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Tankeng LT, Ngatchou Djomo W, Nana TC, Akwa GM, Mbianyor BE, Lifafa Kinge K, Bonny A. Epidemiology and clinical profile of sports injuries treated in the Douala General and Laquintinie Hospitals, in Cameroon. BMJ Open Sport Exerc Med 2024; 10:e002023. [PMID: 39286320 PMCID: PMC11404144 DOI: 10.1136/bmjsem-2024-002023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 09/19/2024] Open
Abstract
Objectives To describe the epidemiological patterns and clinical characteristics of sports injuries treated at two hospitals in Douala. Methods This was a cross-sectional study conducted at the Douala General Hospital and Douala Laquintinie Hospital, involving medical records of patients treated for sports injuries from January 2012 to April 2022. Data extracted from records were entered into a data collection software and analysed using Microsoft Excel 2016. Severe injuries were defined as an injury score greater than or equal to 3 on the Abbreviated Injury Scale. Results The prevalence of sports injuries was 1.12% among all trauma cases. There was a male predominance with 62 (86.1%) males and 10 (13.9%) females. The mean age was 24.97±13.8 years. Most injured persons were students 35 (48.6%), followed by the employed 26 (36.1%), athletes 6 (8.3%) and the unemployed 5 (6.9%). Recreational sports accounted for 43 (59.7%) injuries while 16 (22.2%) injuries occurred during physical education, 8 (11.1%) during trainings and 5 (6.9%) during competitions. Football injuries were 48 (66.7%), running injuries 10 (13.9%) and 9 (12.5%) occurred during long, high and triple jump. Among all injuries, fractures were 43 (59.7%), 11 (15.3%) joint sprains, 5 (6.9%) muscle injuries, 4 (5.6%) brain injuries while 9 (12.5%) were contusions and lacerations. Lower extremity injuries were 34 (47.2%), 21 (29.2%) injuries were on the upper extremities, 4 (5.6%) abdominopelvic, 3 (4.2%) thoracic injuries, 9 (12.5%) head injuries and 1 (1.4%) on the neck. Overall, 53 (73.7%) were severe injuries. Conclusion The majority of sports injuries treated in these hospitals are fractures that occur during recreational sports, particularly football and predominantly involve the lower extremity. A significant proportion are severe injuries.
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Affiliation(s)
- Leonard Tanko Tankeng
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | | | - Gilbert Mua Akwa
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Bill-Erich Mbianyor
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Aimé Bonny
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
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Tata TK, Ohene LA, Dzansi GA, Aziato L. Factors influencing nurses' pain assessment and management of road traffic casualties: a qualitative study at a military hospital in Ghana. BMC Emerg Med 2024; 24:100. [PMID: 38886656 PMCID: PMC11184758 DOI: 10.1186/s12873-024-01016-8] [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: 01/18/2024] [Accepted: 05/28/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Evidence shows that patients who visit the surgical and trauma emergency units may be discharged with untreated or increased pain levels. This study explored nurses' pain assessment and management approaches at a trauma-surgical emergency unit in Ghana. METHODS Seventeen nurses who work in the trauma department participated in this qualitative exploratory descriptive study. In-depth individual interviews were conducted, and the thematic analysis was utilized to identify emerging themes and subthemes. RESULTS Three main themes were identified: patient pain indicators, pain management, and institutional factors influencing pain management. The study revealed that nurses rely on verbal expressions, non-verbal cues, physiological changes, and the severity of pain communicated. The findings highlighted staff shortage, inadequate resources, and lack of standardized guidelines as factors affecting pain and management. CONCLUSIONS Although the study offers critical new perspectives on nurses' experiences regarding pain related issues at the trauma-surgical emergency units, its small sample size limited its generalizability.
