Transcript THE INJURY BURDEN IN UGANDA - Global Surgery Collaboration

THE INJURY BURDEN IN UGANDA
Milton Mutto
Injury Control Center-Uganda
Presentation Outline

Definition

Introduction

The Global and Regional Burdens if disease and death

The Ugandan burden of Disease and death

The Ugandan Injury patterns

Conclusion
Introduction

Everyday around the world, approximately
16,000 people die of injuries

Each death is accompanied with many other
non-fatal injuries, many with permanent
consequences

Injuries have huge cost implications

The costs in grief and pain are not, however,
quantifiable
What is an Injury?

An Injury is a bodily lesion at organic level resulting from
acute exposure to energy interacting with the body in
amounts or rates that exceed the threshold of
physiological tolerance (Baker SP et’al 1984)

The transfer of energy at rates and in amounts above or
below the tolerance of human tissue is the necessary
and specific cause of injury (Robertson LS 1992)
Data sources

The World health report 1999

The MoH HMIS

The ICC-U Trauma registries
AFRICA-Top 10 causes of disease 1998
Rank
0-4
5-14
15-44
45-59
1
Malaria
Malaria
HIV
HIV
2
Diarrhea
Measles
War injuries
CV Disease
3
Perinatal
Conditions
HIV
Interperson
al violence
Ischeamic heart
dx
4
Respiratory dx
Respiratory
disease
Major
depression
Cataracts
5
HIV
RTA
TB
TB
6
Measles
Diarrhea
Tropical dx
Tropical dx
7
Pertussis
Tropical dx
RTA
Obstructive
pulmonary dx
8
Protein energy
mal-nutrition
Drowning
STD
Major depression
9
Congenital
abnormalities
Fires
Alcohol
dependence
Osteoathritis
10
Tetanus
War injuries
Maternal
sepsis
Liver cancers
AFRICA-top 10 causes of death 1998
Rank
0-4
5-14
15-44
45-59
1
Malaria
Malaria
HIV
HIV
2
Diarrhea
Respiratory
disease
Interperson
al violence
CV Disease
3
Respiratory
Diarrhea
War injuries
Ischeamic heart
4
Perinatal
Conditions
Drowning
TB
TB
5
Measles
RTA
RTA
Liver cancers
6
HIV
HIV
Malaria
Violence
7
Pertussis
War injuries
Maternal
hemorrhage
Obstructive
pulmonary
8
Tetanus
Fires
CV disease
War injuries
9
Protein energy
mal-nutrition
Tropical
Maternal
sepsis
RTA
10
War injuries
TB
Abortion
Nephritis
AFRICA-Top 10 causes of disease and death in all ages
1998
Rank
Disease
Frequency
Death
Frequency
1
HIV
54,100,841
HIV
1,829,729
2
Malaria
34,506,494
Malaria
960,734
3
Diarrhea
24,231,478
Acute lower
respiratory
792,568
4
Acute lower
respiratory
22,817,647
Diarrhea
731,475
5
Perinatal
conditions
20,032,582
Perinatal conditions
532,461
6
Measles
17,132,438
Measles
502,510
7
War injuries
11,740,254
Cerebrovascular
disease
448,902
8
Inter personal
violence
7,878,238
War injuries
308,425
9
RTA
6,116,559
Ischeamic heart
disease
275,092
10
Tropical diseases 5,558,249
Interpersonal
violence
265,900
Injury Burden in Uganda

2.2% of OPD in Sept 2003 (HMIS)

30% of emergency admission in Mulago Hospital
(Trauma registry)

Close to half of non-obstetric operating lists (Trauma
registry)

5th/6th leading cause of the disease burden in Uganda
(MoH Burden of disease study 1996)
Trauma registries-Top 6 causes of injury Uganda
Rank
1998/%
1999/%
47
2000/%
1
Traffic
48
Traffic
Traffic
2
Stab/cuts
16
Stab/cuts 17
3
Falls
13
Falls
4
Blunt force 09
5
Burn
6
Animal bite 02 Burn
03
7
Other
08 Other
Stab/cuts 18
11 Falls
Blunt force 10
46
2001/%
Traffic
48
Stab/cuts
16
11 Falls
Blunt force 09
11
Blunt force 10
04 Animal bite 05 Animal bite 08 Animal bite 07
08
Other
Burn
04
Burn
08 Other
04
04
Trauma registries-Top 6 occupations represented
in the injury data in Uganda
Rank
1998/%
1
Student
2
1999/%
28
Student
2000/%
24
Students
26
Civil servants 19
Civil servants18
Peasants
18
3
Casual laborer12
Business
Civil servants 11
4
Business
10
Housewives 09
Business
5
Housewives
06
Unemployed 06
Unemployed 07
6
Combatants
06
Peasant
Housewives 07
7
Other
13
Other
11
06
08
Other
11
20
Trauma registries-Top 6 places represented in the
injury data in Uganda-ICC-U
Rank
1998/%
1999/%
Road
2000/%
1
Road
56
57
Road
59
2
Home
30 Home
28
Home
30
3
Public buildings 04 Public buildings 05
Public buildings 04
4
Industry
03
Industry
03
Industry
03
5
Schools
03
Schools
03
Schools
03
6
Farms
02
Sport
0.6
Farms
02
7
Other
02
Other
3.4
Other
03