Article Text

Download PDFPDF

117 Long-term health, economic, and social impact of injury in four low- and middle-income countries
  1. Abdulgafoor M Bachani1,
  2. Xiaoge Julia Zhang1,
  3. Yuen Wai Hung1,
  4. Casey Risko1,
  5. Rantimi Olumasegun1,
  6. Cuong Pham2,
  7. La Ngoc Quang2,
  8. Muhammad Fadhli Yusoff3,
  9. Sohie Coelho4,
  10. Stephanie Aketch5,
  11. Kent A Stevens1,
  12. Adnan A Hyder1
  1. 1Johns Hopkins International Injury Research Unit, Johns Hopkins University Bloomberg School of Public Health, USA
  2. 2Hanoi School of Public Health, Vietnam
  3. 3Institute Kesihatan Umum, Malaysia
  4. 4Handicap International, Cambodia
  5. 5Handicap International, Kenya


Background With 90% of the burden of injuries concentrated in low- and middle-income countries (LMICs), the impact on individuals, families, and society, especially in the case of non-fatal injuries, is exacerbated by the absence of insurance or social support mechanisms. There is a dearth of information in the literature on the occurrence of non-fatal injuries, and their long-term consequences. This study aims to understand the health (disability), social and economic impact of injuries in LMICs.

Methods This is a prospective cohort study of 4200 moderate to severely injured patients at seven government hospitals in four LMICs (Cambodia, Kenya, Malaysia, and Vietnam). We administer a baseline and four follow-up surveys at home (at 1, 2, 4, and 12 months after discharge) to participants about their injury, functioning and disability, medical costs, employment, household composition and roles, as well as support systems (social & economic).

Results The on-going study has enrolled 2293 individuals at the seven hospitals (Cambodia: 595, Kenya: 320, Malaysia: 284, and Vietnam: 1094). Participants are 72–84% male, with an average age of 30–42 years. The top cause of injury across all countries is road traffic injury (47–72%). The second leading cause is falls (17–20%), except for Kenya, where assaults rank second (20%) and falls rank third (16%). Changes in levels of disability, health care costs, productivity, household economic status, and roles of family members, as well as the respective influencing factors will be examined using marginal models with Generalised Estimating Equations (GEE) approach.

Conclusions Injury predominantly affects young males at their prime, having a significant impact not only on themselves, but their family as well as the society. This study will lead to a better understanding of the far reaching health, social, and economic impact of injuries. Data collected could be used to guide policy and programs in each of the implementing countries.

  • Injury burden
  • disability
  • health care costs
  • family structure

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.