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Global, trauma, systems, africa

Matthew C Hernandez, Arianna Birindelli, John L Bruce, Johannes J P Buitendag, Victory Y Kong, Mircea Beuran, Johnathon M Aho, Ionut Negoi, Damian L Clarke, Salomone Di Saverio, Martin D Zielinski
BACKGROUND: The American Association for the Surgery of Trauma (AAST) anatomic severity grading system for adhesive small bowel obstruction (ASBO) has demonstrated to be a valid tool in North American patient populations. Using a multi-national patient cohort, we retrospectively assessed the validity the AAST ASBO grading system and estimated disease severity in a global population in order to correlate with several key clinical outcomes. METHODS: Multicenter retrospective review during 2012-2016 from four centers, Minnesota USA, Bologna Italy, Pietermaritzburg South Africa, and Bucharest Romania, was performed...
May 16, 2018: World Journal of Surgery
Mark Tomlinson, Lorraine Sherr, Ana Macedo, Xanthe Hunt, Sarah Skeen
BACKGROUND: Globally, and in low and middle income countries (LMIC) specifically, there is a critical shortage of workers. The use of volunteers to support such care delivery systems has been examined, there is scant literature on the impact of volunteers on child outcome in high human immunodeficiency virus (HIV)-affected communities. OBJECTIVES: To examine the differential impact of paid versus volunteer workforce in Community Based Organisations (CBOs) providing care to children and families affected by the HIV epidemic in South Africa and Malawi on child outcomes over time...
2017: Global Health Action
H Uchino, V Y Kong, J L Bruce, G V Oosthuizen, W Bekker, G L Laing, D L Clarke
INTRODUCTION: The ongoing state of global geo-political instability means that it is prudent to prepare civilian surgeons to manage major military-type trauma. Japan has enjoyed a prolonged period of peace and consequently it is unlikely that surgeons will have been exposed to a sufficient volume of cases. This study reviews the state of trauma training and preparedness in Japan and reviews the trauma workload of a major Japanese emergency medical center and compared with a major South African trauma center with the intention of quantifying and comparing the time needed to gain adequate exposure to major trauma at the two centers...
November 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Jessica Eaton, Asma Bilal Hanif, Joanna Grudziak, Anthony Charles
BACKGROUND: Trauma accounts for 4.7 million deaths each year, with an estimated 90% of these occurring in low- and middle-income countries (LMICs). Approximately half of trauma-related deaths are caused by central nervous system injury. Because a thorough understanding of traumatic brain injury (TBI) in LMICs is essential to mitigate TBI-related mortality, we established a clinical and radiographic database to characterize TBI in our low-income setting. METHODS: This is a review of prospectively collected data from Kamuzu Central Hospital, a tertiary care center in the capital of Malawi...
December 2017: World Neurosurgery
(no author information available yet)
BACKGROUND: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. METHODS: We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year...
September 16, 2017: Lancet
David Lee Skinner, Grant L Laing, John Bruce, Bruce Biccard, David J J Muckart
BACKGROUND: Crush injury secondary to sjambok beatings is a well-described phenomenon in southern Africa. Owing to a number of factors, it can result in acute kidney injury (AKI). In 1992, Muckart et al. described a risk stratification system using venous bicarbonate (VB) that can be used in the management of these patients. OBJECTIVE: To validate this score in the modern era of AKI risk stratification. METHODS: A retrospective study was performed on a local trauma database from June 2010 to December 2012...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
E M McClure, A Garces, S Saleem, J L Moore, C L Bose, F Esamai, S S Goudar, E Chomba, M Mwenechanya, O Pasha, A Tshefu, A Patel, S M Dhaded, C Tenge, I Marete, M Bauserman, S Sunder, B S Kodkany, W A Carlo, R J Derman, P L Hibberd, E A Liechty, K M Hambidge, N F Krebs, M Koso-Thomas, M Miodovnik, D D Wallace, R L Goldenberg
OBJECTIVE: We sought to classify causes of stillbirth for six low-middle-income countries using a prospectively defined algorithm. DESIGN: Prospective, observational study. SETTING: Communities in India, Pakistan, Guatemala, Democratic Republic of Congo, Zambia and Kenya. POPULATION: Pregnant women residing in defined study regions. METHODS: Basic data regarding conditions present during pregnancy and delivery were collected...
