Incidence and outcome of injury in Ghana: a community-based survey

Injury is an increasingly significant health problem in most low-income countries. However, strategies for preventing injury have not been well addressed. The present study was carried out to measure the incidence and outcome of various mechanisms of injury in Ghana in order to provide data for use in developing priorities for injury prevention efforts. For this purpose, using two-stage cluster sampling and household interviews, we surveyed 21,105 persons living in 431 urban and rural sites. During the preceding year, 1609 injuries resulting in one or more days of loss of normal activity were reported. Injury-related mortality was slightly higher in the urban (83 per 100,000) than in the rural area (53 per 100,000). However, the burden of disability from nonfatal injuries, as assessed by disability days, was higher in the rural (4697 disability days per 1000 person-years) than in the urban area (2671 days per 1000 person-years). Based on incidence rates and disability times, the major types of injury in the urban area were transport-related injury and falls. In the rural area, agricultural injuries predominated, followed by falls and transport-related injury. In rural and urban areas combined, 73% of motor vehicle-related injuries involved commercial vehicles. In this and other similar developing-country settings, injury prevention efforts should focus on falls and on transport safety in both urban and rural areas, with special attention being paid to commercial vehicles. In rural areas, agricultural injuries contributed the largest burden of morbidity, and should be a priority for prevention efforts.