Mechanisms of trauma at a rural hospital in Uganda

Trauma is an increasing cause of mortality worldwide with road traffic accidents (RTAs) causing 1.3 million deaths annually with 90% of this mortality occurring in low and middle income countries. The rise in trauma deaths has been neglected with infectious diseases taking precedence. More research needs to be conducted in resource poor countries to establish the main causes of trauma and find better solutions to the rising trend in mortality. Much of the trauma research in resource poor countries has focused on urban areas. This study aims to find the leading causes of trauma at a rural Ugandan hospital.

A retrospective case note review was performed on all adult patients admitted to Kuluva Hospital with trauma related injuries in 2007. Kuluva Hospital is a rural 250 bed hospital in North-West Uganda.

490 trauma patients were admitted in 2007 accounting for 9.4% of admissions. 70.2% (n=344) were males and 29.8% (n=146) were females. The mean age of patients was 31.3 years and the mean length of stay was 7.4 days. In 2007 9 patients died following trauma, 6 from RTAs, 2 from burns and one after an assault. RTAs were the leading cause of trauma with 64.2% of admissions (n=315), followed by assaults with 16.5% (n=81) of admissions. Soft tissue injuries with 28.4% (n=149) and lacerations with 27.3% (n=143) were the most common diagnoses after trauma with fractures making up 18.7% of injuries (n=99).

RTAs were an important cause of morbidity and mortality in a rural Ugandan hospital as they also are in urban areas. Low cost initiatives to reduce speed, prevent alcohol impaired driving, improve public education and wider access to high quality trauma care are vital to reducing the mortality and morbidity caused by RTAs in Africa.