Injuries In Ghana Research Articles

Prevalence and characteristics of paediatric burns at the National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Ghana

IntroductionBurn injuries among children have emerged as a significant global public health concern, accounting for substantial morbidity and mortality worldwide. Low and Middle-Income Countries bear a significant burden of paediatric burn injuries. In Ghana, limited data exists on the prevalence, characteristics and outcomes of paediatric burns. This study provides vital data on the local burden and epidemiology of paediatric burns at Ghana’s main burns treatment center. The findings have significant value in informing prevention strategies, allocating resources, and improving quality of paediatric burn care. Study objectiveTo establish the prevalence and characteristics of paediatric burns injuries in Ghana’s leading burn center. MethodologyA retrospective cohort study analyzed data from 662 adult and paediatric patients who presented with burns from all over Ghana between 2020 and 2022. The study encompassed medical records of paediatric burn cases (aged 0–14 years) admitted to the center from January 2020 to December 2022. A purposive sampling technique was used to select cases based on the inclusion criteria and elimination of cases with 20 % missing data. A total of 335 paediatric records were reviewed. Data analytical methodsDescriptive statistics, such as frequencies, mean, percentages were used to establish period prevalence and demographic characteristics of paediatric burns. Chi-square analysis and univariate logistic regression was utilized to explore associations between categorical variables, and predictors of burn outcome. ResultsThe period prevalence of paediatric burns was found to be 50.6 %. Paediatric burn cases predominantly affected males (57.6 %). Majority of cases fell within the age range of 1 to 5 years (70.1 %). Hot water emerged as the leading cause (58.4 %), whiles superficial partial thickness burns (51.9 %) was the predominant type of burn. Most cases involved burns affecting less than 20 % Total Body Surface Area (59.0 %). Multi-part body injuries were common (87.2 %), with the lower limb being the most affected (25.36 %). The mortality rate was calculated to be 21.0 %. Higher TBSA was a significant predictor of mortality (p < 0.001). ConclusionThis study found a high prevalence of paediatric burns with hot water and foods being the predominant causes. Higher TBSA predicted lower chances of survival. The findings have scientific value in informing prevention strategies, allocating resources, and improving the quality of care.

The Pattern, Management and Outcome of Genitourinary Trauma in Ghana

Objectives: This is to review the pattern of causes, management and outcome of genitourinary(GU) injuries managed at the Korle Bu and the 37 Military Teaching Hospitals from 1978 to 2010.&#x0D; Patients and Methods: Prospectively cases of genitourinary trauma from 1978 to 2010 were studied at the Korle Bu and 37 Military Teaching Hospitals. Patient history and clinical examination was taken and classified into haemodynamically stable or unstable condition. Stable patients were admitted and investigated whilst unstable patients were stabilised and operated. Investigations were based on the injuries sustained and included a full blood count , plain and contrast radiological investigations and computerised tomography .&#x0D; Results: A total of 523 cases (460 cases from Korle Bu teaching hospital from 1978 to 2001 and 63 cases from 37 Military Hospital from 2001 to 2010) were managed made up of 412 males (78.8%) and 111 females (21.2%) with a male to female ratio of 4 to 1. The youngest was 4 years and the oldest was 64 years. Sites affected included 38 renal (7.3%), 63 ureteral (12.1%), 109 bladder (20.8%), 233 urethral (44.6%) and 54 external genital (10.3%). Causes included road traffic accidents (49.5%), industrial accidents (0.77%), falls (16.8%), high (1.15%) and low (2.7%) velocity injuries, bites (0.57%), iatrogenic (23.71%) and idiopathic (0.2%). Presentation included haematuria (80%), urinary retention (8%), anuria plus abdominal pain /peritonitis (10%) and 2% with peritonitis. Management was 57 (10.8%) conservative and 466 (89.2%) operative. Outcome was 462 (88.3%) recovery, 47 (8.9%) with complications and 14 (2.64%) deaths. &#x0D; Conclusion: Commonest causes of Genitourinary injuries in Ghana include Road traffic accidents 259(49.5%), Iatrogenic causes 124 (23.7%) and Falls 88 (16.8%). Early intervention in unstable patients prevents mortality .

