Radan Bojana, Ogendi Japheths, Charyk Stewart Tanya, Shkrum Michael
Department of Community and Family Medicine, University of Toronto, Toronto, Canada.
School of Health Sciences, Mount Kenya University, Kigali, Rwanda.
Traffic Inj Prev. 2022;23(sup1):S155-S160. doi: 10.1080/15389588.2022.2115295. Epub 2022 Sep 12.
Road traffic injury (RTI) is a major public health concern in Kenya with more than 13,000 deaths estimated annually. The primary objective of this study was to design and implement an injury surveillance tool for the collection of injury data, and assess the tool's feasibility for the development of a hospital-based trauma registry in a leading Kenyan referral hospital. Secondarily, an epidemiologic profile was created to characterize RTI in the region.
An injury surveillance tool was developed and implemented, on a pilot basis, in a level 5 trauma hospital, Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), in Kisumu City, Western Kenya, for a 4-week period from 2019-07-15 to 2019-08-11. A descriptive statistical analysis summarized injury frequency counts and percentages.
Over the pilot phase, 371 patients had forms completed, but 488 official injury-related hospital registrations, indicating that 117 injury patients (24%) were missed. A process evaluation of the tool implementation revealed issues in the collection protocol that required revisions, resulting in improved data form completeness rates. For the 368 cases with cause documented, the most common mechanisms of injury were RTI (46.5%; = 171), assaults (23.9%; = 88), and falls (14.9%; = 55). For RTI patients, the median age was 28 years (IQR = 16) and 77% ( = 132) were males, with motorbike collision injuries ( = 91; 53.2%) the leading RTI mechanism. There were 348 injuries for 171 patients. The most common anatomical regions for RTI were the lower limb 32.8% ( = 114), upper limb (15.2%; = 53), followed by head lacerations 8.6% ( = 30) and concussions 7.2% ( = 25). Two-thirds of patients ( = 113; 66.1%) were discharged from ED, just over a quarter ( = 46; 26.9%) were admitted to hospital and 9 patients succumbed to RTI (5.3%).
This injury surveillance pilot study produced the first injury dataset in Kisumu City, demonstrating the significant magnitude of RTI in Western Kenya, the leading cause of injury for the region. This dataset can be replicated in other hospitals to create an injury surveillance system for the collection of trauma data, needed for the development of countermeasures for the reduction of trauma, as well as for quality initiatives to improve patient outcomes.
道路交通伤害（RTI）是肯尼亚主要的公共卫生问题，据估计每年有超过13000人死亡。本研究的主要目的是设计并实施一种伤害监测工具以收集伤害数据，并评估该工具在肯尼亚一家领先的转诊医院建立基于医院的创伤登记册的可行性。其次，创建了一份流行病学概况以描述该地区的道路交通伤害情况。
在肯尼亚西部基苏木市的一家5级创伤医院——贾拉莫吉·奥金加·奥廷加教学与转诊医院（JOOTRH），于2019年7月15日至2019年8月11日的4周时间内，试点开发并实施了一种伤害监测工具。进行描述性统计分析以总结伤害发生频率计数及百分比。
在试点阶段，有371名患者的表格填写完成，但有488份与伤害相关的医院正式登记，这表明有117名受伤患者（24%）被遗漏。对工具实施情况的过程评估揭示了收集方案中需要修订的问题，从而提高了数据表格的完整性率。对于368例有原因记录的病例，最常见的伤害机制是道路交通伤害（46.5%；n = 171）、袭击（23.9%；n = 88）和跌倒（14.9%；n = 55）。对于道路交通伤害患者，中位年龄为28岁（四分位间距 = 16），77%（n = 132）为男性，其中摩托车碰撞伤害（n = 91；53.2%）是主要的道路交通伤害机制。171名患者有348处伤害。道路交通伤害最常见的解剖部位是下肢32.8%（n = 114）、上肢（15.2%；n = 53），其次是头部裂伤8.6%（n = 30）和脑震荡7.2%（n = 25）。三分之二的患者（n = 113；66.1%）从急诊科出院，略超过四分之一（n = 46；26.9%）住院，9名患者死于道路交通伤害（5.3%）。
这项伤害监测试点研究在基苏木市产生了首个伤害数据集，表明道路交通伤害在肯尼亚西部规模巨大，是该地区伤害的主要原因。该数据集可在其他医院复制，以创建一个伤害监测系统来收集创伤数据，这对于制定减少创伤的对策以及改善患者预后的质量改进举措是必要的。