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Affiliation(s)
- Thomas Kwame Tata
- 37 Military Hospital, Neghelli Barracks Liberation Rd 37, Accra, Ghana
| | - Lillian Akorfa Ohene
- Department of Public Health Nursing, School of Nursing and Midwifery, University of Ghana, P. O Box LG 43, Legon, Accra, Ghana.
| | - Gladys Akorfa Dzansi
- Department of Adult Health Nursing, School of Nursing and Midwifery of Ghana, P. O Box LG 43, Legon, Accra, Ghana
| | - Lydia Aziato
- University of Health and Allied Sciences, PMB 31, Volta Region, Ho, Ghana
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3
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Abayneh HB, Danielsen SO, Halvorsen K, Engebretsen S. Injury characteristics and mortality in an emergency department in Ethiopia: a single-center observational study. BMC Emerg Med 2024; 24:97. [PMID: 38849745 PMCID: PMC11157871 DOI: 10.1186/s12873-024-01017-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/29/2024] [Indexed: 06/09/2024] Open
Abstract
INTRODUCTION An injury is described as any damage to the body that impairs health, and its severity can span from mild to life-threatening. On a global scale, injuries account for approximately 4.4 million deaths annually and are anticipated to become the seventh leading cause of death by 2030. In Ethiopia, injuries account for 7% of all deaths, with one of the world's highest rates of road traffic injuries. This study, undertaken at a primary trauma centre in the capital of Ethiopia, aimed to explore the characteristics of injured patients and emergency department mortality as the patient outcome. Understanding the patterns and outcomes of injuries helps to anticipate needs, prioritize patients, and allocate resources effectively. METHODS A retrospective single-center observational study utilised patient records from September 2020 to August 2021 at Addis Ababa Burn Emergency and Trauma Hospital, located in Ethiopia. A structured checklist facilitated the data collection. All patients arriving in the ED from September 2020 to August 2021 were eligible for the study while incomplete records (missing > 20% of wanted data elements) were excluded. RESULT Of the 3502 injured patients recorded during the study period, 317 were selected. The mean patient age was 30 years, with 78.5% being male. About 8% arrived the emergency department within an hour after the injury. Ambulances transported 38.8% of patients; 58.5% of these were referred from other facilities. The predominant mechanism of injury both in and outside Addis Ababa was pedestrian road traffic injuries (31.4% and 38%). The predominant injury type was fractures (33.8%). The mortality rate was 5%, of which half were pedestrian road traffic incidents. CONCLUSION Pedestrian road traffic injuries were the main cause of injury in and outside of Addis Ababa. A small proportion of patients arrived at the emergency department within the first hour after an injury event. A significant proportion of ambulance-transported patients were referred from other facilities rather than directly from the scene. The overall mortality rate was high, with pedestrian road traffic injury accounting for half of the proportion.
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Affiliation(s)
- Helina Bogale Abayneh
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
- Department of Emergency and Critical Care Nursing, St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia.
| | - Stein Ove Danielsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristin Halvorsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Stine Engebretsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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4
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Amoadu M, Ansah EW, Sarfo JO. Psychosocial work conditions and traffic safety among minibus and long-bus drivers. J Occup Health 2024; 66:uiad019. [PMID: 38332726 PMCID: PMC11020272 DOI: 10.1093/joccuh/uiad019] [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: 07/17/2023] [Revised: 12/09/2023] [Accepted: 12/16/2023] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE This study sought to examine the association between psychosocial work factors and road traffic crashes (RTCs), and test the differences in psychosocial work factors between minibus and long-bus drivers. METHODS This cross-sectional survey employed a convenient sampling method to collect data from 7315 long-distance minibus and long-bus drivers who operate between the Ghanaian cities, Accra and Tema and other parts of the country. The drivers answered a job content questionnaire, psychosocial safety climate scale (PSC-12), work-family conflict scale, and demographic questions on age, education, driving hours, and RTC history. RESULTS The correlational analysis showed a significant association between psychosocial work factors and RTCs for the previous 2 years. Hierarchical multiple linear regression found that supervisor support, skill discretion, decision autonomy, psychological demands, PSC, and work-family conflict significantly contributed to explaining RTC rates among the drivers. Also, significant differences were found between minibus and long-bus drivers in driving hours, occurrence of near misses, RTCs, and all psychosocial work factors explored in this study except work-family conflict. CONCLUSIONS Psychosocial work factors directly predict RTCs among minibus and long-bus drivers. Policymakers, driver unions, and owners and managers of bus transport businesses should prioritize integrating occupational health and safety into road transport activities. Furthermore, managers and bus owners should use bottom-up communication, provide access to support services and work-family balance initiatives, flexible work schedules, and a supportive work environment to improve road safety.
