Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Institute of Human Virology, Abuja, Nigeria.
Inj Prev. 2018 Aug;24(4):272-278. doi: 10.1136/injuryprev-2016-042254. Epub 2017 Nov 8.
Injury-related morbidity is a neglected health concern in many low-income and middle-income countries. Most injury data in Africa have been collected from hospital-based studies, and few studies have occurred across multiple countries. Using data from a novel cohort, we examined the prevalence and incidence of serious injuries and associated risk factors across five sites in sub-Saharan Africa (SSA).
A common baseline and follow-up survey was administered to participants. The study population included 1316 persons at baseline and 904 persons at follow-up. Frequencies were calculated, and logistic regression models were used to assess risk factors for injury.
A total of 233 (17.7%) persons reported a serious injury at baseline and 60 (6.6%) reported a serious injury 6 months later at follow-up. Sixty-nine per cent of participants responded to the follow-up questionnaire. At baseline and follow-up, the most common cause of serious injury at urban sites was transport related, followed by poison/overdose. In rural Uganda, sharp instruments injuries were most common, followed by transport-related injuries. Living at an urban site was associated with an increased odds for serious injury compared with those at the rural site (OR: 1.83, 95% CI 1.15 to 2.90). Participants who consumed above a moderate amount of alcohol were at a higher risk of serious injury compared with those who did not consume alcohol (OR: 1.86, 95% CI 1.02 to 3.41). High level of education was an important risk factor for injury.
At baseline and follow-up, common causes of serious injury were transport related, sharp instrument and poison/overdose. Alcohol consumption, urban location and education are important risk factors for injury. It is feasible to collect longitudinal injury data using a standardised questionnaire across multiples sites in SSA. Longitudinal data collection should be leveraged to obtain robust data on risk factors for injury in SSA.
在许多低收入和中等收入国家,与伤害相关的发病是一个被忽视的健康问题。大多数非洲的伤害数据都是从医院的研究中收集的,很少有研究在多个国家进行。本研究使用来自一个新队列的数据,在撒哈拉以南非洲的五个地点调查了严重伤害的患病率和发生率以及相关的危险因素。
对参与者进行了一次共同的基线和随访调查。研究人群包括基线时的 1316 人和随访时的 904 人。计算了频率,并使用逻辑回归模型评估了伤害的危险因素。
共有 233 人(17.7%)报告在基线时发生了严重伤害,60 人(6.6%)在随访时报告了 6 个月后发生了严重伤害。69%的参与者回复了随访问卷。在基线和随访时,城市地区最常见的严重伤害原因是交通相关,其次是中毒/过量。在农村乌干达,最常见的严重伤害是锐器伤,其次是交通相关伤害。与农村地区相比,居住在城市地区的人发生严重伤害的几率更高(OR:1.83,95%CI 1.15-2.90)。与不饮酒者相比,大量饮酒者发生严重伤害的风险更高(OR:1.86,95%CI 1.02-3.41)。较高的教育水平是受伤的重要危险因素。
在基线和随访时,严重伤害的常见原因是交通相关、锐器和中毒/过量。饮酒、城市地点和教育是伤害的重要危险因素。在撒哈拉以南非洲的多个地点使用标准化问卷收集纵向伤害数据是可行的。应利用纵向数据收集,获得撒哈拉以南非洲地区伤害危险因素的可靠数据。