Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-25T08:13:52.210Z Has data issue: false hasContentIssue false

Epidemiology of Injuries in Nigeria—A Systematic review of Mortality and Etiology

Published online by Cambridge University Press:  07 October 2011

Lateef O.A. Thanni*
Affiliation:
Associate Professor/Consultant Surgeon, Department of Orthopaedics and Traumatology, Olabisi Onabanjo University Teaching Hospital/Olabisi Onabanjo University, Sagamu, Ogun State, Nigeria
*
Correspondence: Lateef O.A. Thanni Department of Orthopaedics and TraumatologyOlabisi Onabanjo University Teaching HospitalOlabisi Onabanjo UniversityPMB 2022Sagamu 121001, Ogun State, Nigeria E-mail: HYPERLINK “mailto:[email protected][email protected]

Abstract

Background: Trauma is a major health issue worldwide, but especially so in developing countries such as Nigeria, where no comprehensive, national, injury data exist. There is a need to better define the epidemiology of injury as a basis for formulation of violence and injury prevention strategy.

Methods: This is a systematic analysis of published data on the epidemiology of injuries.

Objectives: The objective of this study was to describe the prevalent causes of injury among adults and children, and the causes of injury mortality.

Results: The medical records of 15,694 patients from the age of two weeks to 95 years formed the analysed data set. The mean value of their ages was 27 ±13 years and the gender ratio (M:F) 2:1. The injury burden is 11.2/100,000 population. The prevalent causes of injury are: (1) road traffic crashes (RTCs) = 68.4 % of 9939 patients; (2) fall = 5.5%; (3) gunshot injury = 3.2%; and (4) burns = 2.4%. Among children, the leading causes are: (1) RTC = 33.9% of 2,199 patients; (2) fall = 29.1%; (3) foreign body related = 5.5%; (4) bites = 4.9%; and (5) burns = 4%. Mortality resulted mainly from head injury, 26.6% of 575, and hemorrhage 8.3%.

Conclusions: Road traffic incidents are the leading cause of injury among adults and children. Falls are six times more prevalent among children than for adults. Burns and firearm injuries are relatively uncommon. Injury mortality results mainly from head injury and hemorrhage.

