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Article ; Online: The CBS test: Development, evaluation & cross-validation of a community-based injury severity scoring system in Cameroon.

Tupper, Haley / Oke, Rasheedat / Juillard, Catherine / Dissak-DeLon, Fanny / Chichom-Mefire, Alain / Mbianyor, Mbiarikai Agbor / Etoundi-Mballa, Georges Alain / Kinge, Thompson / Njock, Louis Richard / Nkusu, Daniel N / Tsiagadigui, Jean-Gustave / Carvalho, Melissa / Yost, Mark / Christie, S Ariane

PLOS global public health

2023 Volume 3, Issue 7, Page(s) e0002110

Abstract: Injury-related deaths overwhelmingly occur in low and middle-income countries (LMICs). Community-based injury surveillance is essential to accurately capture trauma epidemiology in LMICs, where one-third of injured individuals never present to formal ... ...

Abstract	Injury-related deaths overwhelmingly occur in low and middle-income countries (LMICs). Community-based injury surveillance is essential to accurately capture trauma epidemiology in LMICs, where one-third of injured individuals never present to formal care. However, community-based studies are constrained by the lack of a validated surrogate injury severity metric. The primary objective of this bipartite study was to cross-validate a novel community-based injury severity (CBS) scoring system with previously-validated injury severity metrics using multi-center trauma registry data. A set of targeted questions to ascertain injury severity in non-medical settings-the CBS test-was iteratively developed with Cameroonian physicians and laypeople. The CBS test was first evaluated in the community-setting in a large household-based injury surveillance survey in southwest Cameroon. The CBS test was subsequently incorporated into the Cameroon Trauma Registry, a prospective multi-site national hospital-based trauma registry, and cross-validated in the hospital setting using objective injury metrics in patients presenting to four trauma hospitals. Among 8065 surveyed household members with 503 injury events, individuals with CBS indicators (CBS+) were more likely to report ongoing disability after injury compared to CBS- individuals (OR 1.9, p = 0.004), suggesting the CBS test is a promising injury severity proxy. In 9575 injured patients presenting for formal evaluation, the CBS test strongly predicted death in patients after controlling for age, sex, socioeconomic status, and injury type (OR 30.26, p<0.0001). Compared to established injury severity scoring systems, the CBS test comparably predicts mortality (AUC: 0.8029), but is more feasible to calculate in both the community and clinical contexts. The CBS test is a simple, valid surrogate metric of injury severity that can be deployed widely in community-based surveys to improve estimates of injury severity in under-resourced settings.
Language	English
Publishing date	2023-07-26
Publishing country	United States
Document type	Journal Article
ISSN	2767-3375
ISSN (online)	2767-3375
DOI	10.1371/journal.pgph.0002110
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Article ; Online: Mobile telephone follow-up assessment of postdischarge death and disability due to trauma in Cameroon: a prospective cohort study.

Ding, Kevin / Sur, Patrick J / Mbianyor, Mbiarikai Agbor / Carvalho, Melissa / Oke, Rasheedat / Dissak-Delon, Fanny Nadia / Signe-Tanjong, Magdalene / Mfopait, Florentine Y / Essomba, Frank / Mbuh, Golda E / Etoundi Mballa, Georges Alain / Christie, S Ariane / Juillard, Catherine / Chichom Mefire, Alain

BMJ open

2022 Volume 12, Issue 4, Page(s) e056433

Abstract: Objectives: In Cameroon, long-term outcomes after discharge from trauma are largely unknown, limiting our ability to identify opportunities to reduce the burden of injury. In this study, we evaluated injury-related death and disability in Cameroonian ... ...

