Main Article Content
Abstract
Low income countries are disproportionately affected by injuries. Most injury related death and disabilities occur as the result of road traffic accidents. This study aims at analysing the epidemiology and pattern of road traffic related injuries in a semi-urban area in the northern part of Cameroon where no such data existed before.
This hospital based retrospective analysis was conducted over a period of five years in a level III institution in the Adamaoua region of Cameroon. The records of all patients received in the emergency department of Ngaoundéré hospital after a road traffic related injury were reviewed for epidemiological variables, type of vehicle involved, nature and severity of injuries, modalities of management and outcome. A total of 1257 victims of road traffic injuries could be analyzed. Their ages ranged from 2 to 84 years and males were more affected than females. Almost 60% of victims were motorcycle users. Each patient sustained a mean of 1.3 lesions. The head and lower limbs were the most affected body parts. The most frequent lesions were soft tissue injuries and bone fractures, involving mostly the lower limb. Most injuries were of minor or moderate severity and the admission rate was 28%. A total of 79 patients (6.3%) were reported dead. Most of them sustained a head injury. The massive presence of motorcycles in the Adamaoua region seems to influence the pattern of road traffic injuries. A more comprehensive system of capturing injury cases needs to be developed in Ngaoundéré.
Résumé
Le nombre croissant des victimes et la gravité des lésions par accident sur la voie publique (AVP) reçus aux urgences de l’Hôpital Régional de Ngaoundéré sont préoccupants.
Ce travail a pour objectif d’identifier les caractéristiques épidémiologiques des accidentés, les types d’engins, les facteurs favorisants, les différentes lésions et les modalités de leur prise en charge.
L’étude rétrospective couvre la période 2005-2010, soit au total 1496 traumatisés, dont 1257 cas d’AVP. La sex-ratio Homme/Femme est de 2.36 et l’âge moyen des victimes est de 43,5± 5 ans.
Les engins mis en cause ont été recensés : les motos (67.77%), les véhicules à 4roues et plus (30.15%), train (1.36%) et bicyclette (0.72%). Les facteurs principaux favorisants sont : la méconnaissance du code de la route, l’excès de vitesse, l’état de dégradation des routes, l’état défectueux des moyens de déplacement, l’alcoolisme et la drogue.
Les lésions les plus fréquentes sont : les fractures (38.05%), les traumatismes crâniens et crânio-faciaux (13.28%), les contusions (12.10%) et les plaies des parties molles (11.38%).
La conduite thérapeutique est fonction de la nature de la lésion. Nous avons enregistré 79 décès soit 6.28%.
Les AVP sont en augmentation constantes du fait de l’adoption de la moto comme moyen principal de transport urbain.
Keywords
Article Details
References
- Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997;349 (9061):1269-76.
- Nordberg E. Injuries as a public health problem in sub-Saharan Africa: epidemiology and prospects for control. East Afr. Med J. 2000;77 (12 Suppl):S1-43.
- Söderlund N, Zwi AB. Traffic-related mortality in industrialized and less developed countries. Bull World Health Organ. 1995;73(2):175-82.
- Nantulya VM, Reich MR. Equity dimensions of road traffic injuries in low- and middle-income countries. Inj Control Saf Promot. 2003;10 (1-2):13-20.
- Romão F, Nizamo H, Mapasse D, Rafico MM, José J, Mataruca S, Efron ML, Omondi LO, Leifert T, Bicho JM. Road traffic injuries in Mozambique. Inj Control Saf Promot. 2003;10(1-2):63-7.
- Afukaar FK, Antwi P, Ofosu-Amaah S. Pattern of road traffic injuries in Ghana: implications for control. Inj Control Saf Promot. 2003;10(1-2):69-76.
- Olukoga IA. Pedestrian casualties and fatalities in road traffic crashes in a South African municipality. Traffic Inj Prev. 2003;4(4):355-7.