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Affiliation(s)
- Mustapha Amoadu
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, +233, Ghana
| | - Edward Wilson Ansah
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, +233, Ghana
| | - Jacob Owusu Sarfo
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, +233, Ghana
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Gemmell E, Adjei-Boadi D, Sarkar A, Shoari N, White K, Zdero S, Kassem H, Pujara T, Brauer M. "In small places, close to home": Urban environmental impacts on child rights across four global cities. Health Place 2023; 83:103081. [PMID: 37506630 PMCID: PMC7615291 DOI: 10.1016/j.healthplace.2023.103081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/03/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023]
Abstract
Urban environments influence child behaviours, exposures and experiences and may affect health, development, achievement and realization of fundamental human rights. We examined the status of eleven UN Convention on the Rights of the Child articles, in a multi-case study across four global cities. Within all study cities, children experienced unequal exposure to urban environmental risks and amenities. Many violations of child rights are related to car-based transportation systems and further challenged by pressures on urban systems from rapid population increases in the context of climate change. A child rights framework provides principles for a collective, multi-sectoral re-imagination of urban environments that support the human rights of all citizens.
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Affiliation(s)
- Emily Gemmell
- School of Population and Public Health, University of British Columbia, Vancouver, 2206 West Mall, Vancouver, BC, V6T 1Z4, Canada.
| | - Dina Adjei-Boadi
- Department of Geography and Resource Development, University of Ghana, MR28+9MQ, Doutor J.B. Danquah Avenue, Accra, Ghana.
| | - Asesh Sarkar
- Department of Architecture and Planning, Indian Institute of Technology, Haridwar Highway, Roorkee, Uttarakhand, 247667, India.
| | - Niloofar Shoari
- MRC Centre for Environment & Health, Department of Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, United Kingdom.
| | - Katherine White
- School of Population and Public Health, University of British Columbia, Vancouver, 2206 West Mall, Vancouver, BC, V6T 1Z4, Canada.
| | - Svetlana Zdero
- School of Population and Public Health, University of British Columbia, Vancouver, 2206 West Mall, Vancouver, BC, V6T 1Z4, Canada.
| | - Hallah Kassem
- School of Population and Public Health, University of British Columbia, Vancouver, 2206 West Mall, Vancouver, BC, V6T 1Z4, Canada.
| | - Tina Pujara
- Department of Architecture and Planning, Indian Institute of Technology, Haridwar Highway, Roorkee, Uttarakhand, 247667, India.
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, 2206 West Mall, Vancouver, BC, V6T 1Z4, Canada; Institute for Health Metrics and Evaluation, Population Health Building, Hans Rosling Center, 3980 15th Ave. NE, Seattle, WA, 98195, USA.
