Trauma Care in Nigeria: Time for an Integrated Trauma System.

Isaac C Okereke,Ubaid Zahoor,Omar Ramadan

doi:10.7759/cureus.20880

Abstract

Traumatic injuries are a global health problem. Most first world countries have developed comprehensive trauma systems to provide optimal care for injured patients. A trauma system is a coordinated effort in a defined geographic area that attempts to deliver trauma care to all injured patients and is usually integrated with the local public health system.The majority of low and middle income countries (LMIC) do not have functional trauma systems. This study aims to critique the status of trauma care in Nigeria and make a case for a re-organisation towards an inclusive trauma system.The methodology was a review of published articles and available grey literature to assess current practices in Nigeria within the various components of a trauma system, viz., injury prevention, pre-hospital care, acute care, and rehabilitation.The conclusions from this review suggest that integrating existing major trauma centres (MTCs) with smaller local hospitals within a region into an inclusive, interconnected region-based trauma system is the cheapest and most efficient way to improve Nigeria's trauma care and significantly reduce trauma mortality rates.

Highlights

BackgroundGlobally, traumatic injuries affect nearly 5.8 million people annually and are the leading cause of lost years of life, estimated to result in 500 years of lost productivity annually per 100,000 population [1,2]
The conclusions from this review suggest that integrating existing major trauma centres (MTCs) with smaller local hospitals within a region into an inclusive, interconnected region-based trauma system is the cheapest and most efficient way to improve Nigeria's trauma care and significantly reduce trauma mortality rates
The public health implications of trauma are more concerning in lower-middle-income countries (LMIC) like Nigeria, where urbanisation and industrialisation [3] without concurrent developments in the health systems have caused a shift in disease epidemiology towards more chronic illnesses and acute traumatic injuries

Summary

Introduction

BackgroundGlobally, traumatic injuries affect nearly 5.8 million people annually and are the leading cause of lost years of life, estimated to result in 500 years of lost productivity annually per 100,000 population [1,2]. The public health implications of trauma are more concerning in lower-middle-income countries (LMIC) like Nigeria, where urbanisation and industrialisation [3] without concurrent developments in the health systems have caused a shift in disease epidemiology towards more chronic illnesses and acute traumatic injuries. LMICs account for 90% of the global trauma morbidity and mortality rates, with more than 50% of all injuries occurring in Sub-Saharan Africa (SSA). A noticeable feature of LMICs that further worsens outcomes is the skewed distribution of resources: the most advanced medical facilities and personnel are in major cities. The implication of this is that the inhabitants of rural areas will often never reach these superior treatment facilities

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Conclusion