Epidemiology of adult trauma injuries in Malawi: results from a multisite trauma registry
This study analyses prevalence, causes, and distribution of trauma in adult patients, and timeliness of transport to health facilities
Abstract
Large-scale multisite trauma registries with broad geographic coverage in low-income countries are rare. This lack of systematic trauma data impedes effective policy responses. All patients presenting with trauma at 10 hospitals in Malawi from September 2018 to March 2020 were enrolled in a prospective registry. Using data from 49,241 cases, we analyze prevalence, causes, and distribution of trauma in adult patients, and timeliness of transport to health facilities and treatment. Falls were the most common mechanism of injury overall, but road traffic crashes (RTCs) were the most common mechanism of serious injury, accounting for (48%) of trauma admissions. This pattern was consistent across all central and district hospitals, with only one hospital recording < 40% of admissions due to RTCs. 49% of RTC-linked trauma patients were not in motorized vehicles at the time of the crash. 84% of passengers in cars/trucks/buses and 48% of drivers of cars/trucks/buses from RTCs did not wear seatbelts, and 52% of motorcycle riders (driver and passenger) did not wear helmets. For all serious trauma cases (defined as requiring hospital admission), median time to hospital arrival was 5 h 20 min (IQR 1 h 20 min, 24 h). Significant predictors of hospital admission include being involved in an RTC, age > 55, Glasgow Coma Score < 12, and presentation at hospital on a weekend. Greater attention to safety for both motorized and especially non-motorized road users, and more timely, higher quality emergency medical services, are important policy priorities for Malawi and other developing countries with high burdens of RTC trauma.
This work is part of the ieConnect for Impact programme
Citation
Chokotho, L., Croke, K., Mohammed, M., Mulwafu, W., Bertfelt, J., Karpe, S., & Milusheva, S. (2022). Epidemiology of adult trauma injuries in Malawi: Results from a multisite trauma registry. Injury Epidemiology, 9(1), 14. https://doi.org/10.1186/s40621-022-00379-5
Link
Epidemiology of adult trauma injuries in Malawi: results from a multisite trauma registry