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Lahare VK, Verma N, Chandrakar A, Shrivastava N, Dengani M, Gupta SA. A Community-Based Cross-Sectional Study on the Epidemiology of Injuries in Raipur City, Chhattisgarh. Cureus 2023; 15:e41868. [PMID: 37581137 PMCID: PMC10423502 DOI: 10.7759/cureus.41868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Globally, injuries are a major public health concern. An injury is a physical damage that results when the human body is suddenly or briefly subjected to intolerable levels of energy. OBJECTIVES The objectives of this study are to describe the nature and mechanism of injuries and their association with age and gender and to assess the health-seeking behavior and cost incurred due to mortality and morbidity related to injuries. METHODS AND MATERIALS A cross-sectional study focused on the community was conducted in 10 chosen wards of Raipur City. The sample size was 310 injured individuals. The recall period was for a full year. Information was gathered by using a questionnaire that had been pretested. The results were given as percentages, and the association was determined using the chi-square test and Fischer's exact test. RESULTS The majority (30.1%) of the study subjects suffered from cut/bite/open wound injuries, followed by fractures (17.3%). The leading type of injury was caused by falls (38.8%) and road traffic injuries (34.9%), followed by burns (7.1%) and dog bites (5.4%). Ninety percent of the study subjects had taken medical care. Half of them (51.3%) visited a private hospital, and 23.1% did not visit any hospital for treatment. Fifty percent of the study subjects or their family had expenses less than Indian National Rupee (INR) 500. A significant association was found between age and fracture and the sprain type of injury. The burn type of injury was more among females, which is significantly associated. A significant association was found between age and injury caused by a dog bite, fall, and traffic. The association between gender and injury caused by traffic, burn, and fall was significant. CONCLUSIONS Focusing on reducing injury-related morbidity may be crucial in injury prevention techniques including behavioral changes, health education, and the urgent need for the proper implementation and oversight of a road safety act.
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Affiliation(s)
- Vipin K Lahare
- Community Medicine, Pt Jawaharlal Nehru Memorial Medical College, Raipur, IND
| | - Nirmal Verma
- Community Medicine, Pt Jawaharlal Nehru Memorial Medical College, Raipur, IND
| | - Aditi Chandrakar
- Community and Family Medicine, All India Institute of Medical Sciences, Raipur, IND
| | | | - Monika Dengani
- Community Medicine, Pt Jawaharlal Nehru Memorial Medical College, Raipur, IND
| | - Shubhra A Gupta
- Community Medicine, Pt Jawaharlal Nehru Memorial Medical College, Raipur, IND
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Morbidity and Outcomes of Pregnancy Among Women with Sickle Cell Disease: A Cross-Sectional Study AT Korle-Bu Teaching Hospital, Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2023. [DOI: 10.1016/j.ijans.2023.100546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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8
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Jumbam DT, Amoako E, Blankson PK, Xepoleas M, Said S, Nyavor E, Gyedu A, Ampomah OW, Kanmounye US. The state of surgery, obstetrics, trauma, and anaesthesia care in Ghana: a narrative review. Glob Health Action 2022; 15:2104301. [PMID: 35960190 PMCID: PMC9586599 DOI: 10.1080/16549716.2022.2104301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Conditions amenable to surgical, obstetric, trauma, and anaesthesia (SOTA) care are a major contributor to death and disability in Ghana. SOTA care is an essential component of a well-functioning health system, and better understanding of the state of SOTA care in Ghana is necessary to design policies to address gaps in SOTA care delivery. Objective The aim of this study is to assess the current situation of SOTA care in Ghana. Methods A situation analysis was conducted as a narrative review of published scientific literature. Information was extracted from studies according to five health system domains related to SOTA care: service delivery, workforce, infrastructure, finance, and information management. Results Ghanaians face numerous barriers to accessing quality SOTA care, primarily due to health system inadequacies. Over 77% of surgical operations performed in Ghana are essential procedures, most of which are performed at district-level hospitals that do not have consistent access to imaging and operative room fundamentals. Tertiary facilities have consistent access to these modalities but lack consistent access to oxygen and/or oxygen concentrators on-site as well as surgical supplies and anaesthetic medicines. Ghanaian patients cover up to 91% of direct SOTA costs out-of-pocket, while health insurance only covers up to 14% of the costs. The Ghanaian surgical system also faces severe workforce inadequacies especially in district-level facilities. Most specialty surgeons are concentrated in urban areas. Ghana’s health system lacks a solid information management foundation as it does not have centralized SOTA databases, leading to incomplete, poorly coded, and illegible patient information. Conclusion This review establishes that surgical services provided in Ghana are focused primarily on district-level facilities that lack adequate infrastructure and face workforce shortages, among other challenges. A comprehensive scale-up of Ghana’s surgical infrastructure, workforce, national insurance plan, and information systems is warranted to improve Ghana’s surgical system.