Type
Comprehensive Review
Copyright
Copyright Thanni © World Association for Disaster and Emergency Medicine 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organization (WHO): Disability, injury prevention and rehabilitation. Available at http://www.searo.who.int/en/Section1174/Section1461.htm. Accessed 06 November 2010.Google Scholar
Thanni, LO, Kehinde, OA: Trauma at a Nigerian teaching hospital: Pattern and documentation of presentation. African Health Sciences 2006;6(2):103106.Google Scholar
Sauaia, A, Moore, FA, Moore, EE, Moser, KS, Brennan, R, Read, RA, Pons, PT: Epidemiology of trauma deaths: A reassessment. J Trauma 1995;38(2):185193.CrossRefGoogle ScholarPubMed
Demetriades, D, Murray, J, Sinz, B, Myles, D, Chan, L, Sathyaragiswaran, L, Noguchi, T, Bongard, FS, Cryer, GH, Gaspard, DJ: Epidemiology of major trauma and trauma deaths in Los Angeles County. J Am Coll Surg 1998;187(4):373383.CrossRefGoogle ScholarPubMed
Soreide, K. Epidemiology of major trauma. BJS 2009;96(7):697698.CrossRefGoogle ScholarPubMed
Saraswat, V: Injury patterns in low intensity conflict. Indian J Anaesth 2009;53(6):672677.Google ScholarPubMed
Hsia, RY, Ozgediz, D, Mutto, M, Jayaraman, S, Kyamanywa, P, Kobusingye, OC: Epidemiology of injuries presenting to the national hospital in Kampala, Uganda: Implications for research and policy. Int J Emerg Med 2010;3(3):165172.CrossRefGoogle Scholar
Mishra, B, Sinha Mishra, ND, Sukhla, S, Sinha, A: Epidemiological study of road traffic accident cases from Western Nepal. Indian J Community Med 2010;35(1):115121.CrossRefGoogle ScholarPubMed
Joshi, SK, Shrestha, S: A study of injuries and violence related articles in Nepal. J Nepal Med Assoc 2009;48(175):209216.CrossRefGoogle ScholarPubMed
Evans, JA, van Wessem, KJ, McDougall, D, Lee, KA, Lyons, T, Balogh, ZJ: Epidemiology of traumatic deaths: Comprehensive population-based assessment. World J Surg 2010;34(1):158163.CrossRefGoogle ScholarPubMed
Panzino, F, Pizà Oliveras, A, Pociello Almiñana, N, García García, JJ, Luaces Cubells, C, Pou Fernández, J, Grupo de Trabajo de Accidentes Infantiles de la SEUP: Multicentre study on risk factors of injuries in car crashes. An Pediatr (Barc) 2009;71(1):2530.CrossRefGoogle ScholarPubMed
de Sousa Petersburgo, D, Keyes, CE, Wright, DW, Click, LA, Macleod, JB, Sasser, SM: The epidemiology of childhood injury in Maputo, Mozambique. Int J Emerg Med 2010;3(3):157163.CrossRefGoogle ScholarPubMed
Lasi, S, Rafique, G, Peermohamed, H: Childhood injuries in Pakistan: Results from two communities. J Health Popul Nutr 2010;28(4):392398.CrossRefGoogle ScholarPubMed
Gad, A, Al-Ansary, S, Saeed, AB, Kabbash, A: Pattern of injuries among children and adolescents in Riyadh, Saudi Arabia: A household survey. J Trop Pediatr 19 August 2010. [Epub ahead of print]Google ScholarPubMed
Adejuyigbe, EA, Onayade, AA, Senbanjo, IO, Oseni, SE: Childhood poisoning at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. Niger J Med 2002;11(4):183–166.Google Scholar
WHO: Global burden of disease. Available at http://www.who.int/healthinfo/global_burden_disease/en. Accessed 09 November 2010.Google Scholar
Chandran, A, Hyder, AA, Peek-Asa, C: The global burden of unintentional injuries and an agenda for progress. Epidemiol Rev 2010;32(1):110120.CrossRefGoogle Scholar
Ohene, SA, Tettey, Y, Kumoji, R. Injury-related mortality among adolescents: Findings from a teaching hospital’s post mortem data. BMC Res Notes 2010;3:124.CrossRefGoogle ScholarPubMed
Qureshi, MA, Khalique, AB, Pasha, IF, Asad, A, Malik, AS, Shah, MQ, Ahmed, A: Epidemiology of non-disaster spinal injuries at a spine unit. J Coll Physicians Surg Pak 2010;20(10):667670.Google Scholar
Pereira, RE, Perdoná, GD, Zini, LC, Cury, MB, Ruzzene, MA, Martin, CC, Martinis, BS: Relation between alcohol consumption and traffic violations and accidents in the region of Ribeirão Preto, São Paulo State. Forensic Sci Int 20 October 2010. [Epub ahead of print]Google Scholar
Hyder, AA, Sugerman, DE, Puvanachandra, P, Razzak, J, El-Sayed, H, Isaza, A, Rahman, F, Peden, M: Global childhood unintentional injury surveillance in four cities in developing countries: A pilot study. Bull World Health Organ 2009;87(5):345352.CrossRefGoogle ScholarPubMed
Meel, BL: Mortality of children in the Transkei region of South Africa. Am J Forensic Med Pathol 2003;24(2):141147.CrossRefGoogle ScholarPubMed
