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Rwanda’s Model Prehospital Emergency Care Service: A Two-year Review of Patient Demographics and Injury Patterns in Kigali

Published online by Cambridge University Press:  22 September 2016

Samuel Enumah Open the ORCID record for Samuel Enumah [Opens in a new window] ,
John W. Scott Open the ORCID record for John W. Scott [Opens in a new window] ,
Rebecca Maine Open the ORCID record for Rebecca Maine [Opens in a new window] ,
Eric Uwitonze ,
Jeanne D’Arc Nyinawankusi ,
Robert Riviello Open the ORCID record for Robert Riviello [Opens in a new window] ,
Jean Claude Byiringiro ,
Ignace Kabagema  and
Sudha Jayaraman
Samuel Enumah
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, MarylandUSA
John W. Scott
Affiliation:
Department of Surgery, Brigham and Women’s Hospital, Boston, MassachusettsUSA
Rebecca Maine
Affiliation:
University of California-San Francisco, Department of Surgery, San Francisco General Hospital, San Francisco, CaliforniaUSA
Eric Uwitonze
Affiliation:
Service d’Aide Medicale Urgente, Ministry of Health, Kigali, Rwanda
Jeanne D’Arc Nyinawankusi
Affiliation:
Service d’Aide Medicale Urgente, Ministry of Health, Kigali, Rwanda
Robert Riviello
Affiliation:
Department of Surgery, Brigham and Women’s Hospital, Boston, MassachusettsUSA Center for Surgery and Public Health, Department of Surgery, Harvard Medical School, Boston, MassachusettsUSA
Jean Claude Byiringiro
Affiliation:
Centre Hospitalier Universitaire de Kigali, Kigali, Rwanda
Ignace Kabagema
Affiliation:
Service d’Aide Medicale Urgente, Ministry of Health, Kigali, Rwanda
Sudha Jayaraman*
Affiliation:
Division of Trauma, Emergency Surgery, and Critical Care, Virginia Commonwealth University, Richmond, VirginiaUSA
*
Correspondence: Sudha Jayaraman, MD, MSc Division of Trauma, Emergency Surgery, and Critical Care Virginia Commonwealth University P.O. Box 980454 Richmond, Virginia 23298-0454 USA E-mail: sudhapjay@gmail.com
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Abstract

Introduction

Injury is responsible for nearly five million annual deaths worldwide, and nearly 90% of these deaths occur in low- and middle-income countries (LMICs). Reliable clinical data detailing the epidemiology of injury are necessary for improved care delivery, but they are lacking in these regions.

Methods

A retrospective review of the Service d’Aide Medicale Urgente (SAMU; Kigali, Rwanda) prehospital database for patients with traumatic injury-related conditions from December 2012 through November 2014 was conducted. Chi-squared analysis, binomial probability test, and student’s t-test were used, where appropriate, to describe patient demographics, injury patterns, and temporal and geographic trends of injuries.

Results

In the two-year period, 3,357 patients were managed by SAMU for traumatic injuries. Males were 76.5% of the study population, and the median age of all injured patients was 29 years (IQR=23-35). The most common causes of injury were road traffic crashes (RTCs; 73.4%), stabbings/cuts (11.1%), and falls (9.4%), and the most common anatomic regions injured were the head (55.7%), lower (45.0%) extremities, and upper (27.0%) extremities. Almost one-fourth of injured patients suffered a fracture (24.9%). The most common mechanism of injury for adults was motorcycle-related RTCs (61.4%), whereas children were more commonly injured as pedestrians (59.8%). Centrally located sectors within Kigali represented common areas for RTCs.

Conclusions

These data support the call for focused injury prevention strategies, some of which already are underway in Rwanda. Further research on care processes and clinical outcomes for injured patients may help identify avenues for improved care delivery.

EnumahS, ScottJW, MaineR, UwitonzeE, NyinawankusiJD, RivielloR, ByiringiroJC, KabagemaI, JayaramanS. Rwanda’s Model Prehospital Emergency Care Service: A Two-year Review of Patient Demographics and Injury Patterns in Kigali. Prehosp Disaster Med. 2016;31(6):614–620.

Keywords

epidemiologyinjuryprehospitalRwandatrauma
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 6 , December 2016 , pp. 614 - 620
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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