Abstract	Objectives: In Cameroon, long-term outcomes after discharge from trauma are largely unknown, limiting our ability to identify opportunities to reduce the burden of injury. In this study, we evaluated injury-related death and disability in Cameroonian trauma patients over a 6-month period after hospital discharge. Design: Prospective cohort study. Setting: Four hospitals in the Littoral and Southwest regions of Cameroon. Participants: A total of 1914 patients entered the study, 1304 were successfully contacted. Inclusion criteria were patients discharged after being treated for traumatic injury at each of four participating hospitals during a 20-month period. Those who did not possess a cellular phone or were unable to provide a phone number were excluded. Primary and secondary outcome measures: The Glasgow Outcome Scale-Extended (GOSE) was administered to trauma patients at 2 weeks, 1 month, 3 months and 6 months post discharge. Median GOSE scores for each timepoint were compared and regression analyses were performed to determine associations with death and disability. Results: Of 71 deaths recorded, 90% occurred by 2 weeks post discharge. At 6 months, 22% of patients still experienced severe disability. Median (IQR) GOSE scores at the four timepoints were 4 (3-7), 5 (4-8), 7 (4-8) and 7 (5-8), respectively, (p<0.01). Older age was associated with greater odds of postdischarge disability (OR: 1.23, 95% CI: 1.07 to 1.41) and mortality (OR: 2.15, 95% CI: 1.52 to 3.04), while higher education was associated with decreased odds of disability (OR: 0.65, 95% CI: 0.58 to 0.73) and mortality (OR: 0.38, 95% CI: 0.31 to 0.47). Open fractures (OR: 1.73, 95% CI: 1.38 to 2.18) and closed fractures (OR: 1.83, 95% CI: 1.42 to 2.36) were associated with greater postdischarge disability, while higher Injury Severity Score (OR: 2.44, 95% CI: 2.13 to 2.79) and neurological injuries (OR: 4.40, 95% CI: 3.25 to 5.96) were associated with greater odds of postdischarge mortality. Conclusion: Mobile follow-up data show significant morbidity and mortality, particularly for orthopaedic and neurologic injuries, up to 6 months following trauma discharge. These results highlight the need for reliable follow-up systems in Cameroon.
MeSH term(s)	Aftercare/methods ; Cameroon/epidemiology ; Cell Phone ; Follow-Up Studies ; Humans ; Patient Discharge ; Prospective Studies
Language	English
Publishing date	2022-04-05
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-056433
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Article ; Online: Chronic Disease Comorbidities Among Injured Patients in Cameroon: A Retrospective Cohort Study.

Blair, Kevin J / Dissak-Delon, Fanny N / Oke, Rasheedat / Carvalho, Melissa / Hubbard, Alan / Mbianyor, Mbiarikai / Etoundi-Mballa, Georges Alain / Kinge, Thompson / Njock, Louis Richard / Nkusu, Daniel N / Tsiagadigui, Jean-Gustave / Dicker, Rochelle A / Chichom-Mefire, Alain / Juillard, Catherine / Christie, S Ariane

The Journal of surgical research

2022 Volume 280, Page(s) 74–84

Abstract: Introduction: Chronic diseases are increasing but underdiagnosed in low-income and middle-income countries (LMICs), where injury mortality is already disproportionately high. We estimated prevalence of known chronic disease comorbidities and their ... ...

Abstract	Introduction: Chronic diseases are increasing but underdiagnosed in low-income and middle-income countries (LMICs), where injury mortality is already disproportionately high. We estimated prevalence of known chronic disease comorbidities and their association with outcomes among injured patients in Cameroon. Materials and methods: Injured patients aged ≥15 y presenting to four Cameroonian hospitals between October 2017 and January 2020 were included. Our explanatory variable was known chronic disease; prevalence was age-standardized. Outcomes were overall in-hospital mortality and admission or transfer from the emergency department (ED). Associations between known chronic disease and outcomes were evaluated using logistic regression adjusted for age, gender, estimated injury severity score (eISS), hospital, and household socioeconomic status. Unadjusted eISS-stratified and age-stratified outcomes were also compared via chi-squared tests. Results: Of 7509 injured patients, 370 (4.9%) reported at least one known chronic disease; age-standardized prevalence was 8.4% (95% confidence interval [CI] 7.5%-9.2%). Patients with known chronic disease had higher mortality (4.6% versus 1.5%, adjusted odds ratio [aOR]: 2.61 [95% CI: 1.25-5.47], P = 0.011) and were more likely to be admitted or transferred from the ED (38.7% versus 19.8%, aOR: 1.40 [95% CI: 1.02-1.92], P = 0.038) compared to those without known comorbidities. Crude differences in mortality (11.3% versus 3.3%, P = 0.002) and hospital admission or transfer (63.8% versus 46.6%, P = 0.011) were most notable for patients with eISS 16-24. Conclusions: Despite underdiagnosis among Cameroonians, we demonstrated worse injury outcomes among those with known chronic diseases. Integrating chronic disease screening with injury care may help address underdiagnosis in Cameroon. Future work should assess whether chronic disease prevention in LMICs could improve injury outcomes.
MeSH term(s)	Humans ; Trauma Centers ; Cameroon/epidemiology ; Retrospective Studies ; Injury Severity Score ; Chronic Disease
Language	English
Publishing date	2022-08-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2022.06.045
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Article ; Online: Changes in the healthcare utilization after establishment of emergency centre in Yaoundé, Cameroon