Observing pedestrian-vehicle traffic conflicts in school zones to evaluate the effectiveness of road safety interventions and reduce injuries in Ghana, Vietnam, and Mexico, 2019-2021.

Daily more than 3,000 children are injured or killed on the road, often along the school route. Road traffic crashes and resulting injuries are preventable. More can be done to reduce injuries and save lives. Traffic Conflict Techniques (TCTs) are simple methods of collecting observational data to evaluate the effectiveness of road safety interventions through counting and analyzing traffic conflicts. A TCT Toolkit was developed and piloted to analyze pedestrian-vehicle traffic conflicts in school zones in low- and middle-income countries. Three non-governmental organizations in Ghana, Vietnam, and Mexico applied three TCTs from the TCT Toolkit to collect traffic conflict data before (pre-intervention) and after (post-intervention) road safety intervention implementation. As the number of traffic conflicts was often less than 100, confidence intervals (CIs) based on gamma distributions were calculated for the traffic conflict rate. Using the calculated traffic conflict rate, the difference between pre- and post-intervention rates was assessed by determining overlap of the CIs. When CIs did not overlap, the difference was said to be statistically significant at the 0.05 level. For each method, results indicated a decrease in traffic conflicts between pre- and post-intervention data collection periods. Pre- and post-intervention traffic conflict rates with non-overlapping CIs demonstrated the results were statistically significant, providing evidence that the road safety interventions were effective. TCTs are relatively low-cost and simple techniques that provide an opportunity to base road safety improvement decisions on real-world data. TCTs are effective in objectively evaluating road safety interventions and can help decision-makers evaluate strategies for improving road safety, preventing injuries and saving lives.

Factors associated with birth injuries in neonates admitted to the neonatal intensive care unit: a retrospective study in a Ghanaian tertiary care setting

Background: A birth injury is structural damage or functional deterioration of the neonate’s body due to a traumatic incident at birth. The prevalence and the type of birth injury vary from place to place. There is paucity of data on the prevalence of birth injuries in Ghana. Objective: The study aimed to determine the prevalence and factors associated with birth injury in neonates admitted in a tertiary institution in Northern Ghana. Methods: This was a quantitative retrospective study carried out on neonates admitted to the neonatal intensive care unit (NICU) of the Tamale Teaching Hospital between January 2018 through December 2019. Results: Out of 5590 neonates admitted to the NICU, 205 were noted to have various forms of birth injury corresponding to a prevalence of 3.66%(37 per 1000 neonates admitted to our unit). Majority were male (n=123/205, 60.0%), most deliveries occurred in the study hospital(n=143/205, 69.75%), and spontaneous vaginal delivery accounted for 70.73% (n=145/205). Extracranial injuries (n=146/221, 66.06%) were the most common form of birth injury. Next was musculoskeletal injuries (n=41/221, 18.55%) with humeral fractures (n=15/221, 6.78%) being the most frequent in this category. Among the neonates with birth injuries there were 23 deaths recorded (11.22%) all but one of whom had associated birth asphyxia. Birth injuries were significantly associated with place of delivery(p=0.029). Out-born babies were more likely to have extracranial injuries (adjusted odds ratio,5.10; 95% CI: 1.53-16.94;p=0.008). Conclusion: Extracranial injuries were the most common in this study. Place of delivery was significantly associated with birth injuries. Building the capacity of health care professionals is essential to reduce incidence of birth injuries. Some of these injuries can be avoided if high risk pregnancies are referred early to institutions that have the resources and skill to deliver such babies.