Diamond, IR, Parkin, PC, Wales, PW, Bohn, D, Kreller, MA, Dykes, EH, McLellan, BA, Wesson, DE: Pediatric blunt and penetrating trauma deaths in Ontario: A population-based study. J Pediatr Surg 2009;44(5):981986.CrossRefGoogle ScholarPubMed
Fraga, AM, Fraga, GP, Stanley, C, Costantini, TW, Coimbra, R: Children at danger: Injury fatalities among children in San Diego County. Eur J Epidemiol 2010;25(3):211217.CrossRefGoogle ScholarPubMed
Rausch, TK, Sanddal, ND, Sanddal, TL, Esposito, TJ: Changing epidemiology of injury-related pediatric mortality in a rural state: implications for injury control. Pediatr Emerg Care 1998;14(6):388392.CrossRefGoogle Scholar
Al Marzooqi, AH, Badi, M, El Jack, A: Road traffic accidents in Dubai, 2002–2008. Asia Pac J Public Health 2010;22(3 Suppl):31S39S.CrossRefGoogle ScholarPubMed
Joshi, SK, Shrestha, S: Economic and social burden due to injuries and violence in Nepal: Across-sectional study. Kathmandu Univ Med J (KUMJ) 2009;7(28):344350.CrossRefGoogle Scholar
Hinchcliff, R, Ivers, RQ, Poulos, R, Senserrick, T: Utilization of research in policymaking for graduated driver licensing. Am J Public Health 2010;100(11):20522058.CrossRefGoogle ScholarPubMed
Novoa, AM, Pérez, K, Santamariña-Rubio, E, Marí-Dell’Olmo, M, Ferrando, J, Peiró, R, Tobías, A, Zori, P, Borrell, C: Impact of the penalty points system on road traffic injuries in Spain: A time-series study. Am J Public Health 2010;100(11):22202227.CrossRefGoogle Scholar
Cameron, MH, Elvik, R: Nilsson’s Power Model connecting speed and road trauma: Applicability by road type and alternative models for urban roads. Accid Anal Prev 2010;42(6):19081915. Epub 2010 Jun 11.CrossRefGoogle ScholarPubMed
Korhonen, N, Niemi, S, Parkkari, J, Palvanen, M, Kannus, P: Unintentional injury deaths among adult Finns in 1971–2008. Injury 17 September 2010. [Epub ahead of print]Google ScholarPubMed
Goonewardene, SS, Baloch, K, Porter, K, Sargeant, I, Punchihewa, G: Road traffic collisions-case fatality rate, crash injury rate, and number of motor vehicles: Time trends between a developed and developing country. Am Surg 2010;76(9):977981.CrossRefGoogle ScholarPubMed
Ackaah, W, Adonteng, DO: Analysis of fatal road traffic crashes in Ghana. Int J Inj Contr Saf Promot. 2010;19:17. [Epub ahead of print]Google Scholar
Gunst, M, Ghaemmaghami, V, Gruszecki, A, Urban, J, Frankel, H, Shafi, S: Changing epidemiology of trauma deaths leads to a bimodal distribution. Proc (Bayl Univ Med Cent) 2010;23(4):349354.Google ScholarPubMed
Demetriades, D, Kimbrell, B, Salim, A, Velmahos, G, Rhee, P, Preston, C, Gruzinski, G, Chan, L: Trauma deaths in a mature urban trauma system: Is “trimodal” distribution a valid concept? J Am Coll Surg. 2005;201(3):343348.CrossRefGoogle Scholar
Gonzalez, RP, Cummings, G, Mulekar, M, Rodning, CB: Increased mortality in rural vehicular trauma: Identifying contributing factors through data linkage. J Trauma 2006;61(2):404409.CrossRefGoogle ScholarPubMed
Ameh, EA, Mshelbwala, PM: Challenges of managing paediatric abdominal trauma in a Nigerian setting. Niger J Clin Practice 2009;12(2):192195.Google Scholar
Thanni, LO, Tade, AO: Epidemiology of severe injury in a Nigerian Hospital. Nig J Orthop Trauma 2007;6(2):6769.Google Scholar
Misauno, MA, Sule, AZ, Nwadiaro, HC, Ozoilo, KN, Akwaras, AL, Ugwu, BT: Severe chest trauma in Jos, Nigeria: pattern and outcome of treatment. Nig J Orthop Trauma 2007;6(2):6466.Google Scholar
Obekpa, PO, Ugwu, BT, Kidmas, AT, Momoh, JT, Edino, S, Igun, G: Experience in managing splenic trauma on the Jos Plateau. West Afr J Med 1997;16(3):150156.Google ScholarPubMed
Madziga, AG: Arrow injuries in North East Nigeria. West Afr J Med 2003;22(2):106109.Google ScholarPubMed
Etebu, EN, Ekere, AU: Paediatric accidental deaths in Port Harcourt, Nigeria: A 10-year retrospective study. Niger J Med 2004;13(2):140143.Google ScholarPubMed
Shokunbi, MT, Solagberu, BA: Mortality in childhood head injury in Ibadan. Afr J Med Med Sci 1995;24(2):159163.Google ScholarPubMed
Odelowo, EO: Factors affecting morbidity and mortality from road traffic accidents: A Nigerian peri-urban study. Afr J Med Med Sci 1993;22(2):6974.Google ScholarPubMed
Odelowo, EO: Pattern of pedestrian injuries from road traffic accidents in Nigerians. West Afr J Med 1992;11(2):130134.Google ScholarPubMed
Adesunkanmi, AR, Oseni, SA, Badru, OS: Severity and outcome of falls in children. West Afr J Med 1999;18(4):281285.Google ScholarPubMed