So Yeon Joyce Kong / Dae Han Wi / Young Sun Ro / Sang Do Shin / Joongsik Jeong / Yun Jeong Kim / Joseph Kamgno / Etoundi Mballa Georges Alain / Bonaventure Hollong / Young Jin Oh

PLoS ONE, Vol 14, Iss 2, p e

A before and after cross-sectional survey analysis.

2019 Volume 0211777

Abstract: In effort to address the shortage of emergency medical care in Cameroon, the Yaoundé Emergency Center (CURY) was established in June, 2015 in Yaoundé, Cameroon. To evaluate its impact on the communities of Yaoundé, we assessed the changes in utilizations ...

Abstract	In effort to address the shortage of emergency medical care in Cameroon, the Yaoundé Emergency Center (CURY) was established in June, 2015 in Yaoundé, Cameroon. To evaluate its impact on the communities of Yaoundé, we assessed the changes in utilizations of emergency medical care since the establishment of the CURY. In 2014 the first survey was conducted on randomly selected 619 households (3,201 individuals) living in six health districts of Yaoundé. In 2017 the second quantitative survey was conducted on 622 households (3,472 individuals) using the same survey methods as the first survey. In both surveys, data on demographic information, socioeconomic status, and utilization of healthcare, including emergency care in the past year were collected on every member of the households via face-to-face interview. Data on two surveys were compared. Participants in the both surveys had similar age and gender distribution with mean age of 21-22 and 46% being male. In 2014 survey, healthcare utilization rates for emergency unit, outpatient, and hospitalization were 4.8%, 36.7%, and 10.0%, respectively. In 2017 survey, corresponding rates were 5.8%, 32.5%, and 9.2%%, respectively. The increase in the utilization of emergency unit between two surveys showed a marginal statistical significance (p = 0.08), while outpatient utilization showed statistically significant decrease from 2014 to 2017 survey (from 36.7% to 32.5%; p <0.001). After the establishment of a dedicated emergency medical center in Yaoundé, Cameroon, the utilization of emergency care was increased in the Yaoundé community. Further studies are warranted to examine the direct effect of the establishment of the CURY on healthcare utilization in Yaoundé.
Keywords	Medicine ; R ; Science ; Q
Subject code	310
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
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Article ; Online: Exploring data sources for road traffic injury in Cameroon: Collection and completeness of police records, newspaper reports, and a hospital trauma registry.

Juillard, Catherine / Kouo Ngamby, Marquise / Ekeke Monono, Martin / Etoundi Mballa, Georges Alain / Dicker, Rochelle A / Stevens, Kent A / Hyder, Adnan A

Surgery

2017 Volume 162, Issue 6S, Page(s) S24–S31

Abstract: Background: Road traffic injury surveillance systems are a cornerstone of organized efforts at injury control. Although high-income countries rely on established trauma registries and police databases, in low- and middle-income countries, the data ... ...

