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Adal O, Tareke AA, Bogale EK, Anagaw TF, Tiruneh MG, Fenta ET, Endeshaw D, Delie AM. Mortality of traumatic chest injury and its predictors across sub-saharan Africa: systematic review and meta-analysis, 2024. BMC Emerg Med 2024; 24:32. [PMID: 38413939 PMCID: PMC10900610 DOI: 10.1186/s12873-024-00951-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/09/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Globally, chest trauma remain as a prominent contributor to both morbidity and mortality. Notably, patients experiencing blunt chest trauma exhibit a higher mortality rate (11.65%) compared to those with penetrating chest trauma (5.63%). AIM This systematic review and meta-analysis aimed to assess the mortality rate and its determinants in cases of traumatic chest injuries. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guided the data synthesis process. Multiple advanced search methods, encompassing databases such as PubMed, Africa Index Medicus, Scopus, Embase, Science Direct, HINARI, and Google Scholar, were employed. The elimination of duplicate studies occurred using EndNote version X9. Quality assessment utilized the Newcastle-Ottawa Scale, and data extraction adhered to the Joanna Briggs Institute (JBI) format. Evaluation of publication bias was conducted via Egger's regression test and funnel plot, with additional sensitivity analysis. All studies included in this meta-analysis were observational, ultimately addressing the query, what is the pooled mortality rate of traumatic chest injury and its predictors in sub-Saharan Africa? RESULTS Among the 845 identified original articles, 21 published original studies were included in the pooled mortality analysis for patients with chest trauma. The determined mortality rate was nine (95% CI: 6.35-11.65). Predictors contributing to mortality included age over 50 (AOR 3.5; 95% CI: 1.19-10.35), a time interval of 2-6 h between injury and admission (AOR 3.9; 95% CI: 2.04-7.51), injuries associated with the head and neck (AOR 6.28; 95% CI: 3.00-13.15), spinal injuries (AOR 7.86; 95% CI: 3.02-19.51), comorbidities (AOR 5.24; 95% CI: 2.93-9.40), any associated injuries (AOR 7.9; 95% CI: 3.12-18.45), cardiac injuries (AOR 5.02; 95% CI: 2.62-9.68), the need for ICU care (AOR 13.7; 95% CI: 9.59-19.66), and an Injury Severity Score (AOR 3.5; 95% CI: 10.6-11.60). CONCLUSION The aggregated mortality rate for traumatic chest injuries tends to be higher in sub-Saharan Africa. Factors such as age over 50 years, delayed admission (2-6 h), injuries associated with the head, neck, or spine, comorbidities, associated injuries, cardiac injuries, ICU admission, and increased Injury Severity Score were identified as positive predictors. Targeted intervention areas encompass the health sector, infrastructure, municipality, transportation zones, and the broader community.
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Affiliation(s)
- Ousman Adal
- Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Abiyu Abadi Tareke
- SLL project, COVID-19 vaccine/EPI Technical Assistant at West Gondar Zonal Health Department, Amref Health Africa in Ethiopia, Bole Sub City, Ethiopia
| | - Eyob Ketema Bogale
- Health Promotion and Behavioral Science Department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tadele Fentabil Anagaw
- Health Promotion and Behavioral Science Department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Misganaw Guadie Tiruneh
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eneyew Talie Fenta
- Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
| | - Destaw Endeshaw
- Department of Adult Health nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amare Mebrat Delie
- Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
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Rodrigues JFB, Queiroz JVSDA, Medeiros RP, Santos RO, Fialho DA, Neto JES, dos Santos RL, Barbosa RC, Sousa WJB, Torres MDCDM, Medeiros LADM, Silva SMDL, Montazerian M, Fook MVL, Amoah SKS. Chitosan-PEG Gels Loaded with Jatropha mollissima (Pohl) Baill. Ethanolic Extract: An Efficient and Effective Biomaterial in Hemorrhage Control. Pharmaceuticals (Basel) 2023; 16:1399. [PMID: 37895870 PMCID: PMC10609772 DOI: 10.3390/ph16101399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 10/29/2023] Open
Abstract
A lack of control over blood loss can have catastrophic implications, including death. Although several hemostatic medications have been employed to reduce bleeding, a vast majority of them are ineffective, expensive, or pose health risks to the patient. To overcome these constraints, chitosan-polyethylene glycol (CS-PEG) hemostatic gels loaded with ethanolic extract of Jatropha mollissima sap (EES) were prepared and their hemostatic, physicochemical, and cytotoxic properties were evaluated. The gels were produced by mixing CS with PEG (an external plasticizer) and EES. The phytochemical analysis revealed a significant concentration of total polyphenols and tannins content in the extract and catechin was identified as one of the key compounds of EES. Infrared spectroscopy analysis revealed the presence of EES in the gels, as well as the chemical interaction between CS and PEG. The gels were thermally stable between 25 and 37 °C (ambient and human body temperature range), had pseudoplastic deformation behavior (rheological properties preserved after shearing), were simple to inject (compression force 30 N), and were biocompatible. In vivo experiments showed that both CS-PEG-EES gels exhibited greater hemostatic action in preventing tail hemorrhage in Wistar rats, with decreased bleeding time and blood weight compared with unloaded CS-PEG gels (control groups) and Hemostank, a commercial product. However, the gel prepared with acetic acid was more efficient in controlling bleeding. These findings reveal that CS-PEG-EES gels can reduce hemorrhages and are a potent, simple, and safe hemostatic agent.