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Affiliation(s)
- Desmond T Jumbam
- Department of Policy and Advocacy, Operation Smile Ghana, Accra, Ghana.,Department of Policy and Advocacy, Operation Smile, Virginia Beach, Virginia, USA
| | - Emmanuella Amoako
- Department of Paediatrics and Child Health, Cape Coast Teaching Hospital, Cape Coast, Ghana.,Department of Paediatrics and Child Health, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Paa-Kwesi Blankson
- Oral and Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Meredith Xepoleas
- Department of Policy and Advocacy, Operation Smile, Virginia Beach, Virginia, USA
| | - Shady Said
- Department of Policy and Advocacy, Operation Smile, Virginia Beach, Virginia, USA
| | - Elikem Nyavor
- Department of Policy and Advocacy, Operation Smile Ghana, Accra, Ghana
| | - Adam Gyedu
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Surgery, University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Opoku W Ampomah
- Department of Policy and Advocacy, Operation Smile Ghana, Accra, Ghana.,Plastics and Reconstructive Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Ulrick Sidney Kanmounye
- Department of Policy and Advocacy, Operation Smile Ghana, Accra, Ghana.,Department of Policy and Advocacy, Operation Smile, Virginia Beach, Virginia, USA
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Factors influencing willingness to intervene as bystanders among adult residents living in crash-prone areas in the Ashanti region of Ghana. Afr J Emerg Med 2022; 12:315-320. [PMID: 35892004 PMCID: PMC9307561 DOI: 10.1016/j.afjem.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/12/2022] [Accepted: 06/24/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Formal prehospital emergency medical services cover only a small percent of the population in most low- and middle-income countries. Increasing the involvement of laypersons in prehospital first aid can be an important part of the response to injuries and other medical emergencies. We sought to understand factors associated with the willingness of laypersons in Ghana to provide first aid to road traffic crash victims. Method This cross-sectional study purposively sampled four crash-prone areas in the Ashanti Region and 385 participants were interviewed. A structured questionnaire was used to ask about their demographic characteristics, first aid knowledge, and perceptions about first aid. Factors affecting willingness to provide first aid were assessed using multivariable logistic regression. Results Most participants were male (57.7%) and young (median age 28 years). A large majority (82.9%) were willing to provide first aid to crash victims. However, only 43.1% had been trained in first aid and only 40.4% had adequate knowledge of first aid (≥ 70% correct). Factors associated with willingness to provide first aid included first aid knowledge (aOR 17.27 for moderate knowledge vs. low knowledge, p=0.018; aOR 13.63 for adequate knowledge vs. low knowledge, p=0.030) and positive attitudes towards first aid, including the feeling that: every person should be trained in first aid (aOR 2.98, p=0.025), first aid increases survival (aOR 2.79, p=0.046), it is important to learn first aid (aOR 2.40, p=0.005), and bystanders have the responsibility to give first aid (aOR 4.34, p<0.001). Conclusion A high percentage of people in these crash-prone areas of Ashanti Region, Ghana were willing to provide first aid. However, under half had been trained in first aid or had adequate knowledge of first aid. A major implication of these findings is the need to increase the availability of quality training in first aid in these areas.
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Ellaban MM, Afifi E, El Houssinie M, Hirshon JM, El-Shinawi M, El-Setouhy M. Epidemiology of Knife Injuries at Ain Shams University Hospital Emergency Department from 2018 to 2019: A Cross-Sectional Study. OPEN ACCESS EMERGENCY MEDICINE 2022; 13:561-567. [PMID: 34984033 PMCID: PMC8702981 DOI: 10.2147/oaem.s338245] [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] [Received: 09/08/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose For knife-related injuries (KRI), a comprehensive understanding of the incidence, mechanism, and pattern of injury is required for the development of prevention strategies. Unfortunately, reliable data on knife-related injuries are difficult to obtain. In Egypt, there is no national routine surveillance system for all knife injuries. The aim was to examine the epidemiologic characteristics of knife-related injuries at the Ain Shams University Hospital (ASUH) emergency department (ED). Patients and Methods A cross-sectional study was conducted on 140 patients who presented with knife injuries at the ASUH ED. Data collection was done during a randomly selected period of seven days each month from October 2018 to September 2019. The sociodemographic characteristics, injury-related variables, and outcomes of the injury were recorded on a structured worksheet. Results Knife-related injuries represented 22.9% of all injury cases that presented to the ED. Majority of the knife-related injuries (87.86%) were accidental, 7.9% were assault, and 4.3% were self-inflicted. Home was the most reported place of injury. Most of the victims were discharged from the ED (87.1%), and 84.3% recovered completely. The mean hospital stay was 3.6 ± 1.3 days. Conclusion Majority of the knife-related injuries were accidental, and the most common pattern was isolated chest injury with contusions. Cases that were not severe and had favorable prognosis (ie, complete recovery) comprised the largest proportion. Recommendations include development of a surveillance system may result in the effective control and prevention of this growing problem of knife-related injuries.