Abstract	Background: Road traffic injury surveillance systems are a cornerstone of organized efforts at injury control. Although high-income countries rely on established trauma registries and police databases, in low- and middle-income countries, the data source that provides the best collection of road traffic injury events in specific low- and middle-income country contexts without mature surveillance systems is unclear. The objective of this study was to compare the information available on road traffic injuries in 3 data sources used for surveillance in the sub-Saharan African country of Cameroon, providing potential insight on data sources for road traffic injury surveillance in low- and middle-income countries. We assessed the number of events captured and the information available in Yaoundé, Cameroon, from 3 separate sources of data on road traffic injuries: trauma registry, police records, and newspapers. Methods: Data were collected from a single-hospital trauma registry, police records, and the 6 most widely circulated newspapers in Yaoundé during a 6-month period in 2009. The number of road traffic injury events, mortality, and other variables included commonly in injury surveillance systems were recorded. We compared these sources using descriptive analysis. Results: Hospital, police, and newspaper sources recorded 1,686, 273, and 480 road traffic injuries, respectively. The trauma registry provided the most complete data for the majority of variables explored; however, the newspaper data source captured 2, mass casualty, train crash events unrecorded in the other sources. Police data provided the most complete information on first responders to the scene, missing in only 7%. Conclusion: Investing in the hospital-based trauma registry may yield the best surveillance for road traffic injuries in some low- and middle-income countries, such as Yaoundé, Cameroon; however, police and newspaper reports may serve as alternative data sources when specific information is needed.
MeSH term(s)	Accidents, Traffic/statistics & numerical data ; Cameroon/epidemiology ; Humans ; Newspapers as Topic ; Police ; Records ; Registries ; Wounds and Injuries/epidemiology
Language	English
Publishing date	2017-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2017.01.025
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Article ; Online: Current knowledge of human Mpox viral infection among healthcare workers in Cameroon calls for capacity-strengthening for pandemic preparedness.

Nka, Alex Durand / Bouba, Yagai / Fokam, Joseph / Ka'e, Aude Christelle / Gabisa, Jeremiah Efakika / Mandeng, Nadia / Mfonkou, Delors Jacques Toumansie / Ambe, Chenwi Collins / Mballa Mpouel, Marie-Laure / Djikeussi, Tatiana / Tchounga, Boris Kevin / Ayuk Ngwese, Derrick Tambe / Njume, Debimeh / Mbala Nomo, Sonia Emmanuelle / Ngoufack Jagni Semengue, Ezechiel / Tiotsia Tsapi, Armand / Fokou, Bernadette Bomgning / Simo Kamdem, Ingrid Koster / Tommo Tchouaket, Michel Carlos /

Takou, Désiré / Pabo, Willy / Sosso, Samuel Martin / Tandi, Erick / Esso, Linda / Etoundi Mballa, Georges Alain / Zoung-Kanyi Bissek, Anne-Cecile / Gregory Edie, Halle-Ekane / Ndembi, Nicaise / Colizzi, Vittorio / Perno, Carlo-Federico / Ndjolo, Alexis

Frontiers in public health

2024 Volume 12, Page(s) 1288139

Abstract: Introduction: An increased incidence of human Monkeypox (Mpox) cases was recently observed worldwide, including in Cameroon. To ensure efficient preparedness and interventions in the health system, we sought to assess the knowledge of Mpox's ... ...

Abstract	Introduction: An increased incidence of human Monkeypox (Mpox) cases was recently observed worldwide, including in Cameroon. To ensure efficient preparedness and interventions in the health system, we sought to assess the knowledge of Mpox's transmission, prevention, and response among healthcare workers (HCWs) in Cameroon. Methods: A cross-sectional online survey was conducted among HCWs in Cameroon using 21-item questions adapted from the United States Centers for Disease Control and Prevention (US-CDC) standard questionnaire on Mpox. The overall knowledge of Mpox was assessed by cumulative score and categorized as excellent (≥80%, 17/21) or good (≥70%, ≥15/21) knowledge. The regression analysis was used to identify the predictors of Mpox knowledge. Results: The survey enrolled 377 participants, but only responses from 342 participants were analyzed. Overall, 50.6% were female participants, and 59.6% aged 30 years or younger. The majority of the participants were medical doctors (50.3%); most worked in central-level hospitals (25.1%) and had 1-5 years of experience (70.7%). A total of up to 92.7% were aware of Mpox, with social media (58.7%) and radio/television (49.2%) as the main sources. The mean knowledge score was 14.0 ± 3.0 (4 to 20), with only 12.9% having excellent knowledge (≥80%) and 42.1% having good knowledge of Mpox. Younger age (26-30 years old) was associated with good knowledge, while workplace type was associated with excellent knowledge of Mpox (aOR [95% CI]: 4.01 [1.43-11.24]). Knowledge of treatment/management of Mpox was generally poor across the different professional categories. Conclusion: Knowledge of Mpox among HCWs is substandard across different professionals. Thus, for optimal preparedness and immediate interventions for Mpox and similar emerging pathogens, capacity-strengthening programs should be organized for HCWs while encouraging scientific literature and organizational social media websites.
MeSH term(s)	United States ; Humans ; Female ; Adult ; Male ; Pandemic Preparedness ; Cameroon ; Cross-Sectional Studies ; Mpox (monkeypox) ; Health Personnel
Language	English
Publishing date	2024-03-12
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2024.1288139
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Article: Performance characteristics of INDICAID antigen rapid diagnostic test on SARS-CoV-2 samples during the omicron wave in Cameroon.

