Abstract
BackgroundMusculoskeletal injuries are a common cause of morbidity after road traffic injury (RTI) in motorizing countries. District hospitals provide front-line orthopedic care in Uganda and other sub-Saharan African nations. Improving care at the district hospital level is an important component of the World Health Organization’s strategy for surgical and trauma systems strengthening, but the data necessary to inform RTI safety and care initiatives has previously been insufficient at the district hospital level. The objective of this study was to provide data on the patient population and patterns of musculoskeletal injury caused by RTI at Ugandan district hospitals.MethodsIn this cross-sectional study, all patients with musculoskeletal injuries identified on x-ray presenting to three Ugandan district hospitals from October 2013 to January 2014 were interviewed and examined to obtain data on patient demographics and injury context by road user category. This manuscript is a sub-group analysis of RTI victims from a broader dataset of all musculoskeletal injuries.ResultsVulnerable road users comprised 92 % of musculoskeletal RTI patients, with 49 % (95 % CI 41–57 %) pedestrians, 41 % (95 % CI 33–49 %) motorcyclists, and 2 % (95 % CI 0–4 %) cyclists. Commonly injured subgroups included student pedestrians (33 % (95 % CI 22–44 %) of pedestrians) and motorcyclists with less than a post-secondary education (74 % (95 % CI 63–85 %) of motorcyclists). The morning hours were the most common time of injury for all RTI patients (37 %%; 95 % CI 30–44 %) and motorcyclists (46 %; 95 % CI 34–58 %), while pedestrians were most commonly injured in the evening (32 %; 95 % CI 21–43 %).ConclusionsBy demonstrating commonly injured demographic groups and high frequency times of day for injury, this surveillance study of musculoskeletal RTI suggests targeted avenues for future road safety research in the districts of Uganda. Compared with previous studies from the capital of Uganda, these results suggest that Ugandan district hospitals care for a disproportionate share of vulnerable road users, a discrepancy which may pertain to other sub-Saharan African nations, as well. Strengthening district hospital orthopedic care should be considered a priority of strategies aimed at improving outcomes for these vulnerable groups.
Highlights
Musculoskeletal injuries are a common cause of morbidity after road traffic injury (RTI) in motorizing countries
We found high proportions of vulnerable road users among the district hospital RTI patients, with 49 % pedestrians, 41 % motorcyclists, and 2 % cyclists (Fig. 1)
The morning hours were the most common time of injury for all RTI patients as well as for motorcyclists, while pedestrians were most commonly injured in the evening
Summary
Musculoskeletal injuries are a common cause of morbidity after road traffic injury (RTI) in motorizing countries. District hospitals provide front-line orthopedic care in Uganda and other sub-Saharan African nations. The objective of this study was to provide data on the patient population and patterns of musculoskeletal injury caused by RTI at Ugandan district hospitals. Road traffic injuries (RTI) are a major and growing cause of morbidity and mortality in low- and middle-income countries (LMICs). Studies from Uganda (Naddumba 2004; Galukande et al 2009), Tanzania (Chalya et al 2012), Nigeria (Okoro & Ohadugha 2010; Eluwa et al 2010; Akinpelu et al 2007), and Cameroon (McGreevy et al 2014; Juillard et al 2014) found that extremity injuries were the most common type of injury among patients presenting for care after RTI. As RTI rates increase, so does the importance of providing quality musculoskeletal care throughout sub-Saharan Africa
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