An assessment of the training and practice of circumcision by medical circumcisers in Ghana

BackgroundCircumcision is a common procedure in most parts of sub-Saharan Africa with an estimated prevalence of 95% in Ghana. It has been documented that most circumcision related injuries in Ghana occur after circumcision by health care professionals who perform these circumcisions in hospitals and other healthcare facilities. In spite of the high rates of circumcision in Ghana, the expertise of circumcision providers and the safety of their practice has not been assessed. This study evaluates the training and practice of circumcision by health care professionals from across the country.MethodsThis is a questionnaire-based study of health care professionals who perform circumcision in Ghana. Data was extracted from pre-conference evaluation questionnaire completed by participants attending a circumcision training workshop from January to October 2019. These participants included responses on their training and practice of circumcision. Data was captured using the Epi-data software and analyzed with PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc.ResultsThere were 378 participants seen over the study period who already performed circumcision. The majority of them were midwives 281 (74.3%), followed by general nurses 89 (23.5%). The duration of practice of circumcision ranged from 4 months to 23 years and one-third of them (33.3%) had practiced circumcision for less than 1 year. The forceps guided technique was the most common (53.2%) circumcision technique used followed by the dorsal slit technique (24.1%). None of these participants who performed circumcision had any formal training on the procedure and all of them had experienced at least one adverse event such as excessive bleeding, insufficient skin coverage or redundant foreskin. Six (6) of them had seen patients who reported later with urethrocutaneous fistula and two of them had caused glans amputations. Only 102 (27%) of these participants offered anesthesia for circumcision.ConclusionThe majority of medical circumcisers in Ghana have no formal training for circumcision. They require formal circumcision training and certification to improve the practice of circumcision in Ghana.

Epidemiology of injuries presenting to the accident centre of Korle-Bu Teaching Hospital, Ghana

BackgroundInjuries directly lead to 5 million deaths every year, accounting for 9% of all deaths worldwide. While knowledge of the pattern of injuries is essential to plan health interventions to reduce the incidence of injuries, these are not thoroughly described in Ghana. The aim of this study was to describe the epidemiology of injuries seen at the Accident centre of the Korle-Bu Teaching Hospital, Ghana’s main referral hospital.MethodA retrospective review of two-year records of all patients who attended the Accident centre of the Korle-Bu Teaching Hospital from January 2016 to December 2017 was done. Data on the cause of injuries was the main focus of this review.ResultsA total of 17,860 patients’ records were included in the study. There were 12,116 (67.8%) males and 5,744 (32.2%) females. The ages of the patients seen during the period ranged from three (3) days to 101 years. The overall mean age was 27.9 (±18.2). Majority of the injuries resulted from road traffic accidents and falls, accounting for 39.1 and 19.7% respectively.ConclusionRoad Traffic accidents (RTA), especially motorcycle related, are a significant cause of injuries in Ghana. Future studies should focus on interventions that can reduce the incidence of RTA’s to reduce the number of injuries that present to the Korle-Bu Teaching Hospital.

Experiences of burn patients in Ghana: A qualitative study at the Korle-Bu Teaching Hospital in Accra

Background: Statistics on the trends of burn injuries in Ghana, Africa, and the world at large indicate unacceptable number of lives lost through burns. Aside these deaths, individuals who survive suffer lots of physical and psychological burdens as a result of long hospitalization and pain from the regular wound dressing, and physical deformities in severe cases. This study focused on the sources of burns, types of burns, how burns are managed, and the effects of burns on victims to enable an empirical basis for formulating preventive educational materials for awareness creation and preventive education. Methodology: We employed a case study design and purposively selected 20 participants made up of 15 adults and 5 caregivers of children with burns who were receiving treatment at the Reconstructive, Plastic Surgery, and Burns Centre of the Korle-Bu Teaching Hospital in Accra for the study. In-depth interviews were conducted with participants to ascertain the type and sources of burns incurred, and their experiences with the study facility and living with the consequences of burns. Recorded interviews were transcribed and analyzed based on themes with the study objectives as a guide. Results: The majority of participants had third-degree burns from explosive sources either at their place of residence or the work-place. The physical and psychological effects of burns have been unbearable. Their encounter with the study facility has been pleasant with few challenges related to the cost of treatment, some personnel, and waiting time. Conclusion: Massive education on burns and the prevention of accidental burns in Ghana is needed. Training of more personnel to handle patients in a professional manner and cost of care of burn patients should be placed on the agenda of all relevant stakeholders in the country.