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Affiliation(s)
- Manar M Ellaban
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman Afifi
- Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Moustafa El Houssinie
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Jon Mark Hirshon
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mohamed El-Shinawi
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,General Surgery Department, Ain Shams University, Cairo, Egypt.,Galala University, Suez, Egypt
| | - Maged El-Setouhy
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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11
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Wound Management Property of a Hydroethanolic Leaf Extract of Cnestis ferruginea DC. Adv Pharmacol Pharm Sci 2021; 2021:6693718. [PMID: 34240058 PMCID: PMC8233097 DOI: 10.1155/2021/6693718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 04/02/2021] [Accepted: 05/21/2021] [Indexed: 12/12/2022] Open
Abstract
Objective To establish the wound management property of a hydroethanolic Cnestis ferruginea leaf extract (CFHE). Materials and Methods The wound area was measured after excision at the dorsal part of the Albino rats, and after treatment with 5–15% w/w CFHE ointments for 14 days. Absorbances of platelet-rich plasma treated with 0.8–100 mg/mL CFHE and an aggregating agent were spectrophotometrically determined in an in vitro platelet aggregation test. Wound tissue histopathology of CFHE ointment-treated animals revealed angiogenesis, reepithelialization, deposition of collagen, and granular tissue formation in wound tissues. Reduction in thigh oedema and pain threshold, in 7-day-old chicks, were assessed by carrageenan-induced oedema and Randall-Sellito pressure models, respectively. By the Agar diffusion method, bacterial growth inhibition by a 15% w/w CFHE ointment was investigated on Salmonella typhi, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus. Aureus, and Streptococcus pyogenes. Results All concentrations of CFHE ointment significantly reduced (p < 0.0001) wound area by 29–41% posttreatment. CFHE (1.6–100 mg/ml) promoted platelet aggregation (p ≤ 0.0001) by 37–67% (IC50: 3.1–6.2 mg/ml). There were improved wound tissue reepithelization, fibroblast proliferation, angiogenesis, and collagen deposition with 15% CFHE ointment treatment. CFHE ointment significantly (p ≤ 0.0001) and dose-dependently reduced thigh oedema and showed a significant (p ≤ 0.05) analgesic effect. In vitro, 15% CFHE ointment caused >100% growth inhibition of selected bacteria. Conclusion The hydroethanolic leaf extract of Cnestis ferruginea possesses wound healing, platelet aggregation, anti-inflammatory, analgesic, and antimicrobial properties and, hence, could be effective in the management of open and some closed wounds.
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12
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Blankson PK, Lartey M. Road traffic accidents in Ghana: contributing factors and economic consequences. Ghana Med J 2021; 54:131. [PMID: 33883755 PMCID: PMC8042801 DOI: 10.4314/gmj.v54i3.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The impact of road traffic injuries could be enormous, affecting societies and individuals in different facets. Despite the prominence of Covid-19 disease in the current public health space, road crashes remain an important contributor to mortality. It is estimated that some 1.4 million people die from road crashes globally, with most of these being the youth, and people from developing countries.1 In Ghana, 72 persons out of every 100 000 population, suffered from grievous bodily injury, and close to 8 of the same population died from Road Traffic Accidents (RTAs) over the past decade. More than 60% of road traffic fatalities occured in children and young persons under 35 years of age.2 Aside the mortality and morbidity associatedwith the road crashes, Ghanaian households spend an average of US$ 1687.65 in direct and indirect cost on severe injuries associated with road crashes, while many suffer considerable degrees of psychological distress.