Fokam, Joseph / Takou, Désiré / Semengue, Ezechiel Ngoufack Jagni / Molimbou, Evariste / Chenwi Ambe, Collins / Durand Nka, Alex / Ndjeyep, Sandrine Djupsa / Beloumou, Grace Angong / Ka'e, Christelle Aude / Gouissi Anguechia, Davy-Hyacinthe / Mundo Nayang, Audrey Rachel / Moko Fotso, Larissa Gaëlle / Kengni Ngueko, Aurelie Minelle / Etame, Naomi-Karell / Tueguem, Pamela Patricia / Tommo Tchouaket, Carlos Michel / Fainguem, Nadine / Abega Abega, Cyrille / Abba, Aissatou /

Tambe Ayuk Ngwese, Derrick / Djubgang Djoukwe, Rina / Akenji, Blaise / Okomo Assoumou, Marie-Claire / Mandeng, Nadia / Esso, Linda / Cappelli, Giulia / Shang, Judith / Ndongmo, Clement / Etoundi Mballa, Georges Alain / Ndembi, Nicaise / Colizzi, Vittorio / Perno, Carlo-Federico / Ndjolo, Alexis

Heliyon

2024 Volume 10, Issue 9, Page(s) e29937

Abstract: Background: WHO recommends the use of COVID-19 antigen rapid diagnostic tests (Ag-RDT) with at least 80 % sensitivity and 97 % specificity. In the era of Omicron variants, we sought to ascertain the performance of the INDICAID™ Ag-RDT compared to real- ... ...

Abstract	Background: WHO recommends the use of COVID-19 antigen rapid diagnostic tests (Ag-RDT) with at least 80 % sensitivity and 97 % specificity. In the era of Omicron variants, we sought to ascertain the performance of the INDICAID™ Ag-RDT compared to real-time PCR (RT-PCR) as the gold standard. Methods: A laboratory-based study was conducted among consenting individuals tested for COVID-19 at the virology laboratory of the Chantal BIYA International Reference Centre, Yaoundé-Cameron. The samples were processed by INDICAID™ Ag-RDT and DaAn Gene real-time PCR according to the manufacturer's instructions, and PCR-results were interpreted as per cycle thresholds (CT). The sensitivity, specificity, positive and negative predictive values (PPV and NVP) of INDICAID™ Ag-RDT were evaluated according to PCR CT-values. Results: A total of 565 nasopharyngeal swabs were collected from participants (median age [IQR]: 40 [31-75]; M/F sex-ratio was 1.2 and 380 were vaccinated). Following PCR, overall COVID-19 positivity was 5.66 %. For CT < 37, INDICAID™ Ag-RDT sensitivity was 21.9 % (95%CI: [8.3-39.9]), specificity 100 % (95%CI: [99.3-100]); PPV 100 % (95%CI: [59.0-100]), NPV 95.5 % (95%CI: [93.4-97.1]) and kappa = 0.34 (95%CI: [0.19-0.35]). For CT < 25, sensitivity was 100 % (95%CI: [47.8-100.0]), specificity 99.6 % (95%CI: [98.7-99.9]); PPV 94.4 % (95%CI: [51.7-100]), NPV 100 % (95%CI: [99.3-100]) and kappa = 0.83 (95%CI: [0.6-1.0]). COVID-19 sequences generated were all Omicron BA.1 subvariants. Conclusion: For patients infected with high viral loads (CT < 25), INDICAID™ Ag-RDT has high intrinsic (sensitivity and specificity) and extrinsic (predictive values) performances for COVID-19 diagnosis. Due to its simplicity and short turnaround time, INDICAID™ Ag-RDT is, therefore a reliable tool to prevent the spread of COVID-19 at community level in the current era of Omicron subvariants.
Language	English
Publishing date	2024-04-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2024.e29937
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Article ; Online: Hospital-based injury data from level III institution in Cameroon: retrospective analysis of the present registration system.

