scholarly journals Injury surveillance in a rural sub-Saharan setting: Results from a surveillance initiative in Nzega District, Tanzania

2016 ◽  
Author(s):  
Laura Davis ◽  
Alyssa Bechtold ◽  
Marc Kaeraa ◽  
Lukas Lacava ◽  
Michael L. Wilson
Keyword(s):  
Road Traffic ◽  
Public Health Problem ◽  
Injury Surveillance ◽  
Surveillance Systems ◽  
Middle Income ◽  
Home Setting ◽  
Middle Income Countries ◽  
Injury Mechanisms ◽  
Sub Saharan ◽  
The Individual

Introduction: Ninety percent of all injuries occur in low- and middle-income countries (LMIC) and most of these injuries are largely preventable. Most injury surveillance systems are focused in large urban settings, which largely ignore injury mechanisms in rural contexts which are critical settings for planning future prevention efforts. Methods: Injury data was collected from July 1 to July 31, 2013 at Nzega District Hospital (NDH) in central Tanzania in the form of an injury questionnaire based off of the WHO’s injury surveillance guidelines. One hundred patients were enrolled and asked questions about the location of their injury, cause of their injury, and many other contextual and demographic factors. Results: Seventy-nine percent of participants were males and the most prevalent injury cause for all participants was road traffic collisions, making up 31% of the injuries. Violence was the second most prevalent cause, accounting for 28% of the injuries, and the number one cause of injuries for women. Twenty-three percent (n=7) of patients suffering from injuries due to road traffic collisions were given a prognosis of long-term disability of six months or more. Forty-four percent of all injuries occurred in the home setting. Conclusion: The incidence rate of injuries overall of 346 per 10 000 per year is consistent with others studies conducted in LMICs and is higher than many infectious diseases that are already considered a pressing public health problem. Injuries create disabilities, which in turn creates an economic burden on the individual, health care system, and society as a whole.

scholarly journals Injury surveillance in a rural sub-Saharan setting: Results from a pilot surveillance initiative in Nzega District, Tanzania

2019 ◽  
Author(s):  
Laura Davis ◽  
Alyssa Bechtold ◽  
Marc Kaeraa ◽  
Lukas Lacava ◽  
Hamisi A. Kigwangalla ◽  
...  
Keyword(s):  
Public Health ◽  
Road Traffic ◽  
Public Health Problem ◽  
Injury Surveillance ◽  
World Health ◽  
Surveillance Systems ◽  
Middle Income ◽  
Sub Saharan ◽  
Health Organization ◽  
Low And Middle Income

Introduction: Ninety percent of all injuries occur in low- and middle-income countries and most of these injuries are largely preventable. Most injury surveillance systems are focused in large urban settings, which largely ignore injury mechanisms in rural contexts which are critical settings for planning future prevention efforts. Methods: Injury event information was collected from July 1 to July 31, 2013 at Nzega District Hospital (NDH) in central Tanzania using an injury questionnaire derived from World Health Organization injury surveillance guidelines. One hundred injured patients were enrolled and surveyed about the location of their injury, cause and other contextual and demographic factors. Results: Seventy-nine percent of participants were males and the most prevalent injury cause for all participants was road traffic collisions, making up 31\% of the injuries. Violence was the second most prevalent cause, accounting for 28\% of the injuries, and the number one cause of injuries for women. Twenty-three percent (n=7) of patients suffering from injuries due to road traffic collisions were given a prognosis of long-term disability of six months or more. Conclusion: Nzega District experienced a large number of injuries in a one-month period, consistent with other studies conducted in low- and middle-income country settings and is higher than several infectious diseases already considered pressing public health problems. More comprehensive data collection is required in order to fully understand the extent of this public health problem.

scholarly journals Injury surveillance in a rural sub-Saharan setting: Results from a pilot surveillance initiative in Nzega District, Tanzania

2019 ◽  
Author(s):  
Laura Davis ◽  
Alyssa Bechtold ◽  
Marc Kaeraa ◽  
Lukas Lacava ◽  
Hamisi A. Kigwangalla ◽  
...  
Keyword(s):  
Public Health ◽  
Road Traffic ◽  
Public Health Problem ◽  
Injury Surveillance ◽  
World Health ◽  
Surveillance Systems ◽  
Middle Income ◽  
Sub Saharan ◽  
Health Organization ◽  
Low And Middle Income

