Mundenga Müller M, Sawe Hendry R, Runyon Michael S, Mwafongo Victor G, Mfinanga Juma A, Murray Brittany L
Department of Emergency Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Heal Africa Hospital, Goma, Democratic Republic of Congo.
BMC Emerg Med. 2019 Jan 24;19(1):15. doi: 10.1186/s12873-019-0222-9.
Alcohol and illicit drugs have been found to be major contributing factors leading to severe injuries in a variety of settings. In Tanzania, the use of these substances among injured patients has not been studied. We investigated the prevalence of positive tests for alcohol and illicit drug use among injured patients presenting to the emergency medicine department (ED) of Muhimbili National Hospital (MNH).
This was a prospective cohort study of a consecutive sample of patients > 18 years of age presenting to the ED-MNH with injury related complaints in October and November 2015. A structured data sheet was used to record demographic information, mechanism of injury, clinical presentation, alcohol and illicit drug test results, and ED disposition. Alcohol levels and illicit drug use were tested by breathalyser device or swab stick alcohol test and multidrug urine panel, respectively. Patients were followed up for 24 h and 30 days using medical chart reviews and phone calls. Descriptive statistics and relative risk were used to describe the results.
We screened 1011 patients and we enrolled all 143 (14.1%) patients who met inclusion criteria. 123 (86.0%) were male, the median age was 30 years (IQR: 23-36 years). The most frequent mechanism of injury was road traffic accidents (84.6%). 67/143 (46.9%) patients tested positive for alcohol and 44/122 (36.1%) patients tested positive for drugs. 29 (26.1%) tested positive for alcohol and drugs. The most frequently detected illicit drug was marijuana in 30/122 (24.5%) injured patients. 23/53 (43.4%) patients with positive alcohol testing self-reported alcohol use. 3/25 patients with positive illicit drug tests who were able to provide self-reports, self-reported drug use. At 30-day followup, 43 (64.2%) injured patients who tested positive for alcohol had undergone major surgery, 6 (9.0%) had died, and 36 (53.7%) had not yet returned to their baseline.
The prevalence of alcohol and illicit drugs is very high in patients presenting to the ED-MNH with injury. Further studies are needed to generalise the results in Tanzania. Public health initiatives to decrease drinking and/or illicit drug use and driving should be implemented.
酒精和非法药物已被发现是导致各种情况下严重受伤的主要因素。在坦桑尼亚，尚未对受伤患者中这些物质的使用情况进行研究。我们调查了在姆希比利国家医院（MNH）急诊科就诊的受伤患者中酒精和非法药物检测呈阳性的患病率。
这是一项前瞻性队列研究，对2015年10月和11月因受伤相关主诉到MNH急诊科就诊的连续样本中年龄大于18岁的患者进行研究。使用结构化数据表记录人口统计学信息、受伤机制、临床表现、酒精和非法药物检测结果以及急诊科处置情况。酒精水平和非法药物使用情况分别通过呼气酒精含量测定仪或酒精拭子检测以及多药物尿液检测板进行检测。通过查阅病历和电话对患者进行了24小时和30天的随访。使用描述性统计和相对风险来描述结果。
我们筛查了1011名患者，纳入了所有符合纳入标准的143名（14.1%）患者。123名（86.0%）为男性，年龄中位数为30岁（四分位间距：23 - 36岁）。最常见的受伤机制是道路交通事故（84.6%）。67/143名（46.9%）患者酒精检测呈阳性，44/122名（36.1%）患者药物检测呈阳性。29名（26.1%）患者酒精和药物检测均呈阳性。最常检测到的非法药物是大麻，在30/122名（24.5%）受伤患者中被检测到。23/53名（43.4%）酒精检测呈阳性的患者自我报告有饮酒行为。3/25名能够提供自我报告的非法药物检测呈阳性的患者自我报告有药物使用行为。在30天随访时，43名（64.2%）酒精检测呈阳性的受伤患者接受了大手术，6名（9.0%）死亡，36名（53.7%）尚未恢复到基线状态。
在MNH急诊科就诊的受伤患者中，酒精和非法药物的患病率非常高。需要进一步研究以将结果推广至坦桑尼亚。应实施公共卫生举措以减少饮酒和/或非法药物使用及驾车行为。