Chichom Mefire, Alain / Etoundi Mballa, Georges Alain / Azabji Kenfack, Marcel / Juillard, Catherine / Stevens, Kent

Injury

2013 Volume 44, Issue 1, Page(s) 139–143

Abstract: Background: Data on the epidemiology of trauma in Cameroon are scarce. Presently, hospital records are still used as a primary source of injury data. It has been shown that trauma registries could play a key role in providing basic data on trauma. Our ... ...

Abstract	Background: Data on the epidemiology of trauma in Cameroon are scarce. Presently, hospital records are still used as a primary source of injury data. It has been shown that trauma registries could play a key role in providing basic data on trauma. Our goal is to review the present emergency ward records for completeness of data and provide an overview of injuries in the city of Limbe and the surrounding area in the Southwest Region of Cameroon prior to the institution of a formal registration system. Methods: A retrospective review of Emergency Ward logs in Limbe Hospital was conducted over one year. Records for all patients over 15 years of age were reviewed for 14 data points considered to be essential to a basic trauma registry. Completeness of records was assessed and a descriptive analysis of patterns and trends of trauma was performed. Results: Injury-related conditions represent 27% of all registered admissions in the casualty department. Information on age, sex and mechanism of injury was lacking in 22% of cases. Information on vital signs was present in 2% (respiratory rate) to 12% (blood pressure on admission) of records. Patient disposition (admission, transfer, discharge, or death) was available 42% of the time, whilst location of injury was found in 84% of records. Road traffic injury was the most frequently recorded mechanism (36%), with the type of vehicle specified in 54% and the type of collision in only 22% of cases. Intentional injuries were the second most frequent mechanism at 23%. Conclusion: The frequency of trauma found in this context argues for further prevention and treatment efforts. The institution of a formal registration system will improve the completeness of data and lead to increased ability to evaluate the severity and subsequent public health implications of injury in this region.
MeSH term(s)	Adolescent ; Adult ; Cameroon/epidemiology ; Emergency Service, Hospital/statistics & numerical data ; Female ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Needs Assessment ; Patient Discharge/statistics & numerical data ; Population Surveillance ; Program Evaluation ; Records as Topic ; Registries ; Retrospective Studies ; Wounds and Injuries/epidemiology ; Wounds and Injuries/prevention & control
Language	English
Publishing date	2013-01
Publishing country	Netherlands
Document type	Journal Article ; Multicenter Study
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2011.10.026
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Article ; Online: Informing prehospital care planning using pilot trauma registry data in Yaoundé, Cameroon.

Nwanna-Nzewunwa, Obieze Chiemeka / Kouo Ngamby, Marquise / Shetter, Elinor / Etoundi Mballa, Georges Alain / Feldhaus, Isabelle / Monono, Martin Ekeke / Hyder, Adnan A / Dicker, Rochelle / Stevens, Kent A / Juillard, Catherine

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2018 Volume 45, Issue 5, Page(s) 877–884

Abstract: Introduction: About 54% of deaths in low- and middle-income countries (LMICs) are attributable to lack of prehospital care. The single largest contributor to the disability-adjusted life years due to poor prehospital care is injury. Despite having ... ...