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Affiliation(s)
| | - Margaret Lartey
- Department of Medicine & Therapeutics, University of Ghana Medical School
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13
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Lawford HLS, Nuamah MA, Liley HG, Lee AC, Botchway F, Kumar S, Adjei AA, Bora S. Gestational Age-Specific Distribution of the Hammersmith Neonatal Neurological Examination Scores Among Low-Risk Neonates in Ghana. Early Hum Dev 2021; 152:105133. [PMID: 33249301 DOI: 10.1016/j.earlhumdev.2020.105133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/07/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe gestational age-specific distribution of scores for the Hammersmith Neonatal Neurological Examination (HNNE) up to 48 h after birth in a low-risk, term-born, single-center sample in Ghana. STUDY DESIGN This is a nested substudy of a larger prospective study (IMPRINT: Impact of Malaria in Pregnancy on Infant Neurodevelopment) comprising 140 low-risk, term-born neonates at Korle Bu Teaching Hospital in Accra, Ghana, between November 2018 and February 2019. The sample was stratified into three gestational age groups: early-term (37 + 0-38 + 6, weeks + days; n = 61), full-term (39 + 0-40 + 6, weeks + days; n = 52), and late/post-term (41 + 0-42 + 6, weeks + days; n = 27). Neonates were administered the 34-item HNNE by trained physicians. As per the original British scoring system, raw scores for the Ghanaian sample were plotted and scores > 10th centile were assigned a score of 1, 5th-10th centile 0.5, and < 5th centile 0. RESULTS The range of raw scores for 16/34 HNNE items varied with gestational age. Specifically, 100% (7/7), 50% (5/10), 33% (1/3), 33% (1/3), 20% (1/5), and 14% (1/7) of items within the orientation and behavior, tone, abnormal signs/patterns, movements, tone patterns, and reflexes subdomain, respectively showed a different distribution of scores above the 10th centile across the three gestational age groups. CONCLUSION Differences in gestational age-specific results within our sample in comparison to the original British sample could be, albeit unlikely, due to misclassification of gestational age, unmeasured maternal or fetal morbidity, or perhaps more likely, variation in testing or test conditions, or some combination of these. Genetic variation in neurological development is also a possibility. Further research is warranted to determine the reasons for differences. Our findings highlight the need to determine the accuracy and reliability of standardized neurologic assessments in predicting neurodevelopmental risk for infants in low- and middle-income countries.
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Affiliation(s)
- Harriet L S Lawford
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia
| | - Mercy A Nuamah
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, College of Health Sciences, Korle Bu Teaching Hospital, Accra, Ghana
| | - Helen G Liley
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia
| | - Anne Cc Lee
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Felix Botchway
- Department of Pathology, University of Ghana Medical School, College of Health Sciences, Korle Bu Teaching Hospital, Accra, Ghana
| | - Sailesh Kumar
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia
| | | | - Andrew A Adjei
- Department of Pathology, University of Ghana Medical School, College of Health Sciences, Korle Bu Teaching Hospital, Accra, Ghana
| | - Samudragupta Bora
- Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia.
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Regina DL, Kanagalakshmi V, Alex RG. Profile, risk factors and outcome of occupational injuries reported to the emergency department in a tertiary care hospital in South India. J Family Med Prim Care 2020; 9:5684-5688. [PMID: 33532414 PMCID: PMC7842461 DOI: 10.4103/jfmpc.jfmpc_1352_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/13/2020] [Accepted: 10/02/2020] [Indexed: 11/05/2022] Open
Abstract
Background: India is an industrialised country and most work is labour intensive. There is very scarce data on occupation related injuries Aim: To evaluate the prevalence, profile, severity and risk factors for occupational injuries presenting to the emergency medicine department of a tertiary care hospital. Materials and Methods: A cross-sectional study was done in the emergency department of Christian Medical College, Vellore among the patients who presented with occupational injuries. The risk factors for occupational injuries like age, gender, shift work, work experience and type of work and their severity and outcome were evaluated. Results: Older age group, working in shift duty, working longer hours were significant risk factors for occupational injuries. Conclusion: Training and use of safety protective measures will decrease occupational injuries.