- Sobngwi-Tambekou J, Bhatti J, Kounga G, Salmi LR, Lagarde E. Road traffic crashes on the Yaoundé-Douala road section, Cameroon. Accid Anal Prev. 2010;42 (2):422-6.
- Chichom Mefire A, Etoundi Mballa GA, Azabji Kenfack M, Juillard C, Stevens K. Hospital-based injury data from level III institution in Cameroon: Retrospective analysis of the present registration system. Injury. 2013;44 (1):139-43.
- Juillard C, Etoundi Mballa GA, Bilounga Ndongo C, Stevens KA, Hyder AA. Patterns of Injury and Violence in Yaoundé Cameroon: An Analysis of Hospital Data. World J Surg. 2010 ; 29.
- Banthia P, Koirala B, Rauniyar A, Chaudhary D, Kharel T, Khadka SB. An epidemiological study of road traffic accident cases attending emergency department of teaching hospital. JNMA J Nepal Med Assoc. 2006;45 (162):238-43.
- Híjar M, Arredondo A, Carrillo C, Solórzano L. Road traffic injuries in an urban area in Mexico. An epidemiological and cost analysis. Accid Anal Prev. 2004;36(1):37-42.
- Swaddiwudhipong W, Nguntra P, Mahasakpan P, Koonchote S, Tantriratna G. Epidemiologic characteristics of drivers, vehicles, pedestrians and road environments involved in road traffic injuries in rural Thailand. Southeast Asian J Trop Med Public Health. 1994;25 (1):37-44.
- Gururaj G. Road traffic deaths, injuries and disabilities in India: current scenario. Natl Med J India. 2008; 21(1):14-20.
- Luby S, Hassan I, Jahangir N, Rizvi N, Farooqi M, Ubaid S, Sadruddin S. Road traffic injuries in Karachi: the disproportionate role of buses and trucks. Southeast Asian J Trop Med Public Health. 1997; 28 (2):395-8.
- Santamariña-Rubio E, Pérez K, Ricart I, Arroyo A, Castellà J, Borrell C. Injury profiles of road traffic deaths. Accid Anal Prev. 2007;39 (1):1-5.
- Zargar M, Khaji A, Karbakhsh M. Pattern of motorcycle-related injuries in Tehran, 1999 to 2000: a study in 6 hospitals. East Mediterr Health J. 2006;12(1-2):81-7.
- von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370 (9596):1453-7.
- Schmucker U, Seifert J, Stengel D, Matthes G, Ottersbach C, Ekkernkamp A. Road traffic crashes in developing countries. Unfallchirurg. 2010;113 (5):373-7.
- Bhalla K, Naghavi M, Shahraz S, Bartels D, Murray CJ. Building national estimates of the burden of road traffic injuries in developing countries from all available data sources: Iran. Inj Prev. 2009;15 (3):150-6.
- Odero W, Khayesi M, Heda PM. Road traffic injuries in Kenya: magnitude, causes and status of intervention. Inj Control Saf Promot. 2003;10 (1-2):53-61.
- Marmor M, Parnes N, Aladgem D, Birshan V, Sorkine P, Halpern P. Characteristics of road traffic accidents treated in an urban trauma center. Isr Med Assoc J. 2005;7(1):9-12.
- Haileyesus T, Annest JL, Dellinger AM. Cyclists injured while sharing the road with motor vehicles. Inj Prev. 2007;13(3):202-6.
- Kobusingye OC, Guwatudde D, Owor G, Lett RR. Citywide trauma experience in Kampala, Uganda: a call for intervention. Inj Prev. 2002;8(2):133-6.
- Taye M, Munie T. Trauma registry in Tikur Anbessa Hospital, Addis Ababa, Ethiopia. Ethiop Med J. 2003;41(3):221-6.
- Di Bartolomeo S, Nardi G, Sanson G, Gordini G, Michelutto V, Ciminello M, Giugni A, Cingolani E, Cancellieri F. The first Italian trauma registry of national relevance: methodology and initial results. Eur J Emerg Med. 2006;13(4):197-203.