Causes, trends and severity of musculoskeletal injuries in Ghana

BackgroundMusculoskeletal [MSK] injuries are common causes of long-term pain and physical disability which affect many people worldwide. The economic and social impacts on the individual, society and national health systems are enormous making a matter of public health concern. Therefore, this study examined the causes and extent of MSK injuries in a referral hospital in Ghana.MethodsA prospective study design with consecutive sampling method was used to recruit patients admitted at Trauma Unit as well as those receiving orthopaedic reviews at St. Joseph’s Orthopaedic Hospital over a ten-month period. A structured questionnaire, Visual Analogue Scale (VAS) and Abbreviated Injury Scale (AIS) were used to collect data which were analysed descriptively using SPSS version 20.ResultsA total of 269 MSK injury patients were identified - of these, 137 (50.9%) males with an average age of 38 years (SD = 19.88). Nearly half (49.1%) of the injuries sustained were fractures, and common causes were vehicular crash 113 (42.0%) and fall 68 (25.3%). Body parts affected most were the knee (19.62) and the mean levels of pain for all injuries were 6.04 ± 2.44 and 3.25 (±1.50) respectively.ConclusionGhana needs a healthy population to steer its development trajectory. Policy makers in Ghana should pay attention to both preventive as well as management of MSK injuries, or else, most of the country’s working class could live with lasting effects of injuries which may have significant impacts on the economy.

Circumcision-related tragedies seen in children at the Komfo Anokye Teaching Hospital, Kumasi, Ghana.

BackgroundCircumcision is a common minor surgical procedure and it is performed to a varying extent across countries and religions. Despite being a minor surgical procedure, major complications may result from it. In Ghana, although commonly practiced, circumcision-related injuries have not been well documented. This study is to describe the scope of circumcision-related injuries seen at the Komfo Anokye Teaching Hospital in Kumasi, Ghana.MethodsThe study was conducted at the Urology Unit of the Komfo Anokye Teaching Hospital in Kumasi. Consecutive cases of circumcision-related injuries seen at the unit over an 18 month period were identified and included in the study. Data was collected using a structured questionnaire. Data was entered and analysed using SPSS version 16. Charts and tables were generated using Microsoft Excel.ResultsA total of 72 cases of circumcision-related injuries were recorded during the 18 month period. Urethrocutaneous fistula was the commonest injury recorded, accounting for 77.8 % of cases. Other injuries recorded were glans amputations (6.9 %); iatrogenic hypospadias (5.6 %), and epidermal inclusion cysts (2.8 %). The majority of children were circumcised in health facilities (75 %) and nurses were the leading providers (77.8 %). The majority of circumcisions were conducted in the neonatal period (94.7 %).ConclusionCircumcision-related injuries commonly occurred in the neonatal period. Most of the injuries happened in health facilities. The most common injury recorded was urethrocutaneous fistula but the most tragic was penile amputation. There is the need for education and training of providers to minimise circumcision-related injuries in Ghana.

Road use behaviour of urban primary school children in Ghana: case study of Ablekuma South Education Circuit of Metropolitan Accra

BackgroundApproximately 300 children die through traffic injuries annually in Ghana and school children are the majority.ObjectiveTo observe the road use behaviour of urban public primary school pupils in the Ablekuma...

PREVALENCE OF DRUNK DRIVING IN GHANA

BackgroundAlcohol impairment is and established risk factor for the incidence and severity of road traffic crashes. Whereas the developed countries have dedicated resources to combating this menace, drunk-driving research and...

Evaluation of speed humps on pedestrian injuries in Ghana

ObjectiveTo evaluate the effectiveness of speed humps in reducing pedestrian crashes at selected settlements located along the Konongo-Kumasi highway.Materials and MethodsThe study adopted before and after comparison of police reported...