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Affiliation(s)
- José F. B. Rodrigues
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - João V. S. de A. Queiroz
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - Rebeca P. Medeiros
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - Rafaela O. Santos
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - Djair A. Fialho
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - João E. S. Neto
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - Rogério L. dos Santos
- Department of Dentistry, Life Science Institute, Federal University of Juiz de Fora, Governador Valadares 36036-900, MG, Brazil
| | - Rossemberg C. Barbosa
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - Wladymyr J. B. Sousa
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - Maria da C. de M. Torres
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
- Chemistry Department, Science and Technology Center, State University of Paraiba, Campina Grande 58429-500, PB, Brazil
| | - Luanna A. D. M. Medeiros
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - Suédina M. de L. Silva
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - Maziar Montazerian
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - Marcus V. L. Fook
- Materials Science and Engineering Department, Northeast Laboratory for Evaluation and Development of Biomaterials, Academic Unit of Materials Science and Engineering, Federal University of Campina Grande, Campina Grande 58429-000, PB, Brazil (M.d.C.d.M.T.); (S.M.d.L.S.); (M.M.); (M.V.L.F.)
| | - Solomon K. S. Amoah
- Brazilian Association of Support Cannabis Esperança, João Pessoa 58013-130, PB, Brazil
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Kassa S, Genetu A, Tesfaye S, Ademe Y, Vervoort D. Penetrating cardiac injury presentation and management in resource-limited settings: A case series from Ethiopia. Int J Surg Case Rep 2023; 106:108114. [PMID: 37030162 PMCID: PMC10113829 DOI: 10.1016/j.ijscr.2023.108114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Penetrating cardiac injury is rare (0.1 % of trauma admissions) but fatal. Presentation is with features of cardiac tamponade or hemorrhagic shock. Urgent clinical evaluation, ultrasound, temporizing pericardiocentesis or surgical repair with cardiopulmonary bypass as back up consist of standard management. In this paper, experience of management of penetrating cardiac injury from a resource limited country is presented. CASE PRESENTATIONS There were seven patients, five had a stab injury and two had gunshot wound. All were men with mean age of 31.1 years. Patients arrived within 30 min (3), 2 h (2), 4 h (1) and 18 h (1) after injury. Mean initial blood pressure and pulse rates were 83/51 mm Hg and 121, respectively. One patient had pericardiocentesis before referral. Exploration was via left anterolateral thoracotomy. Four (57.1 %) had right ventricle perforation, one had both right and left ventricle, and two (28.5 %) had left ventricle perforation. Suture repair (6) and pericardial patch (1) were done without bypass machine as back up. Mean duration of stay in the intensive care unit and in the surgical wards were 4.4 days (range: 2-15) and 10.8 days (range: 1-48), respectively. All were discharged improved. CLINICAL DISCUSSION Penetrating cardiac injury presents with low blood pressure and tachycardia after stab or gunshot wounds. Right ventricle is mostly affected. Pericardiocentesis can be done as temporary measure. While having bypass machine as back up is recommended, the absence of it should not preclude intervention. Suture repair can be done with left anterolateral thoracotomy. CONCLUSION Penetrating cardiac injury can be managed in resource limited settings without back up of cardiopulmonary bypass. Early identification and surgical intervention results in favorable outcome.
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Affiliation(s)
- Seyoum Kassa
- Cardiothoracic Unit, Department of Surgery, College of Health Sciences, Addis Ababa University, Ethiopia.
| | - Abraham Genetu
- Cardiothoracic Unit, Department of Surgery, College of Health Sciences, Addis Ababa University, Ethiopia.
| | - Samuel Tesfaye
- Cardiothoracic Unit, Department of Surgery, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Yonas Ademe
- Cardiothoracic Unit, Department of Surgery, College of Health Sciences, Addis Ababa University, Ethiopia.
| | - Dominique Vervoort
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada.