- Schuurman N, Cinnamon J, Matzopoulos R, Fawcett V, Nicol A, Hameed SM. Collecting injury surveillance data in low- and middle-income countries: The Cape Town Trauma Registry pilot. Glob Public Health. 2010 ; 11:1-16.
- Schultz CR, Ford HR, Cassidy LD, Shultz BL, Blanc C, King-Schultz LW, Perry HB. Development of a hospital-based trauma registry in Haiti: an approach for improving injury surveillance in developing and resource-poor settings. J Trauma. 2007;63(5):1143-54.
- Roudsari BS, Sharzei K, Zargar M. Sex and age distribution in transport-related injuries in Tehran. Accid Anal Prev. 2004;36(3):391-8.
- Suriyawongpaisal P, Kanchanasut S. Road traffic injuries in Thailand: trends, selected underlying determinants and status of intervention. Inj Control Saf Promot. 2003;10(1-2):95-104.
- Garg N, Hyder AA. Road traffic injuries in India: a review of the literature. Scand J Public Health. 2006; 34 (1):100-9.
- Zhou JH, Zhao XC, Wang ZG, Zhu PF, Jian HG, Liu DW, Zhou JL, Liu L. The analysis of epidemiological characteristics of road traffic crashes in a mountain city in western China. Chin J Traumatol. 2003;6 (6):355-8.
- Agnihotri AK, Joshi HS. Pattern of road traffic injuries: one year hospital-based study in Western Nepal. Int J Inj Contr Saf Promot. 2006; 13 (2):128-30.
- Beck LF, Dellinger AM, O'Neil ME. Motor vehicle crash injury rates by mode of travel, United States: using exposure-based methods to quantify differences. Am J Epidemiol. 2007;166(2):212-8.
- Beyaztaş FY, Alagözlü H. Evaluation of traffic accident cases admitted to the emergency department of the Cumhuriyet University Hospital in 1998] Ulus Travma Derg. 2002;8(1):29-33.
- Rodríguez DY, Fernández FJ, Acero Velásquez H. Road traffic injuries in Colombia. Inj Control Saf Promot. 2003;10 (1-2):29-35.
- St Bernard G, Matthews W. A contemporary analysis of road traffic crashes, fatalities and injuries in Trinidad and Tobago. Inj Control Saf Promot. 2003;10(1-2):21-7.
- Olukoga A.Trends in road traffic crashes, casualties and fatalities in Malawi. Trop Doct. 2007;37(1):24-8
- Bachani AM, Koradia P, Herbert HK, Mogere S, Akungah D, Nyamari J, Osoro E, Maina W, Stevens KA. Road traffic injuries in Kenya: the health burden and risk factors in two districts. Traffic Inj Prev. 2012; 13 Suppl 1:24-30.
- Markogiannakis H, Sanidas E, Messaris E, Koutentakis D, Alpantaki K, Kafetzakis A, Tsiftsis D. Motor vehicle trauma: analysis of injury profiles by road-user category. Emerg Med J. 2006;23(1):27-31.
- Umaru H, Ahidjo A, Dogo H. Pedestrian injuries resulting from road traffic accidents: the Azare experience. Niger J Med. 2007;16(2):169-72.
- Zimmerman K, Mzige AA, Kibatala PL, Museru LM, Guerrero A. Road traffic injury incidence and crash characteristics in Dar es Salaam: a population based study. Accid Anal Prev. 2012;45:204-10.
- Akama MK, Chindia ML, Macigo FG, Guthua SW. Pattern of maxillofacial and associated injuries in road traffic accidents. East Afr Med J. 2007;84(6):287-95.
- Agnihotri AK, Joshi HS. Pattern of road traffic injuries: one year hospital-based study in Western Nepal. Int J Inj Contr Saf Promot. 2006 Jun;13(2):128-30.
