Road traffic accident injuries in Kampala

Abstract

Objective: To determine the circumstances related to road traffic injuries (RTIs), emergency and acute care, as well as outcomes in a hospital population.

Setting: The casualty department of a 1200-bed teaching hospital in Kampala.

Method: Information pertaining to age, categorical crash circumstances, activity when injury sustained, crash protection used, alcohol use, transport to hospital, pre-hospital treatment, and injury time were elicited from all admitted patients presenting with injuries due to road traffic crashes. A standardised form was used. Data were linked with the hospital's trauma registry which records injury severity and event location.

Results: During the study period, 6432 patients were treated in the casualty department, of whom 1988 (30.9%) were injury cases. There were 697 road traffic injuries, accounting for 35.1% of all trauma, the largest single external cause. Over half of the cases required admission (351/697, 50.4%), and 10 (1.4%) died in the casualty department. Pedestrians were the largest single external cause, constituting 43.5% (157/361) of RTI. Only 3.4% (3/89) of cyclists reported wearing a helmet; no vehicle occupants reported using safety belts. Private transport to hospital was used by 78% (284/361) of the victims. Mean time from injury to treatment was 155 minutes (range 15-1440, SD +/- 224.2). Mortality two weeks after admission was 10.2% (37/361) and a further 19.1% (67/351) remained in hospital at two weeks.

Conclusion: RTI is the largest single cause of severe injury in this population, with pedestrians, especially children and adolescents, the most affected group. Safety restraint and crash helmet use is rare. Alcohol is an important factor. Prevention and control efforts could focus on safety belt and crash helmet use; improved emergency services, trauma management training, and first-aid.