World Journal of Surgery

, Volume 35, Issue 1, pp 1–8

Patterns of Injury and Violence in Yaoundé Cameroon: An Analysis of Hospital Data

  • Catherine Juillard
  • Georges Alain Etoundi Mballa
  • Chancelline Bilounga Ndongo
  • Kent A. Stevens
  • Adnan A. Hyder



Injuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon’s capital city.

Materials and methods

Administrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.


A total of 6,234 injured people were seen at the Central Hospital of Yaoundé’s emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p < 0.001), whereas patients suffering intentional injuries and bites were less likely to be hospitalized (p < 0.001). Males were significantly more likely to be admitted than females (p < 0.001)


Patterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted.


  1. 1.
    World Health Organization (2003) World Health Report 2003: shaping the future. World Health Organization, GenevaGoogle Scholar
  2. 2.
    Peden M, McGee K, Krug E (2002) Injury: a leading cause of the global burden of disease. World Health Organization, GenevaGoogle Scholar
  3. 3.
    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 95:13–17CrossRefPubMedGoogle Scholar
  4. 4.
    Nantulya V, Reich M (2002) The neglected epidemic: road traffic injuries in developing countries. BMJ 324:1139–1141CrossRefPubMedGoogle Scholar
  5. 5.
    Department of Injuries, Violence Prevention WHO (2002) The injury chart book: a graphical overview of the global burden of injuries. World Health Organization, GenevaGoogle Scholar
  6. 6.
    World Health Organization (2004) Statistical Annex of the World Health Report 2004. Department of Measurement and Health Information, World Health Organization, GenevaGoogle Scholar
  7. 7.
    World Health Organization (2004) Mortality and health status: causes of death. World Health Organization, GenevaGoogle Scholar
  8. 8.
    Mock CN, Abantanga F, Cummings P et al (1999) Incidence and outcome of injury in Ghana: results of a community-based survey. Bull WHO 77:955–964PubMedGoogle Scholar
  9. 9.
    Kobusingye O, Guwatudde D, Lett R (2001) Injury patterns in rural and urban Uganda. Inj Prev 7:46–50CrossRefPubMedGoogle Scholar
  10. 10.
    Moshiro C, Heuch I, Astrom AN et al (2005) Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey. BMC Public Health 5:11CrossRefPubMedGoogle Scholar
  11. 11.
    Olawale OA, Owoaje ET (2007) Incidence and pattern of injuries among residents of a rural area in South-Western Nigeria: a community-based study. BMC Public Health 7:246CrossRefPubMedGoogle Scholar
  12. 12.
    Bowley DM, Khavandi A, Boffard KD et al (2002) The malignant epidemic—changing patterns of trauma. S Afr Med J 92:798–802PubMedGoogle Scholar
  13. 13.
    Norman R, Matzopoulos R, Groenewald P et al (2007) The high burden of injuries in South Africa. Bull WHO 85:695–702PubMedGoogle Scholar
  14. 14.
    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 36:714–717CrossRefPubMedGoogle Scholar
  15. 15.
    Bahebeck J, Masso-Misse P, Essomba A et al (2005) Abdominal gunshot wound: description of 86 cases in Cameroon. Med Trop (Mars) 65:554–558Google Scholar
  16. 16.
    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) 134:154–157Google Scholar
  17. 17.
    Holder Y, Peden M, Krug E et al (2001) Injury surveillance guidelines. World Health Organization, GenevaGoogle Scholar
  18. 18.
    World Health Organization (1994) International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. World Health Organization, GenevaGoogle Scholar
  19. 19.
    Ghaffar A, Hyder AA, Masud TI (2004) The burden of road traffic injuries in developing countries: the 1st national injury survey of Pakistan. Public Health 118:211–217CrossRefPubMedGoogle Scholar
  20. 20.
    London JA, Mock CN, Quansah RE et al (2001) Priorities for improving hospital based trauma care in an African city. J Trauma 51:747–753CrossRefPubMedGoogle Scholar
  21. 21.
    John IA, Mohammed AZ, Lawoko S et al (2008) Implementing a hospital based injury surveillance system: a case study in Nigeria. Med Confl Surviv 24:273–279CrossRefPubMedGoogle Scholar
  22. 22.
    Kobusingye OC, Guwatudde D, Owor G et al (2002) Citywide trauma experience in Kampala, Uganda: a call for intervention. Inj Prev 8:133–136CrossRefPubMedGoogle Scholar
  23. 23.
    Solagberu BA, Adekanye AO, Ofoegbu CP et al (2003) Epidemiology of trauma deaths. West Afr J Med 22:177–181PubMedGoogle Scholar
  24. 24.
    Peden M, Scurfield R, Sleet D et al (2004) World Report on road traffic injury prevention. World Health Organization, GenevaGoogle Scholar
  25. 25.