Peripheral vascular injuries and their management in Accra

The true incidence of vascular injuries in Ghana is not known on account of low reporting. We performed a study aimed at reviewing the pattern of injuries to peripheral vessels, and also the pattern of referral, presentation and management of these injuries at the Korle-Bu Teaching Hospital, Accra. The study covered the period of January 1989 to March 2005 and involved a review of all peripheral vessel injuries referred for vascular surgical opinion. Fifty two (52) patients with aged between 13-50 years were reviewed. Penetrating trauma (82.7%) and blunt trauma (11.5%) were the commonest modes of injury. Arterial injuries (63.5%) and combined arterial and venous injuries (23.1%) were the commonest forms of injury. Brachial artery injuries were the commonest injuries seen. Associated nerve injuries occurred in 25% of patients most of whom also had brachial artery injuries. Late presentations of false aneurysms and arteriovenous fistulae were seen in 40.4% patients. There were delays in referring patients (range 1 hour to 4 years). Vascular investigations like angiograms and duplex scanning were obtained in only 25.0% of patients. Vascular reconstruction was successful in 84.6% patients and 7.7% of patients required major limb amputation and an equal number of patients died from other injuries. There is undue delay in referring patients with vascular injuries for intervention due to the inability of the initial attending medical personnel to recognize these injuries. Most of these injuries can be adequately treated without the use of sophisticated investigations, which are usually expensive.

Study of Vehicle Speeds on a Major Highway in Ghana: Implication for monitoring and control

Objective. Vehicular speeds have been identified to be at the core of road accident severity and frequency globally. Whereas speed control is a fundamental priority and the cornerstone of road safety in the developed world, the subject is at rudimentary stages in most developing countries thus making research into vehicle speeds in developing nations imperative. The main aim of the study was to establish two major speed parameters, namely the mean speed and dispersion, and their implications for more extensive and long-term speed monitoring in Ghana. Methods. Research workers stationed themselves in a parked car and used a radar gun to unobtrusively measure the travelling speeds of 4,163 vehicles over two 24-hour periods at two separate sites on one of the main inter-urban roads (Accra-Kumasi). Both sites were settled areas with posted speed limits of 50 km/hr. Results. Over 95% of vehicles travelled above the posted speed limit of 50 km/hr. Vehicles on an average travelled at 87 km/hr, (95% CI = 87, 88). Variation in speeds was wide, with a standard deviation of 18 km/hr for all classes of vehicles, and with a range of 40 to 187 km/hr. The highest vehicular speed was associated with the private car (97.6 ± 18.3 km/hr) followed by large buses (93.6 ± 13.3 km/hr) and the least was with heavy trucks (73.8 ± 12.9 km/hr). Conclusion. The excessive vehicular speeds coupled with the wide speed variations explain in part the high incidence of traffic crashes and fatalities on the Accra-Kumasi highway. An integrated speed monitoring and control program, and realigning the highway to by-pass small and medium settlements would be required as a long-term measure for the reduction of speed-related road traffic crashes, fatalities, and injuries in Ghana.

Occupational Injuries in Ghana

Household interviews were used to survey 21,105 persons living in 431 urban and rural sites in Ghana, to determine the nature and extent of their occupational injuries. Annual occupational injury rates were 11.5 injuries/1000 persons in the urban areas and 44.9/1000 in the rural areas. Occupational injuries had higher mortality, longer disability, and higher treatment costs than non-occupational injuries. There were substantial occupational injury rates among children, especially in rural areas. In the urban areas, the largest numbers of injuries were to drivers (12.7% of urban occupational injuries) and traders (19.4%), most of which were road-traffic-related. In the rural areas, most injuries (71.6%) were to farm workers. Occupational injuries are a substantial burden in Ghana. Priorities include improving road safety and improving the prevention and treatment of injuries from nonmechanized farming.