- Oluwadiya KS, Oginni LM, Olasinde AA, Fadiora SO. Motorcycle limb injuries in a developing country. West Afr J Med. 2004;23(1):42-7.
- Jeffers RF, Tan HB, Nicolopoulos C, Kamath R, Giannoudis PV. Prevalence and patterns of foot injuries following motorcycle trauma. J Orthop Trauma. 2004 Feb;18(2):87-91.
- Langley J, Marshall SW. The severity of road traffic crashes resulting in hospitalisation in New Zealand. Accid Anal Prev. 1994;26 (4):549-54.
- Andrews CN, Kobusingye OC, Lett R. Road traffic accident injuries in Kampala. East Afr Med J. 1999;76(4):189-94.
- Moghadam PF, Dallago G, Piffer S, Zanon G, Menegon S, Fontanari S, Furlanello C. Epidemiology of traffic accidents in the province of Trento: first results of an integrated surveillance system (MITRIS)] Epidemiol Prev. 2005;29 (3-4):172-9.
- Montazeri A. Road-traffic-related mortality in Iran: a descriptive study. Public Health. 2004;118(2):110-3.
- Forjuoh SN. Traffic-related injury prevention interventions for low-income countries. Inj Control Saf Promot. 2003;10(1-2):109-18.
- Keough L, Rinkle J, Hage R, Brown LH, Hunt RC. The effect of road improvements on motor vehicle crash injury and mortality in a developing country. Annu Proc Assoc Adv Automot Med. 2001;45:369-75.
References
Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997;349 (9061):1269-76.
Nordberg E. Injuries as a public health problem in sub-Saharan Africa: epidemiology and prospects for control. East Afr. Med J. 2000;77 (12 Suppl):S1-43.
Söderlund N, Zwi AB. Traffic-related mortality in industrialized and less developed countries. Bull World Health Organ. 1995;73(2):175-82.
Nantulya VM, Reich MR. Equity dimensions of road traffic injuries in low- and middle-income countries. Inj Control Saf Promot. 2003;10 (1-2):13-20.
Romão F, Nizamo H, Mapasse D, Rafico MM, José J, Mataruca S, Efron ML, Omondi LO, Leifert T, Bicho JM. Road traffic injuries in Mozambique. Inj Control Saf Promot. 2003;10(1-2):63-7.
Afukaar FK, Antwi P, Ofosu-Amaah S. Pattern of road traffic injuries in Ghana: implications for control. Inj Control Saf Promot. 2003;10(1-2):69-76.
Olukoga IA. Pedestrian casualties and fatalities in road traffic crashes in a South African municipality. Traffic Inj Prev. 2003;4(4):355-7.
Sobngwi-Tambekou J, Bhatti J, Kounga G, Salmi LR, Lagarde E. Road traffic crashes on the Yaoundé-Douala road section, Cameroon. Accid Anal Prev. 2010;42 (2):422-6.
Chichom Mefire A, Etoundi Mballa GA, Azabji Kenfack M, Juillard C, Stevens K. Hospital-based injury data from level III institution in Cameroon: Retrospective analysis of the present registration system. Injury. 2013;44 (1):139-43.
Juillard C, Etoundi Mballa GA, Bilounga Ndongo C, Stevens KA, Hyder AA. Patterns of Injury and Violence in Yaoundé Cameroon: An Analysis of Hospital Data. World J Surg. 2010 ; 29.
Banthia P, Koirala B, Rauniyar A, Chaudhary D, Kharel T, Khadka SB. An epidemiological study of road traffic accident cases attending emergency department of teaching hospital. JNMA J Nepal Med Assoc. 2006;45 (162):238-43.
Híjar M, Arredondo A, Carrillo C, Solórzano L. Road traffic injuries in an urban area in Mexico. An epidemiological and cost analysis. Accid Anal Prev. 2004;36(1):37-42.
Swaddiwudhipong W, Nguntra P, Mahasakpan P, Koonchote S, Tantriratna G. Epidemiologic characteristics of drivers, vehicles, pedestrians and road environments involved in road traffic injuries in rural Thailand. Southeast Asian J Trop Med Public Health. 1994;25 (1):37-44.