January 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Sven Young, Leonard Banza, Boston S Munthali, Kumbukani G Manda, Jared Gallaher, Anthony Charles
Background and purpose - The burden of road traffic injuries globally is rising rapidly, and has a huge effect on health systems and development in low- and middle-income countries. Malawi is a small low-income country in southeastern Africa with a population of 16.7 million and a gross national income per capita of only 250 USD. The impact of the rising burden of trauma is very apparent to healthcare workers on the ground, but there are very few data showing this development. Patients and methods - The annual number of femoral fracture patients admitted to Kamuzu Central Hospital (KCH) in the Capital of Malawi, Lilongwe, from 2009 to 2014 was retrieved from the KCH trauma database...
December 2016: Acta Orthopaedica
Jared R Gallaher, Bryce E Haac, Andrew J Geyer, Charles Mabedi, Bruce A Cairns, Anthony G Charles
BACKGROUND: Traumatic injury in the elderly is an emerging global problem with an associated increase in morbidity and mortality. This study sought to describe the epidemiology of elderly injury and outcomes in sub-Saharan Africa. METHODS: We conducted a retrospective analysis of adult patients (≥ 18 years) with traumatic injuries presenting to the Kamuzu Central Hospital (KCH) in Lilongwe, Malawi, over 5 years (2009-2013). Elderly patients were defined as adults aged ≥65 years and compared to adults aged 18-44 and 45-64 years...
November 2016: World Journal of Surgery
Laura P Boschini, Yemeng Lu-Myers, Nelson Msiska, Bruce Cairns, Anthony G Charles
INTRODUCTION: Traumatic injuries account for the greatest portion of global surgical burden particularly in low- and middle-income countries (LMICs). To assess effectiveness of a developing trauma system, we hypothesize that there are survival differences between direct and indirect transfer of trauma patients to a tertiary hospital in sub Saharan Africa. METHODS: Retrospective analysis of 51,361 trauma patients within the Kamuzu Central Hospital (KCH) trauma registry from 2008 to 2012 was performed...
May 2016: Injury
Isabelle Citron, Linda Chokotho, Chris Lavy
INTRODUCTION: Disease amenable to surgical intervention accounts for 11-15 % of world disability and there is increasing interest in surgery as a global public health issue. National Health Strategic Plans (NHSPs) reflect countries' long-term health priorities, plans and targets. These plans were analysed to assess the prioritisation of surgery as a public health issue in Africa. METHODS: NHSPs of 43 independent Sub-Saharan African countries available in the public domain in March 2014 in French or English were searched electronically for key terms: surg*, ortho*, trauma, cancer, appendic*, laparotomy, HIV, tuberculosis, malaria...
April 2016: World Journal of Surgery
(no author information available yet)
Despite the fact that orthopaedic trauma injuries represent a serious cause of mortality and morbidity worldwide, there are few data in low-middle income countries quantifying the burden of fractures and describing current treatment practices. To address this critical knowledge gap, a large multinational prospective observational study of 40,000 patients with musculoskeletal trauma in Africa, Asia, and Latin America is proposed. The International Orthopaedic Multicentre Study in Fracture Care (INORMUS) study seeks to determine the incidence of major complications (mortality, reoperation, and infection) within 30 days after a musculoskeletal injury and to determine patient, treatment, and system factors associated with these major complications in low-middle income countries...
October 2015: Journal of Orthopaedic Trauma
Nadine Schuurman, Jonathan Cinnamon, Blake Byron Walker, Vanessa Fawcett, Andrew Nicol, Syed Morad Hameed, Richard Matzopoulos
BACKGROUND: Injury is a truly global health issue that has enormous societal and economic consequences in all countries. Interpersonal violence is now widely recognized as important global public health issues that can be addressed through evidence-based interventions. In South Africa, as in many low- and middle-income countries (LMIC), a lack of ongoing, systematic injury surveillance has limited the ability to characterize the burden of violence-related injury and to develop prevention programmes...
2015: Global Health Action
Gregory D Schroeder, Alexander R Vaccaro, Christopher K Kepler, John D Koerner, F Cumhur Oner, Marcel F Dvorak, Luiz R Vialle, Bizhan Aarabi, Carlo Bellabarba, Michael G Fehlings, Klaus J Schnake, Frank Kandziora
STUDY DESIGN: Survey of spine surgeons. OBJECTIVE: To develop a validated regional and global injury severity scoring system for thoracolumbar trauma. SUMMARY OF BACKGROUND DATA: The AOSpine Thoracolumbar Spine Injury Classification System was recently published and combines elements of both the Magerl system and the Thoracolumbar Injury Classification System; however, the injury severity of each fracture has yet to be established. METHODS: A survey was sent to 100 AOSpine members from all 6 AO regions of the world (North America, South America, Europe, Africa, Asia, and the Middle East)...