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Shumet T, Kebede F. Incidence and Predictors of Inpatient Mortality Rate After Cases Started Care in the Intensive Care Unit in Debre Markos Referral Hospital. Health Serv Res Manag Epidemiol 2023; 10:23333928231208252. [PMID: 37901610 PMCID: PMC10612449 DOI: 10.1177/23333928231208252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023] Open
Abstract
Background The intensive care unit (ICU) is a separate area in which potential health care services for patients who are in critical condition with detailed observation, monitoring, and advanced treatment than other units. This study aimed to assess the incidence and predictors of inpatient mortality after inpatient treatment was started in Debre Markos Comprehensive Specialized Hospital. Methods A facility-based retrospective cohort study was employed among 384 ICU-admitted patients from December 30, 2020 to January 1, 2022. The collected data were entered into Epi Data version 4.2 and exported to STATA 14.0 for further analysis. The Cox proportional hazard regression model was fitted after checking using the Schoenfeld residual and log-log plot test. A categorical variable with an adjusted hazard ratio of 95% CI was claimed for predictors. Result Overall, 384 admitted adult patients were included in the final analysis with a mean (±SD) age of 42.1 (±17.1) years. At the end of the follow-up period, 150 (39.06%) cases died in the ICU. The overall incidence of the mortality rate was 16.9 (95% CI: 13.7-19.55) per 100 person per day. Epidemiologically, 347 (90.36%) cases were medical illness, 25 (6.51%) surgical, and 12 (3.13%) were obstetric cases, respectively. The median length of inpatient stay was found to be 4.9 (IQR ± 2.8) days. In multivariable analysis; being (+) for human immunodeficiency virus (AHR = 0.59, 95% CI: 0.39-0.91), age ≥65yearas (AHR = 1.61, 95% CI: 1.11-2.32), and admission on weekend-time (AHR = 1.48, 95% CI: 1.06-2.06) were predictors of inpatient death. Conclusion The overall in-hospital mortality rate was significantly higher than in the previous study in this hospital with a short median survival time. The inpatient mortality rate was significantly associated with age ≥65 years, being HIV positive, and admission during weekend time. Therefore, effective intervention strategies should be highly needed for ICU team members for early risk factors prevention.
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Affiliation(s)
- Tesfaye Shumet
- Department of Epidemiology and Biostatics, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Fassikaw Kebede
- Department of Epidemiology and Biostatics, College of Health Science, Woldia University, Woldia, Ethiopia
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Ghazali DA, Ilha-Schuelter P, Barreyre L, Stephan O, Barbosa SS, Oriot D, Tourinho FSV, Plaisance P. Development and validation of the first performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study. Eur J Trauma Emerg Surg 2022; 48:4069-4078. [PMID: 35376968 DOI: 10.1007/s00068-022-01928-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/20/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Chest tube insertion requires interdisciplinary teamwork including an emergency surgeon or physician in conjunction with a nurse. The purpose of the study was to validate an interdisciplinary performance assessment scale for chest tube insertion developed from literature analysis. METHODS This prospective study took place in the simulation center of the University of Paris. The participants included untrained emergency/intensivist residents and trained novice emergency/intensivist physicians with less than 2 years of clinical experience and 6 months following training in thoracostomy, and nursing students. Each interdisciplinary pair participated in a high-fidelity simulation session. Two independent observers (O1 and O2) evaluated 61 items. Internal coherence using the Cronbach's α coefficient, intraclass correlation coefficient (ICC), and correlation of scores by regression analysis (R2) were analyzed. Comparison between O1 and O2 mean scores used a t test and F test for SDs. p Value < 0.05 was significant. RESULTS From an initial selection of 11,277 articles, 19 were selected to create the initial scale. The final scale comprises 61 items scored out of 80, including 24 items for nursing items, 24 items for medical competence, and 13 mixed items for the competence of both. 40 simulations including 80 participants were evaluated. Cronbach's α = 0.76, ICC = 0.92, R2 = 0.88. There was no difference between the observers' assessments of means (p = 0.82) and SDs (p = 0.92). Score was 51.6 ± 5.9 in the group of untrained residents and nursing student, and 57.2 ± 2.8 in the trained group of novice physicians and nursing students (p = 0.0003). CONCLUSIONS This first performance assessment scale for interdisciplinary chest tube insertion is valid and reliable.
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Affiliation(s)
- Daniel Aiham Ghazali
- Emergency Department and EMS, University Hospital of Amiens, 1 Rue du Professeur Christian Cabrol, 80000, Amiens, France. .,DREAMS, Department of Research in Emergency Medicine and Simulation, University Hospital and University of Amiens, 80000, Amiens, France. .,IAME "Infection, Antimicrobials, Modelling, Evolution" Research Center, UMR 1137-INSERM, University of Paris, 16 rue Henri Huchard, 75018, Paris, France. .,Simulation Center, University Paris, Paris, France.
