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Original Article |

Traumatic Injuries in Developing Countries:  Report From a Nationwide Cross-Sectional Survey of Sierra Leone

Kerry-Ann A. Stewart, PhD; Reinou S. Groen, MIH, MD; Thaim B. Kamara, MD; Mina M. Farahzad, BA; Mohamed Samai, MBBS, PhD; Laura D. Cassidy, PhD; Adam L. Kushner, MPH, MD; Sherry M. Wren, MD
JAMA Surg. 2013;148(5):463-469. doi:10.1001/jamasurg.2013.1341.
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Objective To use a nationwide household survey tool to provide an estimate of injury prevalence, mechanisms of traumatic injuries, and number of injury-related deaths in a low-income country.

Design A randomized, cross-sectional nationwide survey using the Surgeons OverSeas Assessment of Surgical Need tool was conducted in 2012.

Setting Sierra Leone, Africa.

Participants Three thousand seven hundred fifty randomly selected participants throughout Sierra Leone.

Main Outcome Measures Mechanisms of injury based on age, sex, anatomic location, cause, and sociodemographic factors as well as mechanisms of injury-related deaths in the previous year were the primary outcome measures.

Results Data were collected and analyzed from 1843 households and 3645 respondents (98% response rate). Four hundred fifty-two respondents (12%) reported at least 1 traumatic injury in the preceding year. Falls were the most common cause of nonfatal injuries (40%). The extremities were the most common injury site regardless of age or sex. Traffic injuries were the leading cause of injury-related deaths (32% of fatal injuries).

Conclusions This study provides baseline data on the mechanisms of traumatic injuries as well as the sociodemographic factors affecting injury prevalence in one of the world's poorest nations. It is anticipated that these data will provide an impetus for further studies to determine injury severity, associated disability, and barriers to accessing care in these resource-poor areas.

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Figure. Demographic structure of the Sierra Leone Surgeons Overseas Assessment of Surgical Need study population (2012).

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