Gururaj G. Road traffic deaths, injuries and disabilities in India: current scenario. Natl Med J India. 2008; 21(1):14-20.
Luby S, Hassan I, Jahangir N, Rizvi N, Farooqi M, Ubaid S, Sadruddin S. Road traffic injuries in Karachi: the disproportionate role of buses and trucks. Southeast Asian J Trop Med Public Health. 1997; 28 (2):395-8.
Santamariña-Rubio E, Pérez K, Ricart I, Arroyo A, Castellà J, Borrell C. Injury profiles of road traffic deaths. Accid Anal Prev. 2007;39 (1):1-5.
Zargar M, Khaji A, Karbakhsh M. Pattern of motorcycle-related injuries in Tehran, 1999 to 2000: a study in 6 hospitals. East Mediterr Health J. 2006;12(1-2):81-7.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370 (9596):1453-7.
Schmucker U, Seifert J, Stengel D, Matthes G, Ottersbach C, Ekkernkamp A. Road traffic crashes in developing countries. Unfallchirurg. 2010;113 (5):373-7.
Bhalla K, Naghavi M, Shahraz S, Bartels D, Murray CJ. Building national estimates of the burden of road traffic injuries in developing countries from all available data sources: Iran. Inj Prev. 2009;15 (3):150-6.
Odero W, Khayesi M, Heda PM. Road traffic injuries in Kenya: magnitude, causes and status of intervention. Inj Control Saf Promot. 2003;10 (1-2):53-61.
Marmor M, Parnes N, Aladgem D, Birshan V, Sorkine P, Halpern P. Characteristics of road traffic accidents treated in an urban trauma center. Isr Med Assoc J. 2005;7(1):9-12.
Haileyesus T, Annest JL, Dellinger AM. Cyclists injured while sharing the road with motor vehicles. Inj Prev. 2007;13(3):202-6.
Kobusingye OC, Guwatudde D, Owor G, Lett RR. Citywide trauma experience in Kampala, Uganda: a call for intervention. Inj Prev. 2002;8(2):133-6.
Taye M, Munie T. Trauma registry in Tikur Anbessa Hospital, Addis Ababa, Ethiopia. Ethiop Med J. 2003;41(3):221-6.
Di Bartolomeo S, Nardi G, Sanson G, Gordini G, Michelutto V, Ciminello M, Giugni A, Cingolani E, Cancellieri F. The first Italian trauma registry of national relevance: methodology and initial results. Eur J Emerg Med. 2006;13(4):197-203.
Schuurman N, Cinnamon J, Matzopoulos R, Fawcett V, Nicol A, Hameed SM. Collecting injury surveillance data in low- and middle-income countries: The Cape Town Trauma Registry pilot. Glob Public Health. 2010 ; 11:1-16.
Schultz CR, Ford HR, Cassidy LD, Shultz BL, Blanc C, King-Schultz LW, Perry HB. Development of a hospital-based trauma registry in Haiti: an approach for improving injury surveillance in developing and resource-poor settings. J Trauma. 2007;63(5):1143-54.
Roudsari BS, Sharzei K, Zargar M. Sex and age distribution in transport-related injuries in Tehran. Accid Anal Prev. 2004;36(3):391-8.
Suriyawongpaisal P, Kanchanasut S. Road traffic injuries in Thailand: trends, selected underlying determinants and status of intervention. Inj Control Saf Promot. 2003;10(1-2):95-104.
Garg N, Hyder AA. Road traffic injuries in India: a review of the literature. Scand J Public Health. 2006; 34 (1):100-9.
Zhou JH, Zhao XC, Wang ZG, Zhu PF, Jian HG, Liu DW, Zhou JL, Liu L. The analysis of epidemiological characteristics of road traffic crashes in a mountain city in western China. Chin J Traumatol. 2003;6 (6):355-8.