Introduction: Ninety percent of all injuries occur in low- and middle-income countries and most of these injuries are largely preventable. Most injury surveillance systems are focused in large urban settings, which largely ignore injury mechanisms in rural contexts which are critical settings for planning future prevention efforts. Methods: Injury event information was collected from July 1 to July 31, 2013 at Nzega District Hospital (NDH) in central Tanzania using an injury questionnaire derived from World Health Organization injury surveillance guidelines. One hundred injured patients were enrolled and surveyed about the location of their injury, cause and other contextual and demographic factors. Results: Seventy-nine percent of participants were males and the most prevalent injury cause for all participants was road traffic collisions, making up 31\% of the injuries. Violence was the second most prevalent cause, accounting for 28\% of the injuries, and the number one cause of injuries for women. Twenty-three percent (n=7) of patients suffering from injuries due to road traffic collisions were given a prognosis of long-term disability of six months or more. Conclusion: Nzega District experienced a large number of injuries in a one-month period, consistent with other studies conducted in low- and middle-income country settings and is higher than several infectious diseases already considered pressing public health problems. More comprehensive data collection is required in order to fully understand the extent of this public health problem.

scholarly journals Affordability and Availability of Child Restraints in an Under-Served Population in South Africa

2020 ◽  
Vol 17 (6) ◽  
pp. 1979 ◽  
Author(s):  
Prasanthi Puvanachandra ◽  
Aliasgher Janmohammed ◽  
Pumla Mtambeka ◽  
Megan Prinsloo ◽  
Sebastian Van As ◽  
...  
Keyword(s):  
South Africa ◽  
Road Traffic ◽  
Public Health Problem ◽  
Global Public Health ◽  
Injury Death ◽  
Middle Income ◽  
Suitable Alternative ◽  
Middle Income Countries ◽  
Restraint Use ◽  
Child Restraint

Background: Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa where injury death rates are 41 per 100,000 for under 5′s and 24.5 per 100,000 for 5–14-year-old. Despite their known effectiveness in reducing injuries amongst children, the rates of use of child restraint systems (CRS) remains low in South Africa. Little is known about barriers to child restraint use especially in low- and middle-income countries. Methods: We carried out observation studies and parent/carer surveys in 7 suburbs of Cape Town over a three month period to assess usage rates and explore the knowledge and perceptions of parents towards child restraint legislation, ownership and cost; Results: Only 7.8% of child passengers were observed to be properly restrained in a CRS with driver seatbelt use and single child occupancy being associated with higher child restraint use. 92% of survey respondents claimed to have knowledge of current child restraint legislation, however, only 32% of those parents/carers were able to correctly identify the age requirements and penalty. Reasons given for not owning a child seat included high cost and the belief that seatbelts were a suitable alternative. Conclusions: These findings indicate the need for a tighter legislation with an increased fine paired with enhanced enforcement of both adult seatbelt and child restraint use. The provision of low-cost/subsidised CRS or borrowing schemes and targeted social marketing through online fora, well baby clinics, early learning centres would be beneficial in increasing ownership and use of CRS.

scholarly journals Establishment of a road traffic trauma registry for northern Sri Lanka

2020 ◽  
Vol 5 (1) ◽  
pp. e001818 ◽  
Author(s):  
Thayasivam Gobyshanger ◽  
Alison M Bales ◽  
Claire Hardman ◽  
Mary McCarthy
Keyword(s):  
Sri Lanka ◽  
Low Income ◽  
Trauma Registry ◽  
Road Traffic ◽  
Prehospital Care ◽  
Public Health Problem ◽  
Global Public Health ◽  
Middle Income ◽  
Road Traffic Crashes ◽  
Middle Income Countries