Abstract	Introduction: About 54% of deaths in low- and middle-income countries (LMICs) are attributable to lack of prehospital care. The single largest contributor to the disability-adjusted life years due to poor prehospital care is injury. Despite having disproportionately high injury burdens, most LMIC trauma systems have little prehospital organization. An understanding of existing prehospital care patterns in LMICs is warranted as a precursor to strengthening prehospital systems. Methods: In this retrospective pilot study, we collected demographic and injury characteristics, therapeutic itinerary, and transport data of patients that were captured by the trauma registry at the Central Hospital of Yaoundé (CHY) from April 15, 2009 to October 15, 2009. Bivariate and multivariate regression analyses were used to explore relationships between care-seeking behavior, method of transport, and predictor variables. Results: The mean age was 30.2 years (95% CI [29.7, 30.7]) and 73% were male. Therapeutic itinerary was available for 97.5% of patients (N = 2855). Nearly 18.7% of patients sought care elsewhere before CHY and 82% of such visits were at district hospitals or health clinics. Moderately (OR 1.336, p = 0.009) and severely (OR 1.605, p = 0.007) injured patients were more likely to seek care elsewhere before CHY and were less likely to be discharged home after their emergency ward visit as opposed to being admitted to the hospital for further treatment (OR 0.462, p < 0.001). Commercial vehicles provided most prehospital transport (65%), while police or ambulance transported few injured patients (7%). Conclusions: Possible areas for prehospital trauma care strengthening include training lay commercial vehicle drivers in trauma care and formalizing triage, referral, and communication protocols for prehospital care to optimize timely transfer and care while minimizing secondary injury to patients.
MeSH term(s)	Adolescent ; Adult ; Cameroon/epidemiology ; Emergency Medical Services/methods ; Female ; Humans ; Male ; Middle Aged ; Pilot Projects ; Quality of Health Care/statistics & numerical data ; Registries ; Retrospective Studies ; Transportation of Patients/statistics & numerical data ; Trauma Centers/statistics & numerical data ; Wounds and Injuries/epidemiology ; Wounds and Injuries/therapy ; Young Adult
Language	English
Publishing date	2018-03-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-018-0939-2
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Article ; Online: Road traffic injuries in Yaoundé, Cameroon: A hospital-based pilot surveillance study.

McGreevy, Jolion / Stevens, Kent A / Ekeke Monono, Martin / Etoundi Mballa, Georges Alain / Kouo Ngamby, Marquise / Hyder, Adnan A / Juillard, Catherine

Injury

2014 Volume 45, Issue 11, Page(s) 1687–1692

Abstract: Background: Road traffic injuries (RTIs) are a major cause of death and disability worldwide. In Cameroon, like the rest of sub-Saharan Africa, more data on RTI patterns and outcomes are needed to improve treatment and prevention. This study analyses ... ...

Abstract	Background: Road traffic injuries (RTIs) are a major cause of death and disability worldwide. In Cameroon, like the rest of sub-Saharan Africa, more data on RTI patterns and outcomes are needed to improve treatment and prevention. This study analyses RTIs seen in the emergency room of the busiest trauma centre in Yaoundé, Cameroon. Methods: A prospective injury surveillance study was conducted in the emergency room of the Central Hospital of Yaoundé from April 15 to October 15, 2009. RTI patterns and relationships among demographic variables, road collision characteristics, injury severity, and outcomes were identified. Results: A total of 1686 RTI victims were enrolled. The mean age was 31 years, and 73% were male. Eighty-eight percent of road collisions occurred on paved roads. The most common user categories were 'pedestrian' (34%) and 'motorcyclist' (29%). Pedestrians were more likely to be female (p<0.001), while motorcyclists were more likely to be male (p<0.001). Injuries most commonly involved the pelvis and extremities (43%). Motorcyclists were more likely than other road users to have serious injuries (RR=1.45; 95% CI: 1.25, 1.68). RTI victims of lower economic status were more likely to die than those of higher economic status. Discussion: Vulnerable road users represent the majority of RTI victims in this surveillance study. The burden of RTI on hospitals in Cameroon is high and likely to increase. Data on RTI victims who present to trauma centres in low- and middle-income countries are essential to improving treatment and prevention.
MeSH term(s)	Accident Prevention/methods ; Accidents, Traffic/mortality ; Accidents, Traffic/prevention & control ; Accidents, Traffic/statistics & numerical data ; Adolescent ; Adult ; Cameroon/epidemiology ; Emergency Medical Services/organization & administration ; Environment Design ; Female ; Humans ; Male ; Middle Aged ; Pilot Projects ; Population Surveillance ; Prospective Studies ; Public Health ; Trauma Centers/statistics & numerical data ; Wounds and Injuries/mortality ; Wounds and Injuries/prevention & control
Language	English
Publishing date	2014-06-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2014.05.001
Database	MEDical Literature Analysis and Retrieval System OnLINE

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