury and violence in Yaounde Cameroon: an analysis of hospital data. World J Surg 35(1):1–8

  13. Thanni LO, Kehinde OA (2006) Trauma at a Nigerian teaching hospital: pattern and documentation of presentation. Afr Health Sci 6(2):104–107

    PubMed  CAS  PubMed Central  Google Scholar 

  14. Yu KL, Bong CN, Huang MC et al (2009) The use of hospital medical records for child injury surveillance in northern Malawi. Trop Doct 39(3):170–172

    Article  PubMed  CAS  Google Scholar 

  15. Rutta E, Mutasingwa D, Ngallaba SE et al (2001) Epidemiology of injury patients at Bugando Medical Centre. Tanzania. East Afr Med J 78(3):161–164

    CAS  Google Scholar 

  16. Chichom Mefire A, Etoundi Mballa GA, Azabji Kenfack M et al (2013) Hospital-based injury data from level III institution in Cameroon: retrospective analysis of the present registration system. Injury 44(1):139–143

    Article  PubMed  Google Scholar 

  17. Holder Y, Peden M, Krug E et al (2004) Injury surveillance guidelines. World Health Organization and Center for Disease Contro and Prevention, Geneva

    Google Scholar 

  18. Hyder AA, Sugerman DE, Puvanachandra P et al (2009) Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study. Bull World Health Organ 87(5):345–352

    Article  PubMed  PubMed Central  Google Scholar 

  19. Holder Y, Peden M, Krug E et al (2001) Injury surveillance guidelines. World Health Organization, Geneva

    Google Scholar 

  20. Kobusingye Lett RR (2000) Hospital-based trauma registries in Uganda. J Trauma 48:498–502

    Article  PubMed  CAS  Google Scholar 

  21. Labinjo M, Juillard C, Kobusingye OC et al (2009) The burden of road traffic injuries in Nigeria: results of a population-based survey. Inj Prev 15(3):157–162

    Article  PubMed  CAS  Google Scholar 

  22. Talwar S, Jain S, Porwal R et al (1999) Trauma scoring in a developing country. Singapore Med J 40(6):386–388

    PubMed  CAS  Google Scholar 

  23. McLellan BA, Koch JP, Wortzman D et al (1989) Early identification of high-risk patients using the “estimated” injury severity score and age. Accid Anal Prev 21(3):283–290

    Article  PubMed  CAS  Google Scholar 

  24. Institut National de la Statistique (INS) et ORC Macro (2004) Enquête Démographique et de Santé du Cameroun 2004, INS et ORC Macro, Calverton

  25. Collaborative Institutional Training Initiative (CITI) (2011) from http://www.citiprogram.org.Accessed 12 Nov 2011

  26. StataCorp (2009) Stata Statistical Software: Release 11. StataCorp LP, College Station, TX

    Google Scholar 

  27. World Bank. World Development Indicators. http://databank.worldbank.org/data/home.aspx. Accessed 16 Nov 2012

  28. World Bank. Official exchange rate (LCU per US$, period average). http://data.worldbank.org/indicator/PA.NUS.FCRF. Accessed 13 Aug 2012

  29. Samuel JC, Akinkuotu A, Villaveces A et al (2009) Epidemiology of injuries at a tertiary care center in Malawi. World J Surg 33(9):1836–1841

    Article  PubMed  PubMed Central  Google Scholar 

  30. Tollefson TT, Larrabee WF Jr (2012) Global surgical initiatives to reduce the surgical burden of disease. JAMA 307(7):667–668

    Article  PubMed  Google Scholar 

  31. Ozgediz D, Riviello R (2008) The other neglected diseases in global public health: surgical conditions in sub-Saharan Africa. PLoS Med 5(6):e121

    Article  PubMed  PubMed Central  Google Scholar 

  32. Gosselin RA, Gyamfi YA, Contini S (2010) Challenges of meeting surgical needs in the developing world. World J Surg 35(2):258–261

    Article  PubMed Central  Google Scholar 

  33. Juillard C, Labinjo M, Kobusingye O et al (2010) Socioeconomic impact of road traffic injuries in West Africa: exploratory data from Nigeria. Inj Prev 16(6):389–392

