. 2024 Sep 30;11(1):e38693.

doi: 10.1016/j.heliyon.2024.e38693. eCollection 2025 Jan 15.

Incidence and prevalence of traumatic and non-traumatic wounds and burns and access to wound care in Sierra Leone; data from a nationwide household survey (PRESSCO) 2020

Jonathan H Vas Nunes^{1

2

3

4

5}, Alex J van Duinen^{3

6

7

8

9}, Daniel Boateng^{10

11}, Amidu J Tommy^{3

7}, Osman Sankoh^{12

13

14

15

16}, Martin P Grobusch^{3

17

18

19

20}, Håkon A Bolkan^{3

6

7

8}; PRESSCO 2020 study group

Affiliations

¹ Department of Surgery, Amsterdam University Medical Centres, location AMC, Amsterdam, the Netherlands.
² Global Surgery Amsterdam, Amsterdam, the Netherlands.
³ Masanga Medical Research Unit, Masanga, Sierra Leone.
⁴ Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centres, location AMC, Amsterdam Infection and Immunity, Amsterdam Public Health, Amsterdam, the Netherlands.
⁵ Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
⁶ Clinic of Surgery, St. Olavs Hospital HF, Trondheim University Hospital, Trondheim, Norway.
⁷ CapaCare, Norway, the Netherlands, Sierra Leone.
⁸ Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
⁹ Surgical Department, ELWA Hospital, Monrovia, Liberia.
¹⁰ Department of Global Public Health & Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.
¹¹ Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
¹² Deputy Vice Chancellor (Adm), University of Management and Technology (UNIMTECH), Kissy Dockyard, Freetown, Sierra Leone.
¹³ Honorary Professor, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹⁴ Visiting Scientist, Heidelberg Institute of Global Health, University of Heidelberg Medical School, Heidelberg, Germany.
¹⁵ Adjunct Professor, Njala University, School of Community Health Sciences, Bo Campus, Bo, Sierra Leone.
¹⁶ Member, International Advisory Board, The Lancet Global Health, Sierra Leone.
¹⁷ Centre of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, the Netherlands.
¹⁸ Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
¹⁹ Centre de Recherches Médicales en Lambaréné (CERMEL), Lambaréné, Gabon.
²⁰ Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.

PMID: 39802020
PMCID: PMC11719355
DOI: 10.1016/j.heliyon.2024.e38693

Incidence and prevalence of traumatic and non-traumatic wounds and burns and access to wound care in Sierra Leone; data from a nationwide household survey (PRESSCO) 2020

Jonathan H Vas Nunes et al. Heliyon. 2024.

. 2024 Sep 30;11(1):e38693.

doi: 10.1016/j.heliyon.2024.e38693. eCollection 2025 Jan 15.

Authors

Affiliations

¹ Department of Surgery, Amsterdam University Medical Centres, location AMC, Amsterdam, the Netherlands.
² Global Surgery Amsterdam, Amsterdam, the Netherlands.
³ Masanga Medical Research Unit, Masanga, Sierra Leone.
⁴ Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centres, location AMC, Amsterdam Infection and Immunity, Amsterdam Public Health, Amsterdam, the Netherlands.
⁵ Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
⁶ Clinic of Surgery, St. Olavs Hospital HF, Trondheim University Hospital, Trondheim, Norway.
⁷ CapaCare, Norway, the Netherlands, Sierra Leone.
⁸ Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
⁹ Surgical Department, ELWA Hospital, Monrovia, Liberia.
¹⁰ Department of Global Public Health & Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.
¹¹ Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
¹² Deputy Vice Chancellor (Adm), University of Management and Technology (UNIMTECH), Kissy Dockyard, Freetown, Sierra Leone.
¹³ Honorary Professor, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹⁴ Visiting Scientist, Heidelberg Institute of Global Health, University of Heidelberg Medical School, Heidelberg, Germany.
¹⁵ Adjunct Professor, Njala University, School of Community Health Sciences, Bo Campus, Bo, Sierra Leone.
¹⁶ Member, International Advisory Board, The Lancet Global Health, Sierra Leone.
¹⁷ Centre of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, the Netherlands.
¹⁸ Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
¹⁹ Centre de Recherches Médicales en Lambaréné (CERMEL), Lambaréné, Gabon.
²⁰ Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.

PMID: 39802020
PMCID: PMC11719355
DOI: 10.1016/j.heliyon.2024.e38693

Abstract

Objectives: This wound section of the PREvalence Study on Surgical COnditions (PRESSCO) determines the incidence and prevalence of wounds and burns in Sierra Leone. It further describes access to wound care and wound-related healthcare-seeking behaviour.

