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Admissions for injury at a rural hospital in Ghana: implications for prevention in the developing world.

C N Mock, E Adzotor, D Denno, E Conklin and F Rivara

Holy Family Hospital, Berekum, Ghana.

OBJECTIVES. Strategies for injury prevention have been extensively studied in developed nations but not in the developing world. This study sought to determine which mechanisms of injury were common in a rural developing area and which were important contributors to mortality and disability. METHODS. All 614 patients admitted for injuries to a rural African hospital between 1987 and 1991 were analyzed retrospectively for mechanism of injury and outcome, as assessed by mortality and long-term functional status. RESULTS. The leading mechanisms of injury were transport related (29%) and burns (16%). Burns accounted for 61% of injuries in children under 5 years. Mortality was 7.3% in the series, with 24% of deaths owing to transport injuries. Disability developed in 103 (22%) of the 462 survivors available for assessment, with most disability resulting from transport injuries (26% of all disabilities), burns (13%), and agricultural injuries (14%). CONCLUSIONS. Among injured patients who presented for treatment in this rural developing area, the largest burden of mortality and disability was from burns and transport-related injuries. Population-based studies are needed to substantiate whether these should be priorities for injury prevention efforts.

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