Junaid Ahmad Bhatti

Incidence of burns and factors associated with their hospitalisation in Rawalpindi, Pakistan

BACKGROUND The burden of burns is largely underreported due to the lack of a surveillance system in Pakistan. The aim of our study was to determine the incidence of burns and factors associated with their hospitalisation in the city of Rawalpindi, Pakistan. METHODS A prospective observational study from July 2007 to June 2008 was conducted. All the burn-related injury patients presenting to emergency departments (EDs) of the three public teaching hospitals in Rawalpindi city were included. A standard World Health Organization questionnaire was used to record the information about injury victims. RESULTS A total of 1498 burned patients presented to EDs. Females accounted for 40% of the patients. The majority of patients were ≤ 46 years. Most of the burns occurred at home (79.2%). The overall incidence of burn-related injuries per 100,000 inhabitants was 76.3 for emergency visits, 17.0 for hospitalisation and 0.3 for ED deaths. Female patients (adjusted odds ratio (aOR)=1.49, 95% confidence interval (95% CI)=1.09, 2.06), intentional burns (aOR=5.25, 95% CI=2.17-12.74) and injuries at work (aOR=3.81, 95% CI=2.40, 6.07) and in a market area (aOR=2.25, 95% CI=1.36-3.74) were more likely to result in hospitalisation. CONCLUSION Rawalpindi city has a significant burden of burns. These results showed that investigating further factors leading to burns at home and work could be useful for future safety education campaigns. Moreover, continuous surveillance is warranted to decrease burns in Pakistan.

Road traffic crashes on the Yaoundé-Douala road section, Cameroon

OBJECTIVE Developing countries account for more than 85% of all road traffic deaths in the world. Our aims were to estimate road morbidity and mortality and to describe the main characteristics of road traffic crashes on a heavy traffic road section in Cameroon. METHODS We conducted a study of police reports of the 2004-2007 period retrieved from the 13 police stations in charge of the 243 km Yaoundé-Douala road section in Cameroon. RESULTS The estimated overall number of people killed per 100 million kilometres driven was 73, more than 35 times higher than on similar roads in the US or Europe. The most severe crashes were those involving vulnerable road users (97 deaths) and vehicles travelling in opposite directions (136 deaths). The main causes of fatal crashes were mechanical failures (28%), two-thirds being tyre problems, hazardous overtaking (23%), and excessive speed (20%). CONCLUSIONS The burden of road traffic injuries on heavy traffic roads in Cameroon calls for urgent interventions. Traffic calming measures and control of vehicle condition appear to be the most cost-effective interventions.

Epidemiological patterns of suicide terrorism in the civilian Pakistani population

In this study, we assessed the epidemiological patterns of suicide terrorism in the civilian population of Pakistan. Information about suicide terrorism-related events, deaths and injuries was extracted from the South-Asian Terrorism Portal (SATP) for the period from 2002 to October 2009. Of 198 events, civilians were involved in 194 events. Civilians accounted for 74.1% (N = 2017) of those who died and 93.8% (N = 6129) of those who were injured. In nine districts, mortality rates were more than one death per 100,000 inhabitants per year. The yearly trend showed a shift of attack targets from foreigners and sectarian targets in 2002–2005 to security forces or general public in 2006–2009. Attacks on public installations (mosques) or political gatherings resulted in a significantly greater (P ≤ 0.02) number of deaths (22 vs. 8) and injuries (59 vs. 24) per event compared with security installations. These results show that prevention might focus on political negotiation with armed groups and that appropriate measures should be taken to protect mosques and political gatherings.

Emergency Trauma Care for Severe Injuries in a Moroccan Region: Conformance to French and World Health Organization Standards

&NA; In Morocco, injuries account for 11% of total burden of disease. Better organization of emergency care can improve the outcome of trauma patients. In Morocco, these services have been reorganized recently, but were never evaluated. The objective was to assess actual structure and processes of emergency trauma care in a Moroccan region. This comparative qualitative study was carried out in the region of Fez. The process and structure of contacting emergency care and prehospital emergency care were compared with the French 2002 standards. Emergency care at the University Teaching Hospital (UTH) was compared with World Health Organization 2005 Essential Trauma Care guidelines. Predefined care items were categorized as conforming to the standards or not. An emergency call center with a dedicated dial–up number has been established in the region since January 2007. Compared with the standards, this center was not protected by any legislation and was run by interns only. The center was underutilized during triage to help transportation of severe trauma patients. At the prehospital care level, only 3 out of 15 ambulances were equipped with resuscitation equipment and were used rarely. Only one of the ambulance staff out of three was trained in required skills. At the UTH, emergency care equipment and staff was nearly adequate. This study identified several opportunities for improvement in organizing trauma care in Fez particularly at emergency call center and ambulance service. A quality assurance program would be useful to further identifying improvements in this system.

Average out-of-pocket healthcare and work-loss costs of traffic injuries in Karachi, Pakistan

The objective of this study was to assess the average out-of-pocket healthcare and work-loss costs of road traffic injuries (RTI) in Karachi. In this cross-sectional study, RTI patients presenting to the five trauma centres in Karachi were contacted using stratified sampling to report their inpatient and outpatient expenses, the time spent in hospital and their average monthly income. These costs were compared among different categories of patient-related variables using analysis of variance test. Out of 341 RTI victims, two wheelers accounted for the majority of injuries (77.2%, N = 256) followed by pedestrians (14.2%, N = 48). Almost half of the sample patients were breadwinners (N = 135, 45.2%), with 87.4% (N = 118) earning less than US

Burden and factors associated with highway work-zone crashes, on a section of the Karachi-Hala Road, Pakistan.

248. Average out-of-pocket healthcare costs were US

Challenges in Evaluating the Decade of Action for Road Safety in Developing Countries: A Survey of Traffic Fatality Reporting Capacity in the Eastern Mediterranean Region

271 (SD = 440.9), which were significantly higher (P ≤ 0.026) for pedestrians (US

Situational factors associated with road traffic crashes: A case–control study on the Yaoundé–Douala road section, Cameroon

442), moderate (US

Concordance Between Road Mortality Indicators in High-Income and Low- and Middle-Income Countries

341.7) or severe (US

Differences in reporting of violence and deliberate self harm related injuries to health and police authorities, Rawalpindi, Pakistan

553.8) injury, and treatment in private hospitals (US