Journal Article > ResearchFull Text
Public Health Action. 1 August 2023; Volume 13 (Issue 2(Suppl 1)); 25-29.; DOI:10.5588/pha.23.0007
Niyonzima F, Kamosi HM, Soro J, Ntihabose O, Hehadji D, et al.
Public Health Action. 1 August 2023; Volume 13 (Issue 2(Suppl 1)); 25-29.; DOI:10.5588/pha.23.0007
CONTEXTE
En 2015, Médecins Sans Frontières a ouvert un Centre de Traumatologie Arche Kigobe à Bujumbura, Burundi, pour prise en charge des victimes des violences, et a élargi en 2016 les critères d’admission aux brûlures, sans unité spécialisé pour leur prise en charge.
OBJECTIF
Etudier les facteurs associés à une issue défavorable (décès, référés, et sortis contre avis médical), chez les brûlés hospitalisés dans ce centre.
MÉTHODE
Ceci est étude descriptive et analytique rétrospective des patients brûlés hospitalisés
RÉSULTATS
De 2016 à 2020, 477 patients ont été hospitalisés au Centre pour brûlure, dont 301 (63%) avaient moins de 5 ans, 169 (35%) étaient de sexe féminin, et 48 (10%) avaient une issue défavorable. L’anémie (OR 11 ; IC 95% 2,7–48), l’infection (OR 11 ; IC 95% 5,7–22), et l’inhalation de fumée (OR 28 ; IC 95% 7–111), étaient parmi les principaux facteurs associés à une issue défavorable.
CONCLUSION
Même dans les contextes à ressources limitées, pour minimiser les issues défavorables liés à l’inhalation et l’infection chez les brûlés, un circuit d’isolement septique, la formation, un service de bactériologie, et les appareils de ventilation en pression positive continue pourraient être mis en place.
En 2015, Médecins Sans Frontières a ouvert un Centre de Traumatologie Arche Kigobe à Bujumbura, Burundi, pour prise en charge des victimes des violences, et a élargi en 2016 les critères d’admission aux brûlures, sans unité spécialisé pour leur prise en charge.
OBJECTIF
Etudier les facteurs associés à une issue défavorable (décès, référés, et sortis contre avis médical), chez les brûlés hospitalisés dans ce centre.
MÉTHODE
Ceci est étude descriptive et analytique rétrospective des patients brûlés hospitalisés
RÉSULTATS
De 2016 à 2020, 477 patients ont été hospitalisés au Centre pour brûlure, dont 301 (63%) avaient moins de 5 ans, 169 (35%) étaient de sexe féminin, et 48 (10%) avaient une issue défavorable. L’anémie (OR 11 ; IC 95% 2,7–48), l’infection (OR 11 ; IC 95% 5,7–22), et l’inhalation de fumée (OR 28 ; IC 95% 7–111), étaient parmi les principaux facteurs associés à une issue défavorable.
CONCLUSION
Même dans les contextes à ressources limitées, pour minimiser les issues défavorables liés à l’inhalation et l’infection chez les brûlés, un circuit d’isolement septique, la formation, un service de bactériologie, et les appareils de ventilation en pression positive continue pourraient être mis en place.
Journal Article > ResearchFull Text
Surgery. 29 March 2022; 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. 29 March 2022; 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.