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Affiliation(s)
- Divya L Regina
- Department and Accident and Emergecy Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - V Kanagalakshmi
- Community Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Reginald George Alex
- Department and Accident and Emergecy Medicine, Christian Medical College, Vellore, Tamil Nadu, India
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15
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Injuries and their related household costs in a tertiary hospital in Ghana. Afr J Emerg Med 2020; 10:S44-S49. [PMID: 33318901 PMCID: PMC7723915 DOI: 10.1016/j.afjem.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 04/02/2020] [Accepted: 04/12/2020] [Indexed: 11/22/2022] Open
Abstract
Introduction Injuries remain a leading cause of death in many developing countries, accounting for more deaths than HIV, tuberculosis, and malaria combined. This study set out to determine the associated patient costs of reported injury cases at the Accident and Emergency Department of the Korle-Bu Teaching Hospital (KBTH) in Accra, Ghana. Method A cross-sectional retrospective Cost-of-Illness study of 301 sampled patients was undertaken, following a review of injured patients' records from January–December 2016. Direct cost, (consisting of consultation, surgery, medicines, transportation, property damage, food and consumables) was estimated. Indirect cost was calculated using the Human capital approach. Intangible cost was assessed using Likert scale analysis. The overall household cost, average cost of various injuries and intangible costs were determined. Results The total annual household cost of injuries to patients who attended KBTH was US$11,327,461.96, of which 82% was the direct cost. The average household cost of injuries was US$ 1276.15. All injuries recorded some level of high intangible cost but was exceptional for burns. Conclusion Injured patients incur high direct treatment cost in all aetiology, with generally high intangible cost as well. It is therefore imperative that injury prevention strategies be prioritized in national health policies, while broader discussions continue on sustainable health financing of injury management.
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Benchmarking Global Trauma Care: Defining the Unmet Need for Trauma Surgery in Ghana. J Surg Res 2019; 247:280-286. [PMID: 31690530 DOI: 10.1016/j.jss.2019.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/01/2019] [Accepted: 10/05/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND The Lancet Commission on Global Surgery recommended 5000 operations/100,000 persons annually, but did not define condition-specific guidelines. New Zealand, Lancet Commission on Global Surgery's benchmark country, documented 1158 trauma operations/100,000 persons, providing a benchmark for trauma surgery needs. We sought to determine Ghana's annual trauma operation rate compared with this benchmark. METHODS Data on all operations performed in Ghana from June 2014 to May 2015 were obtained from representative sample of 48/124 district (first level), 8/11 regional, and 3/5 tertiary hospitals and scaled up for nationwide estimates. Trauma operations were grouped by hospital level and categorized into "essential" (most cost-effective, highest population impact) versus "other" (specialized) as per the World Bank's Disease Control Priorities Project. Ghana's annual trauma operation rate was compared with the New Zealand benchmark to quantify current met needs for trauma surgery. RESULTS About 232,776 operations were performed in Ghana; 35,797 were for trauma. Annual trauma operation rate was 134/100,000 (95% UI: 98-169), only 12% of the New Zealand benchmark. District hospitals performed 62% of all operations in the country, but performed only 38% of trauma operations. Eighty seven percentage of trauma operations were deemed "essential". Among specialized trauma operations, only open reduction and internal fixations had even modest numbers (3483 operations). Most other specialized trauma operations were rare. CONCLUSIONS Ghana has a large unmet need for operative trauma care. The low percentage of trauma operations in district hospitals indicates an even greater unmet need in rural areas. Future global surgery benchmarking should consider benchmarks for trauma and other specialties, as well as for different hospital levels.
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