April 15, 2015: Spine
Linda Chokotho, Wakisa Mulwafu, Kathryn H Jacobsen, Hemant Pandit, Chris Lavy
BACKGROUND: Few injury surveillance systems collect data in sub-Saharan Africa. This medical record review of four rural hospitals provides baseline data on the burden of trauma in Malawi. METHODS: We reviewed all outpatient, inpatient, and mortuary records for one full year at four of the 28 district hospitals in Malawi: Dedza in central Malawi, Mangochi in the east, Nkhata Bay in the north, and Thyolo in the south. We used descriptive and comparative statistics to examine characteristics of patients and the data file...
December 2014: Injury
Ernest Tambo, Emmanuel Chidiebere Ugwu, Jeane Yonkeu Ngogang
UNLABELLED: There is growing concern in Sub-Saharan Africa about the spread of the Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, and the public health burden that it ensues. Since 1976, there have been 885,343 suspected and laboratory confirmed cases of EVD and the disease has claimed 2,512 cases and 932 fatality in West Africa. There are certain requirements that must be met when responding to EVD outbreaks and this process could incur certain challenges. For the purposes of this paper, five have been identified: (i) the deficiency in the development and implementation of surveillance response systems against Ebola and others infectious disease outbreaks in Africa; (ii) the lack of education and knowledge resulting in an EVD outbreak triggering panic, anxiety, psychosocial trauma, isolation and dignity impounding, stigmatisation, community ostracism and resistance to associated socio-ecological and public health consequences; (iii) limited financial resources, human technical capacity and weak community and national health system operational plans for prevention and control responses, practices and management; (iv) inadequate leadership and coordination; and (v) the lack of development of new strategies, tools and approaches, such as improved diagnostics and novel therapies including vaccines which can assist in preventing, controlling and containing Ebola outbreaks as well as the spread of the disease...
2014: Infectious Diseases of Poverty
Alain Chichom-Mefire, Nicole Therese Mbarga-Essim, Martin Ekeke Monono, Marcelin Ngowe Ngowe
BACKGROUND: Injuries are a major cause of death and disability worldwide. Low-income countries, particularly in Africa, are disproportionately affected. The burden of injuries can be alleviated by preventive measures and appropriate management of injury cases. African countries generally lack trauma care systems based on reliable and affordable guidelines. The aim of this study was to assess the compliance of some district hospitals in Cameroon with World Health Organization/International Association for Trauma and Intensive Care (WHO/IATSIC) guidelines for care of the injured...
October 2014: World Journal of Surgery
Hassan Saidi, Ben Kasyoka Mutiso, Julius Ogengo
BACKGROUND: Africa has 4% of the global vehicles but accounts for about one tenth of global vehicular deaths. Major trauma in Kenya is associated with excess mortality in comparison with series from trauma centers. The determinants of this mortality have not been completely explored. OBJECTIVES: To determine the factors affecting mortality among road users in Nairobi, Kenya. METHODS: Cross-sectional study of prospectively collected data of trauma admissions at the Kenyatta National Hospital over a calendar year (2009-2010)...
2014: Journal of Trauma Management & Outcomes
G L Laing, D L Skinner, J L Bruce, C Aldous, G V Oosthuizen, D L Clarke
BACKGROUND: The Pietermaritzburg Metropolitan Trauma Service (PMTS) attempts to provide care for a whole city and hence is referred to as a service rather than a center. As part of a multifaceted quality improvement program, the PMTS has developed and implemented a robust electronic surgical registry (ESR). This review of the first year's data from the ESR forms part of a situational analysis to assess the burden of trauma managed by the service and the quality of care delivered within the constraints of the available resources...
July 2014: World Journal of Surgery
P Sharan, C Gallo, O Gureje, E Lamberte, J J Mari, G Mazzotti, V Patel, L Swartz, S Olifson, I Levav, A de Francisco, S Saxena
BACKGROUND: Studies suggest a paucity of and lack of prioritisation in mental health research from low- and middle-income (LAMI) countries. AIMS: To investigate research priorities in mental health among researchers and other stakeholders in LAMI countries. METHOD: We used a two-stage design that included identification, through literature searches and snowball technique, of researchers and stakeholders in 114 countries of Africa, Asia, Latin America and the Caribbean; and a mail survey on priorities in research...
October 2009: British Journal of Psychiatry: the Journal of Mental Science
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