Road traffic injuries are a neglected global public health problem. Over 1.25 million people are killed each year, and middle-income countries, which are motorising rapidly, are the hardest hit. Sri Lanka is dealing with an injury-related healthcare crisis, with a recent 85% increase in road traffic fatality rates. Road traffic crashes now account for 25 000 injuries annually and 10 deaths daily. Development of a trauma registry is the foundation for injury control, care and prevention. Five northern Sri Lankan provinces collaborated with Jaffna Teaching Hospital to develop a local electronic registry. The Centre for Clinical Excellence and Research was established to provide organisational leadership, hardware and software were purchased, and data collectors trained. Initial data collection was modified after implementation challenges were resolved. Between 1 June 2017 and 30 September 2017, 1708 injured patients were entered into the registry. Among these patients, 62% were male, 76% were aged 21–50, 71.3% were motorcyclists and 34% were in a collision with another motorcyclist. There were frequent collisions with uncontrolled livestock (12%) and with fixed objects (14%), and most patients were transported by private vehicles without prehospital care. Head (n=315) and lower extremity (n=497) injuries predominated. Establishment of a trauma registry in low-income and middle-income countries is a significant challenge and requires invested local leadership; the most challenging issue is ongoing funding. However, this pilot registry provides a valuable foundation, identifying unique injury mechanisms, establishing priorities for prevention and patient care, and introducing the concept of an organised system to this region.

scholarly journals Pattern of Severity of Road Traffic Injuries Among Pedestrians in Low- and Middle-Income Countries: A Systematic Review

2021 ◽  
Author(s):  
Neeraj Sharma ◽  
Mohan Bairwa ◽  
S. D. Gupta ◽  
D. K. Mangal
Keyword(s):  
Systematic Review ◽  
Injury Severity ◽  
Road Traffic ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Road Traffic Injuries ◽  
Middle Income Countries ◽  
Sub Saharan ◽  
Low And Middle Income

ABSTRACTBackgroundLow-and middle-income countries (LMICs) contribute about 93 per cent of road traffic injuries (RTIs) and deaths worldwide with a significant proportion of pedestrians (22 per cent). Various scales are used to assess the pattern of injury severity, which are useful in predicting the outcomes of RTIs. We conducted this systematic review to determine the pattern of RTI severity among pedestrians in LMICs.MethodsWe searched the electronic databases PubMed, CINHAL, CENTRAL, Web of Science, Scopus, EMBASE, ProQuest and SciELO, and examined the references of the selected studies. Original research articles published on the RTI severity among pedestrians in LMICs during 1997-2016 were eligible for this review. Quality of publications was assessed using an adapted Newcastle-Ottawa Scale of observational studies. Findings of this study were presented as a meta-summary.ResultsFive articles from 3 LMICs were eligible for the systematic review. Abbreviated Injury Score, Glasgow Coma Scale and Maxillofacial Injury Severity Score were used to assess the injury severity in the selected studies. In a multicentric study from China (2013), 21, 38 and 19 per cent pedestrians with head injuries had AIS scores 1-2, 3-4 and 5-6, respectively. In another study from China (2010), the proportion of AIS score 1-2 and AIS score 3 and above (serious to un-survivable) injuries occurred due to crash with sedan cars were 65 and 35 per cent, respectively. Such injuries due to minivan crashes were 49.5 per cent and 50.5 per cent, respectively. Two studies Ikeja, Nigeria (2014) and Elazig, Turkey (2009) presented, 24.5 and 32.5 per cent injured had a severe head injury (GCS < 8), respectively. In another study from Ibadan, Nigeria (2014), the severe maxillofacial injuries were seen in the victims of car/minibus pedestrian crashes 46 per cent, and 17 per cent had a fatal outcome.ConclusionA varied percent of pedestrians (24.5 to 57 percent) had road traffic injuries of serious to fatal nature, depending on type of collision and injury severity scale. This study pressed the need to conduct studies with a robust methodology on the pattern of RTI severity among pedestrians to guide the programme managers, researchers and policymakers in LMICs to formulate the policies and programmes to save the pedestrian lives.African relevancePrior RTI research reveals that pedestrians and cyclists were at the highest risk of fatality of in Sub-Saharan Africa, whereas motorcyclists had significantly higher fatality rates in Asian countries such as Malaysia and Thailand (1–3).Fifty-seven type of injury severity scoring systems have been developed to assess the injury severity for triage and timely decision making for patient treatment need, outcome prediction, quality of trauma care, and epidemiological research and evaluation (4,5).We found two studies from sub-Saharan Africa in this review which showed that severe pedestrian injuries ranged from 24.5 to 46 per cent of total pedestrian RTIs.Despite the findings of review affected by limited and variegated sample, it could be useful to guide for future research.

