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Epidemiology and cost of pediatric injury in Yaoundé, Cameroon: a prospective study

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Abstract

Purpose

Unintentional injury is the leading cause of death among children aged 10–19 years and over 95% of injury deaths occur in low- and middle-income countries (LMICs). As patterns of injury in the pediatric population may differ from those in adults, risks specific to children in LMICs need to be identified for effective injury prevention and treatment. This study explores patterns of pediatric injury epidemiology and cost in Yaoundé, Cameroon to inform injury prevention and resource allocation.

Methods

Pediatric (age < 20 years) trauma patient data were collected at the emergency department (ED) of Central Hospital of Yaoundé (CHY) from April through October 2009. Univariate, bivariate, and multivariate analyses were used to explore injury patterns and relationships between variables. Regression analyses were conducted to identify predictors of receiving surgical care.

Results

Children comprised 19% (544) of trauma cases. About 54% suffered road traffic injuries (RTIs), which mostly affected the limbs and pelvis (37.3%). Half the RTI victims were pedestrians. Transportation to CHY was primarily by taxi or bus (69.4%) and a preponderance (71.1%) of the severely and profoundly injured patients used this method of transport. Major or minor surgical intervention was necessary for 17.9% and 20.8% of patients, respectively. Patients with an estimated injury severity score ≥ 9 (33.2%) were more likely to need surgery (p < 0.01). The median ED cost of pediatric trauma care was USD12.71 [IQR 12.71, 23.30].

Conclusions

Injury is an important child health problem that requires adequate attention and funding. Policies, surgical capacity building, and health systems strengthening efforts are necessary to address the high burden of pediatric injuries in Cameroon. Pediatric injury prevention efforts in Cameroon should target pedestrian RTIs, falls, and burns and consider school-based interventions.

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Acknowledgements

We would like to thank the Ministry of Public Health of Cameroon, the Central Hospital of Yaoundé, and all of the research assistants for their support and efforts, which made this project possible.

Funding

None.

Author information

Authors and Affiliations

  1. Center for Global Surgical Studies, Department of Surgery, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, USA

    Obieze Nwanna-Nzewunwa & Girish Motwani

  2. Ministry of Public Health, Yaoundé, Cameroon

    Marquise Kouo Ngamby & Georges Alain Etoundi

  3. School of Medicine, Johns Hopkins University, Baltimore, MD, USA

    Jacob Cox

  4. Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA

    Isabelle Feldhaus

  5. World Health Organization (WHO) Regional Office, Brazzaville, Republic of the Congo

    Martin Ekeke Monono

  6. Department of Surgery, University of California, Los Angeles, 10833 Le Conte Ave, 72-215 CHS, Los Angeles, CA, 90095, USA

    Rochelle A. Dicker & Catherine Juillard

  7. International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Adnan A. Hyder

Authors
  1. Obieze Nwanna-Nzewunwa
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  2. Marquise Kouo Ngamby
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  5. Girish Motwani
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  6. Martin Ekeke Monono
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  7. Georges Alain Etoundi
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  8. Rochelle A. Dicker
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  9. Adnan A. Hyder
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  10. Catherine Juillard
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Corresponding author

Correspondence to Catherine Juillard.

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Conflict of interest

ONN, MKN, JC, IF, GM, MEM, GAE, RAD, AAH, and CJ declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Nwanna-Nzewunwa, O., Ngamby, M.K., Cox, J. et al. Epidemiology and cost of pediatric injury in Yaoundé, Cameroon: a prospective study. Eur J Trauma Emerg Surg 46, 1403–1412 (2020). https://doi.org/10.1007/s00068-019-01104-6

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  • DOI: https://doi.org/10.1007/s00068-019-01104-6

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