Agnihotri AK, Joshi HS. Pattern of road traffic injuries: one year hospital-based study in Western Nepal. Int J Inj Contr Saf Promot. 2006; 13 (2):128-30.
Beck LF, Dellinger AM, O'Neil ME. Motor vehicle crash injury rates by mode of travel, United States: using exposure-based methods to quantify differences. Am J Epidemiol. 2007;166(2):212-8.
Beyaztaş FY, Alagözlü H. Evaluation of traffic accident cases admitted to the emergency department of the Cumhuriyet University Hospital in 1998] Ulus Travma Derg. 2002;8(1):29-33.
Rodríguez DY, Fernández FJ, Acero Velásquez H. Road traffic injuries in Colombia. Inj Control Saf Promot. 2003;10 (1-2):29-35.
St Bernard G, Matthews W. A contemporary analysis of road traffic crashes, fatalities and injuries in Trinidad and Tobago. Inj Control Saf Promot. 2003;10(1-2):21-7.
Olukoga A.Trends in road traffic crashes, casualties and fatalities in Malawi. Trop Doct. 2007;37(1):24-8
Bachani AM, Koradia P, Herbert HK, Mogere S, Akungah D, Nyamari J, Osoro E, Maina W, Stevens KA. Road traffic injuries in Kenya: the health burden and risk factors in two districts. Traffic Inj Prev. 2012; 13 Suppl 1:24-30.
Markogiannakis H, Sanidas E, Messaris E, Koutentakis D, Alpantaki K, Kafetzakis A, Tsiftsis D. Motor vehicle trauma: analysis of injury profiles by road-user category. Emerg Med J. 2006;23(1):27-31.
Umaru H, Ahidjo A, Dogo H. Pedestrian injuries resulting from road traffic accidents: the Azare experience. Niger J Med. 2007;16(2):169-72.
Zimmerman K, Mzige AA, Kibatala PL, Museru LM, Guerrero A. Road traffic injury incidence and crash characteristics in Dar es Salaam: a population based study. Accid Anal Prev. 2012;45:204-10.
Akama MK, Chindia ML, Macigo FG, Guthua SW. Pattern of maxillofacial and associated injuries in road traffic accidents. East Afr Med J. 2007;84(6):287-95.
Agnihotri AK, Joshi HS. Pattern of road traffic injuries: one year hospital-based study in Western Nepal. Int J Inj Contr Saf Promot. 2006 Jun;13(2):128-30.
Oluwadiya KS, Oginni LM, Olasinde AA, Fadiora SO. Motorcycle limb injuries in a developing country. West Afr J Med. 2004;23(1):42-7.
Jeffers RF, Tan HB, Nicolopoulos C, Kamath R, Giannoudis PV. Prevalence and patterns of foot injuries following motorcycle trauma. J Orthop Trauma. 2004 Feb;18(2):87-91.
Langley J, Marshall SW. The severity of road traffic crashes resulting in hospitalisation in New Zealand. Accid Anal Prev. 1994;26 (4):549-54.
Andrews CN, Kobusingye OC, Lett R. Road traffic accident injuries in Kampala. East Afr Med J. 1999;76(4):189-94.
Moghadam PF, Dallago G, Piffer S, Zanon G, Menegon S, Fontanari S, Furlanello C. Epidemiology of traffic accidents in the province of Trento: first results of an integrated surveillance system (MITRIS)] Epidemiol Prev. 2005;29 (3-4):172-9.
Montazeri A. Road-traffic-related mortality in Iran: a descriptive study. Public Health. 2004;118(2):110-3.
Forjuoh SN. Traffic-related injury prevention interventions for low-income countries. Inj Control Saf Promot. 2003;10(1-2):109-18.
Keough L, Rinkle J, Hage R, Brown LH, Hunt RC. The effect of road improvements on motor vehicle crash injury and mortality in a developing country. Annu Proc Assoc Adv Automot Med. 2001;45:369-75.