scholarly journals Factors related to road accidents in Palembang, South Sumatera, Indonesia

2021 ◽  
Vol 10 (3) ◽  
pp. 638
Author(s):  
Desheila Andarini ◽  
Anita Camelia ◽  
Mochammad Malik Ibrahim
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Road Accidents ◽  
Middle Income ◽  
Police Station ◽  
The Road ◽  
Middle Income Countries ◽  
Traffic Injury

Road traffic injuries are a major public health problem and a leading cause of death and injury worldwide. More than 90% of all road deaths occur in lowand middle-income countries, which own less than half of the world's vehicles. The research aimed was to identify the factors related to road accidents in Palembang, Indonesia. The research method used was qualitative approach by using in-depth interviews and observation. This research was conducted from August to December, 2019. The results showed that the factors related to road accidents were human factor, environmental and climatic factor. From this research, the working areas identified as accidentprone zone were Sukarami II and Ilir Barat I Police Station. Referring to the accident and interviews, it is known that the road locations that have the highest casualties were in the road of Kolonel H. Barlian, Jendral Sudirman, Demang Lebar Daun, Ahmad Yani, and Soekarno Hatta. The conclusion was the accident-prone zone located on the main arterial road in Palembang City, Jendral Sudirman Road with a total of 81 cases of traffic accidents in the last three years that need further investigation to minimize traffic injury.

scholarly journals Diversion, Misuse and Abuse of Prescription Drugs in Upper-Middle-Income Countries: Narrative Literature Review

2019 ◽  
Vol 11 (12) ◽  
pp. 27
Author(s):  
Buyisile Chibi ◽  
Tivani P Mashamba-Thompson
Keyword(s):  
Prescription Drugs ◽  
Behavioural Change ◽  
Public Health Problem ◽  
Screening Tools ◽  
Surveillance Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Regulatory Policies ◽  
Drug Diversion ◽  
Factors Influencing

Globally, the diversion, misuse, and abuse of prescription drugs is a growing public health problem. This narrative review focused on factors influencing this problem in Upper-Middle-Income Countries. The literature reports that factors related to health systems and health providers such as retail pressure, insufficient consultation time, lack of screening tools, ineffective monitoring and surveillance systems, poor implementation of regulatory policies, lack of strict enforcement of prescribing policies as well as lack of specialized training perpetuate the problem. Evidence suggests that consumers with lack of appropriate knowledge about medication use, lack of awareness regarding potential risks, and poor attitude toward medication usage were more likely to engage into drug diversion and misuse. Based on a critical reflection of the literature, we propose a framework that outlines interventions needed to halt factors influencing drug diversion, misuse and abuse through a collaborative approach that will enable behavioural change and reduce the risk of harmful health outcomes.

scholarly journals A Fatal and Rare Case of Hydatid Cyst in the Pouch of Douglas

2021 ◽  
Author(s):  
Ritu Asnani ◽  
Sunil Kumar Yeshvanth ◽  
Lancelot Lobo ◽  
Shipra Sonkusare
Keyword(s):  
Hydatid Cyst ◽  
Rare Case ◽  
Frozen Section ◽  
Public Health Problem ◽  
Zoonotic Infection ◽  
Middle Income ◽  
Middle Income Countries ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Pouch Of Douglas

Abstract Hydatid cyst is a zoonotic infection and a significant public health problem in low- and middle-income countries. A 79-year-old female patient was presented to the gynecology outpatient department with complaints of pain in the abdomen and difficulty in micturition, with a mass palpable per speculum. The ultrasound was suggestive of an ovarian cystadenocarcinoma, whereas computed tomography of the abdomen favored hydatid cyst with adnexal neoplasm as a differential diagnosis. Considering the contradictory findings, a frozen section was sent to confirm the diagnosis, which showed hooklets of Echinococcus granulosus/hydatid cyst under the microscope. This was a rare case of pelvic hydatid cyst mimicking ovarian malignancy and was associated with a less-preferred mode of investigation (frozen section). This article focuses on how a frozen section, despite its limitations and being expensive, can still be considered for accurate patient management.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

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