Journal Article > ResearchFull Text
Surgery. 2022 March 29; Volume 5 (Issue 2); e68-e68.; DOI:10.1097/GH9.0000000000000068
De Costa J, Briskin E, Trelles M, Dominguez LB, Nyaruhirira I, et al.
Surgery. 2022 March 29; Volume 5 (Issue 2); e68-e68.; DOI:10.1097/GH9.0000000000000068
INTRODUCTION
Medecins Sans Frontieres (MSF) is known for its work providing surgical care for victims of violent trauma (VT) in conflict zones. However, the trauma centers also deal with road traffic accidents (RTAs) which may require different staffing, facilities and supplies as compared with those required for VT. This study aimed to compare differences in types of injuries, clinical outcomes, and resources needed to properly operate trauma centers in low and middle-income countries.
MATERIAL AND METHODS
This was a retrospective analysis of routine program data of >70,000 patient presentations in the emergency, in-patient, and operating departments of 2 of MSF’s major trauma centers, in Kunduz (Afghanistan) and Bujumbura (Burundi), using data from 2011 to 2018.
RESULTS
RTAs comprised a significant proportion of overall presentations to these centers (23% in Kunduz and 56% in Bujumbura). RTA patients presented with different patterns of injury, with higher rates of fractures, extremity injuries, and traumatic brain injury. RTA patients were 2.3 times more likely to have a peripheral injury (extremities and head) as VT patients, and 12.5 times more likely to undergo an orthopedic procedure. VT patients had higher rates of abdominal injury. However, there was no statistically significant difference in overall mortality and length of stay between the 2 groups.
CONCLUSION
This study demonstrates that trauma centers, even in zones of conflict, need to be prepared and resourced to manage RTA cases. Policy-makers in such centers should be aware of the different injury patterns associated with this patient group and have appropriate, sustainable capacity to manage RTA trauma, particularly in terms of management of orthopedic injuries.
Medecins Sans Frontieres (MSF) is known for its work providing surgical care for victims of violent trauma (VT) in conflict zones. However, the trauma centers also deal with road traffic accidents (RTAs) which may require different staffing, facilities and supplies as compared with those required for VT. This study aimed to compare differences in types of injuries, clinical outcomes, and resources needed to properly operate trauma centers in low and middle-income countries.
MATERIAL AND METHODS
This was a retrospective analysis of routine program data of >70,000 patient presentations in the emergency, in-patient, and operating departments of 2 of MSF’s major trauma centers, in Kunduz (Afghanistan) and Bujumbura (Burundi), using data from 2011 to 2018.
RESULTS
RTAs comprised a significant proportion of overall presentations to these centers (23% in Kunduz and 56% in Bujumbura). RTA patients presented with different patterns of injury, with higher rates of fractures, extremity injuries, and traumatic brain injury. RTA patients were 2.3 times more likely to have a peripheral injury (extremities and head) as VT patients, and 12.5 times more likely to undergo an orthopedic procedure. VT patients had higher rates of abdominal injury. However, there was no statistically significant difference in overall mortality and length of stay between the 2 groups.
CONCLUSION
This study demonstrates that trauma centers, even in zones of conflict, need to be prepared and resourced to manage RTA cases. Policy-makers in such centers should be aware of the different injury patterns associated with this patient group and have appropriate, sustainable capacity to manage RTA trauma, particularly in terms of management of orthopedic injuries.
Journal Article > Case Report/SeriesFull Text
Oxf Med Case Reports. 2020 August 1; Volume 2020 (Issue 8); omaa061.; DOI:10.1093/omcr/omaa061
Haddara MM, Haberisoni JB, Trelles M, Gohou JP, Christella K, et al.
Oxf Med Case Reports. 2020 August 1; Volume 2020 (Issue 8); omaa061.; DOI:10.1093/omcr/omaa061
Hippopotamus is one of the most-loved animals in Africa, yet it is aggressive and dangerous. The co-existence of humans in close proximity to their natural habitat increases the probability of human injury. Hippopotamus attacks have long been recognized to cause serious injuries, but its magnitude and burden are still unknown. The medical literature is very scarce when it comes to documenting hippopotamus bite injuries and their outcomes. We present a cohort of 11 patients who suffered hippopotamus bite injuries in Burundi. To our knowledge, this is the largest case series reporting on the clinical presentation, injury patterns and surgical outcomes of hippopotamus bites. The results show a high incidence of wound infections, amputations and permanent disability among other complications. Hippopotamus-inflicted injuries should, therefore, be triaged as major trauma rather than just 'mammalian bites'.