Occupational Injuries in Ghana

Occupational Injuries in Ghana

Pattern of road traffic injuries in Ghana: Implications for control

Road traffic injuries and fatalities are increasing in Ghana. Police-collected crash and injury data for the period 1994-1998 were aggregated and analyzed using the MAAP5 accident analysis package developed by the Transport Research Laboratory, U.K. Published results of recent transport-related epidemiological and other surveys provided an additional data source. According to the 1994-1998 police data, road traffic crashes were a leading cause of death and injuries in Ghana. The other leading causes of death and injuries are occupational injuries which involve nonmechanized farming and tribal conflicts. The majority of road traffic fatalities (61.2%) and injuries (52.3%) occurred on roads in rural areas. About 58% more people died on roads in the rural areas than in urban areas, and generally more severe crashes occurred on rural roads compared with urban areas. Pedestrians accounted for 46.2% of all road traffic fatalities. The majority of these (66.8%) occurred in urban areas. The second leading population of road users affected was riders in passenger-ferrying buses, minibuses and trucks. The majority of these (42.8%) were killed on roads that pass through rural areas. Pedestrian casualties were overrepresented (nearly 90%) in five regions located in the southern half of the country. Efforts to tackle pedestrian safety should focus on the five regions of the country where most pedestrian fatalities occur in urban areas. Policies are also needed to protect passengers in commercially operated passenger-ferrying buses, minibuses and trucks because these vehicles carry a higher risk of being involved in fatal crashes.

Economic consequences of injury and resulting family coping strategies in Ghana

The toll of human suffering from illness and injury is usually measured by mortality and disability rates. Economic consequences, such as treatment costs and lost productivity, are often considered as well. Lately, increasing attention has been paid to the economic effects of illness on a household level. In this study, we sought to assess the economic consequences of injuries in Ghana by looking at the effects on households and the coping mechanisms these households employed. Using cluster sampling and household interviews, we surveyed 21,105 persons living in 431 urban and rural sites. We sought information on any injury that occurred to a household member during the prior year and that resulted in one or more days of disability time. A total of 1609 injuries were reported for the prior year. Treatment costs and disability days were higher in the urban area than in the rural. Coping strategies were different between the two areas. Rural households were more likely to utilize intra-family labor reallocation (90%) than were urban households (75%). Rural households were also more likely to borrow money (24%) than were urban (19%). Households in both areas were equally likely to sell belongings, although the nature of the belongings sold were different. Although injuries in the urban area had more severe primary effects (treatment cost and disability time), the ultimate effect on rural households appeared more severe. A greater percentage of rural households (28%) reported a decline in food consumption than did urban households (19%). These findings result in several policy implications, including measures that could be used to assist family coping strategies and measures directed toward injuries themselves.

Role of commercial drivers in motor vehicle related injuries in Ghana

Introduction—In many low income countries, commercial vehicles are the major source of motorized transport. Drivers of such vehicles may be an important focus for road safety efforts. Aims—An estimation of...

Epidemiology of transport-related injuries in Ghana

To better elucidate the incidence, characteristics, and consequences of transport-related injuries in a less developed country in Africa, we undertook an epidemiologic survey in Ghana. A total of 21 105 persons were surveyed, in both an urban area (Kumasi, n=11 663) and a rural area (Brong-Ahafo, n=9442). In the preceding year, a total of 656 injuries were reported in the urban area and 928 injuries reported in the rural area. Transport-related mechanisms accounted for 16% of all injuries in the urban and 10% of all injuries in the rural area. The annual incidence of transport-related injuries was almost identical in the two settings, 997/100 000 persons in the urban area and 941/100 000 in the rural area. In both settings, transport-related injuries were more severe than other types of injuries in terms of mortality, length of disability, and economic consequences. In the urban area, the most common transport-related mechanisms were either to passengers involved in crashes of mini-buses or taxis (29%) or to pedestrians struck by these vehicles (21%). In the rural area, the most common transport-related mechanisms were bicycle crashes. The second most common rural mechanisms were motor vehicle crashes, which were the most severe and which involved commercial (83%) rather than private vehicles. Prevention strategies need to be different from those in developed countries and should target commercial drivers more than private road users.