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Updated: Aug 9, 2025
Design and Analysis for Fall Detection System Simplification
Published on: April 6, 2020
Fall-Related Injuries in Malawi: Outcomes and Trends Over Time
Selena J An1, Natasha Ngwira2, Dylane Davis3
1Department of Surgery, University of North Carolina at Chapel Hill, 4001 Burnett Womack Building, CB 7050, Chapel Hill, NC, 27599, USA.
Background:
Fall-related injury (FRI) is a leading cause of injuries worldwide. Data on injury patterns and trends over time are lacking in resource-limited settings.
Methods:
We performed a retrospective analysis of FRI at Kamuzu Central Hospital in Malawi from 2009 to 2021. Outcomes were compared between patients presenting with FRI and those with other injury mechanisms. Bivariate and multivariate regressions were used to determine predictors of presentation following falls and mortality. We also analyzed time trends.
Results:
A total of 166,047 patients were included, of which 41,695 were patients presenting after falls (25.7%). Most FRI patients were between 5 and 45 (67.2%) and male (66.9%). Most falls occurred at home (67.3%) and resulted in extremity injuries (51.6%). The predicted probability of hospital presentation after falling is highest for children ≤ 5 years and adults > 60 years and decreases over time. On multivariate analysis, patients between 5 and 15 [adjusted odds ratio (AOR) 1.70, 95% confidence interval (CI) 1.63-1.77] and > 60 (AOR 1.14, 95% CI 1.07-1.22) and women (AOR 1.13, 95% CI 1.10-1.16) are more likely to present with FRI. Compared to patients with non-FRI, those with FRI were more likely to have been injured at school (AOR 2.16, 95% CI 2.01-2.32) and during sports and recreation (AOR 4.53, 95% CI 4.24-4.85).
Conclusion:
FRI is the most common injury presentation after motor vehicle injury in this low-resource setting. This study provides essential information about FRI in Malawi over time. Our findings can help inform resource allocation and injury prevention initiatives.
Insights
Fall-related injuries are common in Malawi, particularly affecting children and older adults. This study highlights injury patterns and trends to guide prevention efforts in low-resource settings.
Area of Science:
- Public Health
- Epidemiology
- Trauma Surgery
Background:
- Fall-related injury (FRI) is a significant global health concern.
- Limited data exist on FRI patterns and trends in resource-limited settings.
Purpose of the Study:
- To analyze the epidemiology of FRI in Malawi from 2009 to 2021.
- To identify predictors of FRI presentation and mortality.
- To examine temporal trends in FRI.
Main Methods:
- Retrospective analysis of FRI cases at Kamuzu Central Hospital, Malawi (2009-2021).
- Comparison of outcomes between FRI and non-FRI patients.
- Bivariate and multivariate regression analyses for predictors and mortality.
- Time trend analysis.
Main Results:
- FRI constituted 25.7% of injuries, with most patients aged 5-45 years and male.
- Falls occurred predominantly at home, causing extremity injuries.
- Higher presentation probability for FRI in children ≤5 and adults >60 years.
- Increased likelihood of FRI presentation for ages 5-15 and >60, and for women.
- School and sports/recreation were significant injury locations for FRI.
Conclusions:
- FRI is a major injury cause in Malawi, second only to motor vehicle injuries.
- This study provides crucial data on FRI epidemiology and trends in a low-resource context.
- Findings can inform targeted injury prevention strategies and resource allocation.