    Saidi HS, Macharia WM, Ating’a JEO (2005) Outcome for hospitalized road trauma patients at a tertiary hospital in Kenya. Eur J Trauma 4:401–406CrossRefGoogle Scholar
  26. 26.
    Odero W, Garner P, Zwi A (1997) Road traffic injuries in developing countries: a comprehensive review of epidemiologic studies. Trop Med Int Health 2:445–460CrossRefPubMedGoogle Scholar
  27. 27.
    Lagarde E (2007) Road traffic injury is an escalating burden in Africa and deserves proportionate research efforts. PLoS Med 4:e170CrossRefPubMedGoogle Scholar
  28. 28.
    Romao F, Nizamo H, Mapasse D et al (2003) Road traffic injuries in Mozambique. Inj Control Saf Promot 10:63–67CrossRefPubMedGoogle Scholar
  29. 29.
    Afukaar FK, Antwi P, Ofosu-Amaah S (2003) Pattern of road traffic injuries in Ghana: implications for control. Inj Control Saf Promot 10:69–76CrossRefPubMedGoogle Scholar
  30. 30.
    Solagberu B, Adekanye A, Ofoegbu C et al (2002) Clinical spectrum of trauma at a university hospital in Nigeria. Eur J Trauma 6:365–369CrossRefGoogle Scholar
  31. 31.
    Napolitano LM, Greco ME, Rodriguez A et al (2001) Gender differences in adverse outcomes after blunt trauma. J Trauma 50:274–280CrossRefPubMedGoogle Scholar
  32. 32.
    Evans L (2001) Female compared with male fatality risk from similar physical impacts. J Trauma 50:281–288CrossRefPubMedGoogle Scholar
  33. 33.
    Ahuja RB, Bhattacharya S (2004) Burns in the developing world and burn disasters. BMJ 329:447–449CrossRefPubMedGoogle Scholar
  34. 34.
    Paolisso M, Leslie J (1995) Meeting the changing health needs of women in developing countries. Soc Sci Med 40:55–65CrossRefPubMedGoogle Scholar
  35. 35.
    Saleh S, Gadalla S, Fortney JA et al (1986) Accidental burn deaths to Egyptian women of reproductive age. Burns Incl Therm Inj 12:241–245PubMedGoogle Scholar
  36. 36.
    Gupta RK, Srivastava AK (1988) Study of fatal burns cases in Kanpur (India). Forensic Sci Int 37:81–89CrossRefPubMedGoogle Scholar
  37. 37.
    Swart LA, Seedat M (2001) An epidemiological study of injury in a low socioeconomic context: implications for prevention. Inj Control Saf Promot 8:241–249CrossRefGoogle Scholar
  38. 38.
    Smith GS, Barss P (1991) Unintentional injuries in developing countries: the epidemiology of a neglected problem. Epidemiol Rev 13:228–266PubMedGoogle Scholar
  39. 39.
    LeBras J, Semenor M, Gate C (1982) Importance, répartition et causes principales des accidents observés en 1980 dans deux formations sanitaires rurales de la Côte d’Ivoire: étude comparative (French). Med Trop 42:129–144Google Scholar
  40. 40.
    Kale OO (1977) Epidemiology and treatment of dog bites in Ibadan: a 12-year retrospective study of cases seen at the University College Hospital Ibadan (1962–1973). Afr J Med Sci 6:133–140Google Scholar
  41. 41.
    University of the Witwatersrand, Johannesburg (2004) University of the Witwatersrand, Johannesburg: Trauma Unit: Workload. 2004. Accessed 15 Aug 2010
  42. 42.
    Mock C, Ofosu A, Gish O (2001) Utilization of district health services by injured persons in a rural area of Ghana. Int J Health Plann Manage 16:19–32CrossRefPubMedGoogle Scholar
  43. 43.
    Forjuoh SN, Guyer B, Strobino DM (1995) Determinants of modern health care use by families after a childhood burn in Ghana. Injury Prev 1:31–34CrossRefGoogle Scholar
  44. 44.
    Bartlett SN (2002) The problem of children’s injuries in low-income countries: a review. Health Policy Plan 17:1–13CrossRefPubMedGoogle Scholar
  45. 45.
    Fides JJ (ed) (2005) American College of Surgeons Committee on Trauma. National Trauma Data Bank Report 2005. American College of Surgeons, ChicagoGoogle Scholar
  46. 46.
    American College of Surgeons (2003) American College of Surgeons Committee on Trauma: Subcommittee on Trauma Registry Programs. National Trauma Data Bank Report Reference Manual: Background, caveats, and resources, ChicagoGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Catherine Juillard
    • 1
    • 2
  • Georges Alain Etoundi Mballa
    • 3
  • Chancelline Bilounga Ndongo
    • 4
  • Kent A. Stevens
    • 5
  • Adnan A. Hyder
    • 6
  1. 1.Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Department of Surgery, David Geffen School of MedicineUniversity of California Los AngelesLos AngelesUSA
  3. 3.Department of Emergency MedicineCentral Hospital of YaoundéYaoundéCameroon
  4. 4.Faculty of MedicineUniversity of Yaoundé IYaoundéCameroon
  5. 5.Department of SurgeryJohns Hopkins UniversityBaltimoreUSA
  6. 6.International Injury Research Unit, Department of International Health, and Center for Injury Research and PolicyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA

Personalised recommendations