Methods: Between October 2019 and March 2020, a nationwide cross-sectional household survey was performed. The survey was based on Surgeons OverSeas Assessment of Surgical Need (SOSAS). Additional questions relating to wounds and burns were added. Following randomization, 25 households in 75 clusters were sampled. Severe wounds were clinically examined.

Results: Of the 3600 individuals included, 143 had developed 151 wounds, including burns (15.2 %) during the year preceding the interview (incidence 4.2 %). A total of 77 people had 83 wounds and burns at the time of the survey (prevalence 2.3 %), of which 23 were severe (prevalence 0.6 %). Burn incidence and prevalence were 0.6 % and 0.1 %, respectively. Most wounds were on extremities (73.5 %), often resulting from cuts (32.8 %), falls (22.4 %), or road traffic accidents (RTA; 16.4 %). Risk factors for developing a wound were male sex (p = 0.004), older age (p = 0.037) and smoking (p = 0.001). Severe wounds had a median duration of 18 months. For 70.2 % of wounds, care at a health facility was sought. Only 49.9 % of households reported financial capacity to visit a secondary health facility. For 56 (37.1 %) of wounds, the desired care was not obtainable. An estimated 44,000 (95 % CI 29,760-67,410) people in Sierra Leone suffer from a severe wound. An estimated 11,000 (95 % CI 6,416-18,268) annual deaths occur due to wounds, predominantly due to RTA's (66.7 %) and accidental injuries (20.0 %).

Conclusions: Wounds and burns account for an extensive burden on the health and economics of the individual, the household, and the Sierra Leonean society. For over one-third of wounds, the desired surgical care was not obtainable.

Keywords: Accidents; Burns; General surgery; Health care surveys; Healthcare inequalities; Help-seeking behaviour; Needs assessment; Neglected diseases; Sierra Leone; Traffic; Wounds and injuries.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

**Fig. 1**
flowchart of respondents and wound numbers.

**Fig. 2**
Distribution of wounds and burns.

See this image and copyright information in PMC

References

1. Mitjà O., Marks M., Bertran L., Kollie K., Argaw D., Fahal A.H., Fitzpatrick C., Fuller L.C., Garcia Izquierdo B., Hay R., Ishii N., Johnson C., Lazarus J.V., Meka A., Murdoch M., Ohene S.-A., Small P., Steer A., Tabah E.N., Tiendrebeogo A., Waller L., Yotsu R., Walker S.L., Asiedu K. Integrated control and management of neglected tropical skin diseases. PLoS Neglected Trop. Dis. 2017;11 doi: 10.1371/journal.pntd.0005136. - DOI - PMC - PubMed
1. Engelman D., Fuller L.C., Solomon A.W., McCarthy J.S., Hay R.J., Lammie P.J., Steer A.C. Opportunities for integrated control of neglected tropical diseases that affect the skin. Trends Parasitol. 2016;32:843–854. doi: 10.1016/j.pt.2016.08.005. - DOI - PubMed
1. Seth D., Cheldize K., Brown D., Freeman E.E. Global burden of skin disease: inequities and innovations. Curr Dermatol Rep. 2017;6:204–210. doi: 10.1007/s13671-017-0192-7. - DOI - PMC - PubMed
1. Roa L., Jumbam D.T., Makasa E., Meara J.G. Global surgery and the sustainable development goals. Br. J. Surg. 2019;106:e44–e52. doi: 10.1002/bjs.11044. - DOI - PubMed
1. Debas H.T., Donkor P., Gawande A., Jamison D.T., Kruk M.E., Mock C.N. third ed. (Volume 1. Essential Surgery, The World Bank; 2015. Disease Control Priorities. - DOI - PubMed

LinkOut - more resources

Full Text Sources
- Elsevier Science
- PubMed Central

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Incidence and prevalence of traumatic and non-traumatic wounds and burns and access to wound care in Sierra Leone; data from a nationwide household survey (PRESSCO) 2020

Affiliations

Incidence and prevalence of traumatic and non-traumatic wounds and burns and access to wound care in Sierra Leone; data from a nationwide household survey (PRESSCO) 2020

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

References

LinkOut - more resources

Full Text Sources

Abstract

Conflict of interest statement

Figures

Similar articles

References

Related information

LinkOut - more resources

Full Text Sources