| | - Patricia Ilha-Schuelter
- Department of Undergraduate and Graduate Nursing, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Lou Barreyre
- Emergency Department, University Hospital of Bichat, 75018, Paris, France
| | - Olivia Stephan
- Emergency Department, University Hospital of Bichat, 75018, Paris, France
| | - Sarah Soares Barbosa
- Department of Undergraduate and Graduate Nursing, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Denis Oriot
- ABS Lab, Simulation Center of Poitiers University, 86000, Poitiers, France.,Pediatric Emergency Department, University Hospital of Poitiers, 86000, Poitiers, France
| | | | - Patrick Plaisance
- Emergency Department, University Hospital of Lariboisière, 75010, Paris, France.,Ilumens Simulation Center of Paris University, 75018, Paris, France
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Pasquali GF, Kock KDS. Epidemiological profile of chest trauma and predictive factors for length of hospital stay in a hospital in Southern Brazil. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2021; 11:54-61. [PMID: 33824786 PMCID: PMC8012872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 01/26/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Thoracic trauma is one of the most common types, corresponding to 10% of the traumas admitted in emergency services. OBJECTIVE To analyse epidemiologic aspects of patients diagnosed with chest trauma in a hospital at the south of Brazil and its predictive factor for prolonged length of stay. METHODS We conducted a retrospective cohort involving patients who were victims of chest trauma. They were described by the International Classification of Diseases (ICD) from S20 to S29 admited in a regional hospital in Southern Brazil, from January 2008 to December 2018. The analysed variables were: sex, age, ICD, type of trauma, complication, need for intensive care unit (ICU), mechanical ventilation (MV) and oxygen therapy (O2), scores on Injury Severity Score (ISS) and Thoracic Trauma Severity Score (TTSS) and outcomes length of stay and death. RESULTS 121 patients were evaluated, with median age 47.0 (35-0-58.5) years, where 84.3% being of them were male. Blunt trauma had a higher prevalence with 85.1%, with the most frequent complication being spine fractures (30.4%), followed by rib fractures (23.2%) and pneumothorax (16.8%). There was need of ICU in 14%, use of O2 in 30.6% and need of MV in 5.8%. The median length of stay was 6.0 (4.0-10.5), and death as an outcome was found in only 1.7%. Relying on the TTSS, the median (p25-p75) found was 3.0 (2.0-5.0) points and the ISS score was 4.0 (0.0-9.0). If observing patients with a length of stay ≥ 6 days, there were an association with the female gender, need of ICU, O2 and MV, ISS scores, and TTSS scores in the categories who involved pleural commitment and minor PaO2/FiO2. CONCLUSION Most of the victims were male young adults with low mortality. The TTSS and ISS were found to be adequate predictors of prolonged length of stay.
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Affiliation(s)
| | - Kelser de Souza Kock
- University of Southern Santa Catarina (UNISUL), Medicine Course Tubarão, Santa Catarina, Brazil
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Denu ZA, Osman MY, Bisetegn TA, Biks GA, Gelaye KA. Prevalence and risk factors for road traffic injuries and mortalities in Ethiopia: systematic review and meta-analysis. Inj Prev 2021; 27:384-394. [PMID: 33579673 DOI: 10.1136/injuryprev-2020-044038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/04/2021] [Accepted: 01/09/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Road traffic injuries, which are responsible for premature deaths and functional losses, are the leading causes of unintentional injuries in Ethiopia. As most studies on road traffic injuries, so far, have been either local or regional, it is believed that combining the regional or local data to get nationally representative information could help programme implementers in setting priorities. OBJECTIVE The aim of this review was to estimate the proportion of road traffic injuries, mortality and risk factors for the problem among all age groups in Ethiopia. DATA SOURCES A systematic review of articles using MEDLINE/PubMed SCOPUS Web of Science and science direct was conducted. Additional studies were identified via manual search. STUDY SELECTION Only studies that reported road traffic injuries and/or mortalities for all age groups were included in this review. DATA SYNTHESIS All pooled analyses were based on random-effect models. Twenty-six studies for the prevalence of RTIs (n=37 424), 24 studies for road traffic injuries (RTI) mortality, (n=38 888), 9 studies for prevalence of fracture among RTIs (n=2817) and 5 studies for the prevalence of post-traumatic stress disorder (n=1733) met our inclusion criteria. Driving in the dark increased severity of injury by 1.77, 95% CI 1.60 to 1.95). The certainty of the evidence was assessed using GRADEpro Guideline Development Tool. CONCLUSION In this review, the burden of road traffic injuries and mortalities remains high in Ethiopia. Human factors are the most common causes of the problem in Ethiopia. The existing safety regulations should be re-evaluated and supported by continuous behavioural interventions. PROSPERO REGISTRATION NUMBER CRD42019124406.
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Affiliation(s)
- Zewditu Abdissa Denu
- Department of Anaesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Mensur Yassin Osman
- Department of Surgery, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Telake Azale Bisetegn
- Department of Health Communication and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Gashaw Andargie Biks
- Department of Health Policy and Management, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
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