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869 Road traffic injuries in kenya: a hospital-based surveillance study
  1. Isaac M Botchey1,
  2. Yuen W Hung1,
  3. Huan He1,
  4. Abdul M Bachani1,
  5. Hassan Saidi2,
  6. Adnan A Hyder1,
  7. Kent A Stevens1,3
  1. 1Johns Hopkins International Injury Research Unit, USA
  2. 2University of Nairobi, Kenya
  3. 3Johns Hopkins Hospital Department of Surgery, USA

Abstract

Background Road Traffic Injuries (RTIs) are a leading cause of disability and mortality worldwide with a disproportionate burden in Low-and Middle-Income Countries (LMICs). RTIs account for 3.6 percent of the global mortality burden [1]. Additionally, the risk of death from injuries in LMICs is six times more likely than in High Income Countries (HICs)[2]. RTIs are estimated to be the fifth leading cause of disability-adjusted life-years (DALYs) lost by 2030 worldwide[3]. Data defining the burden of injury, risk factors and outcomes of RTIs in LMICs are limited. Our study analyses RTIs seen in the casualty departments at four regional referral hospitals in Kenya.

Methods Electronic-based trauma registries were developed at four regional hospitals in Kenya: Kenyatta National, Thika, Meru and Machakos. Information on mechanism of injury, injury severity, patient outcomes, and patterns of care (pre-hospital and hospital-based) was collected prospectively between January 2014 to September 2015.

Results A total of 6429 patients were enrolled. Patients were predominantly male (78.5%), young (median age 27.6 years) and arrived mainly by car/taxi (49.4%), mini bus (18.9%) or an ambulance (16.2%). Injuries were common amongst pedestrians (40.8%) and passengers (36.7%). Seatbelts were used by 7.2% of passengers. Body regions most commonly injured were the extremities (54%) and head (22.7%). The overall mortality rate was 2.2%. Predictors of RTI deaths were moderate head injury [GCS 9–12] (OR 6.4, 95% CI: 4.0–10.1), severe head injury [GCS ≤ 8] (OR 71.5, 95% CI: 49.7–102.8), moderate ISS [ISS 9–15] (OR 3.6, 95% CI: 2.5–5.1) and severe ISS [ISS > 15] (OR 9.4,95% CI: 5.7–15.2).

Conclusions RTIs contribute significantly to the burden of disease in Kenya. A renewed focus on addressing this burden through the development of a trauma care system is necessary. Trauma registries can be used as a plausible tool to identify priority areas for quality improvement and injury prevention.

  • Road Traffic Injuries
  • Low-and Middle-Income Countries
  • Trauma registries
  • Kenya

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