Trauma in rural Kenya

Abstract 

Background: Trauma in Africa is an increasingly significant problem. The aims of this study were to document the epidemiology and clinical management of trauma in a rural Kenyan hospital and from this to highlight important areas for the medical training of doctors managing trauma in similar situations.

Methods: Prospective audit of 202 consecutive trauma patients admitted to Kijabe Hospital.

Results: The mean patient age was 31, 77% were males. The median Injury Severity Score (ISS) was nine. The median distance to hospital was 60km, with a 9h delay in presentation. Injury mechanisms included road traffic accidents 52%, fall 22%, assaults 13% and burns 6%. The main injuries were limb fractures, soft tissue injuries, head injury and haemo/pneumothorax. Common interventions included fracture management, wound debridement, chest drain insertion, blood transfusion and skin grafting. The overall mortality rate was 3.5%.

Conclusion: With appropriate resources and training, good trauma outcomes are possible. The importance of access to hospital care and orthopaedic training are highlighted.

Keywords:  Trauma, Kenya, Road traffic crash, Unintentional injury, Injury Severity Score, Mortality, Fractures, Surgery