Ayoade, BA, Salami, BA, Tade, AO, Musa, AA, Olawoye, OA: Abdominal injuries in Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria: Pattern and outcome. Nig J Orthop Trauma 2006;5(2):4549.Google Scholar
Ohanaka, EC, Osime, U, Okonkwo, CE: A five year review of splenic injuries in the University of Benin Teaching Hospital, Benin City, Nigeria. West Afr J Med Med 2001;20(1):4851.Google ScholarPubMed
Adegboye, VO, Ladipo, JK, Adebo, OA, Brimmo, AI: Diaphragmatic injuries. Afr J Med Med Sci 2002;31(2):149153.Google ScholarPubMed
Adegboye, VO, Ladipo, JK, Brimmo, IA, Adebo, AO: Blunt chest trauma. Afr J Med Med Sci 2002;31(4):315320.Google ScholarPubMed
Odelowo, EO: Pattern of trauma resulting from motorcycle accidents in Nigerians: A two-year prospective study. Afr J Med Sci 1994;23(2):109112.Google ScholarPubMed
Ohaegbulam, SC: Analysis of 1089 cases of head injury. Afr J Med Sci 1978;7(1):2327.Google ScholarPubMed
Solagberu, BA, Duze, AT, Ofoegbu, CP, Adekanye, AO, Odelowo, EO: Surgical morbidity and mortality pattern in the accident and emergency room—A preliminary report. Afr J Med Sci 2000;29(3–4):315318.Google ScholarPubMed
Balogun, JA, Abereoje, OK: Pattern of road traffic accident cases in a Nigerian university teaching hospital between 1987 and 1990. J Trop Med Hyg 1992;95(1):2329.Google Scholar
Odelowo, EO: The problem of trauma in Nigeria. Pattern as seen in a multicentre study. Trop Geogr Med 1991;43(1–2):8084.Google Scholar
Afuwape, O, Alonge, T: An audit of gunshot injuries seen in the accident and emergency department of a Nigerian tertiary hospital. West Afr J Med 2006;25(4):295297.Google ScholarPubMed
Oluwadiya, KS, Oginni, LM, Olasind, AA, Fadiora, SO: Motorcycle injuries in a developing country. West Afr J Med 2004;23(1):4247.CrossRefGoogle ScholarPubMed
Solagberu, BA, Adekanye, AO, Ofoegbu, CP, Udoffa, US, Abdur-Rahman, LO, Taiwo, JO: Epidemiology of trauma deaths. West Afr J Med 2003;22(2):177181.Google ScholarPubMed
Solagberu, BA: Spinal cord injuries in Ilorin, Nigeria. West Afr J Med 2002;21(3):230232Google ScholarPubMed
Seleye-Fubara, D, Ekere, AU: Pedestrian deaths resulting from road traffic accidents seen at the University of Port Harcourt Teaching Hospital—Six-year review. Niger J Med 2003;12(2):103105.Google ScholarPubMed
Aderounmu, AO, Fadiora, SO, Adesunkanmi, AR, Agbakwuru, EA, Oluwadiya, KS, Adetunji, OS: The pattern of gunshot injuries in a communal clash as seen in two Nigerian teaching hospitals. J Trauma 2003;55(4):626630.CrossRefGoogle Scholar
Adesunkanmi, AR, Oginni, LM, Oyelami, AO, Badru, OS: Epidemiology of childhood injury. J Trauma 1998;44(3):506512.CrossRefGoogle ScholarPubMed
Fatusi, OA, Fatusi, AO, Olabanji, JK, Alatise, OI: Management outcome and associated factors in burn injuries with and without facial involvement in a Nigerian population. J Burn Care Res 2006;27(6):869876.CrossRefGoogle Scholar
Adesunkanmi, AR, Oginni, LM, Oyelami, OA, Badru, OS: Road traffic accidents to African children: Assessment of severity using the injury severity score (ISS). Injury 2000;31(4):225228.CrossRefGoogle ScholarPubMed
Seleye-Fubara, SD, Ekere, AU: Domestic accidental deaths in the Niger Delta Region, Nigeria. East Afr Med J 2003;80(12):622626.Google ScholarPubMed
Anyanwu, CH, Swarup, AS: Chest trauma in a developing country. Ann R Coll Surg Engl 1981;63(2):102104Google ScholarPubMed
Emejulu, JK, Shokunbi, MT: Aetiological patterns and management outcome of paediatric head trauma: One-year prospective study. Niger J Clin Pract 2010;13(3):276279.Google ScholarPubMed
Nzegwu, MA, Banjo, AA, Akhiwu, W, Aligbe, JU, Nzegwu, CO: Morbidity and mortality among road users in Benin-City, Nigeria. Ann Afr Med 2008;7(3):102106.CrossRefGoogle ScholarPubMed
Madubueze, CC, Chukwu, CO, Omoke, NI, Oyakhilome, OP, Ozo, C: Road traffic injuries as seen in a Nigerian teaching hospital. Int Orthop 11 July 2010. [Epub ahead of print]Google Scholar
Afolayan, MO, Tijani, KH, Adetayo, FO, Mofikoya, BO, Jeje, EA, Ogunleye, EO, Ogunjimi, OA: Genito-urinary system injuries in Lagos: pattern and general treatment outcome. Nig Q J Hosp Med 2010;20(1):3237.CrossRefGoogle ScholarPubMed
Okoje, VN, Alonge, TO, Oluteye, OA, Denloye, OO: Changing pattern of pediatric maxillofacial injuries at the Accident and Emergency. Prehosp Disaster Med 2010;25(1):6871.CrossRefGoogle ScholarPubMed