    Article  PubMed  Google Scholar 

  34. Spangenberg K, Mock C (2006) Utilization of health services by the injured residents in Kumasi, Ghana. Int J Inj Contr Saf Promot 13(3):194–196

    Article  PubMed  Google Scholar 

  35. Esperato A, Bishai D, Hyder AA (2012) Projecting the health and economic impact of road safety initiatives: a case study of a multi-country project. Traffic Inj Prev 13(Suppl 1):82–89

    Article  PubMed  Google Scholar 

  36. Nwomeh BC, Lowell W, Kable R et al (2006) History and development of trauma registry: lessons from developed to developing countries. World J Emerg Surg 1:32

    Article  PubMed  PubMed Central  Google Scholar 

  37. Payne SR, Waller JA (1989) Trauma registry and trauma center biases in injury research. J Trauma 29:424

    Article  PubMed  CAS  Google Scholar 

  38. Zafar H, Rehmani R, Raja AJ et al (2002) Registry based trauma outcome: perspective of a developing country. Emerg Med J 19(5):391–394

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  39. Taye M, Munie T (2003) Trauma registry in Tikur Anbessa Hospital, Addis Ababa, Ethiopia. Ethiop Med J 41(3):221–226

    PubMed  Google Scholar 

  40. Schultz CR, Ford HR, Cassidy LD et al (2007) Development of a hospital-based trauma registry in Haiti: an approach for improving injury surveillance in developing and resource-poor settings. J Trauma 63(5):1143–1154

    Article  PubMed  Google Scholar 

  41. Chardbunchachai W, Suppachutikul A, Santikarn C (2002) Development of service system for injury patients by utilizing data from the trauma registry (ISBN: 974-294-569-1), Office of Research and Textbook Project, Khon Kaen Hospital, Khon Kaen

  42. Mock C, Maier RV, nii-Amon-Kotei D (1997) Low utilization of formal medical services by injured persons in a developing nation. J Trauma 42:504–513

    Article  PubMed  CAS  Google Scholar 

  43. London JA, Mock CN, Quansah RE et al (2001) Priorities for improving hospital based trauma care in an African city. J Trauma 51:747–753

    Article  PubMed  CAS  Google Scholar 

  44. American College of Surgeons Committee on Trauma (2005) National Trauma Data Bank Report 2005. American College of Surgeons, Chicago

    Google Scholar 

  45. American College of Surgeons Committee on Trauma: Subcommittee on Trauma Registry Programs (2003) National Trauma Data Bank Report Reference Manual: Background, caveats, and resources. Chicago; American College of Surgeons

  46. Moore L, Clark DE (2008) The value of trauma registries. Injury 39(6):686–695

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA

    Catherine J. Juillard, Kent A. Stevens, Jolion McGreevy & Adnan A. Hyder

  2. Department of Surgery, University of California, Los Angeles, 10833 LeConte Avenue, Los Angeles, CA, 90095, USA

    Catherine J. Juillard & Gill Cryer

  3. World Health Organization, Africa Regional Office, Brazzaville, Congo

    Martin Ekeke Monono

  4. Central Hospital of Yaoundé, BP87, Quartier Centre Ville, Rue Henri Dunan, Yaoundé, Cameroon

    Georges Alain Etoundi Mballa

  5. Department of Family Health, Ministry of Health, P.O. BOX 4284, Yaoundé, Cameroon

    Marquise Kouo Ngamby

  6. Department of Surgery, San Francisco General Hospital, University of California, San Francisco, 1001 Portrero Avenue, 3A, Box 0807, San Francisco, CA, 94110, USA

    Catherine J. Juillard

Authors
  1. Catherine J. Juillard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kent A. Stevens
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin Ekeke Monono
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Georges Alain Etoundi Mballa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marquise Kouo Ngamby
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jolion McGreevy
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gill Cryer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Adnan A. Hyder
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Catherine J. Juillard.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Juillard, C.J., Stevens, K.A., Monono, M.E. et al. Analysis of Prospective Trauma Registry Data in Francophone Africa: A Pilot Study from Cameroon. World J Surg 38, 2534–2542 (2014). https://doi.org/10.1007/s00268-014-2604-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-014-2604-1

Keywords

Search

Navigation