Prevalence and predictors of injuries in Kenya: findings from the national STEPs survey
Tóm tắt
Injuries are becoming an increasingly important public health challenge globally, and are responsible for 9% of deaths. Beyond their impact on health and well-being, fatal and non-fatal injuries also affect social and economic development for individuals concerned. Kenya has limited data on the magnitude and factors associated with injuries. This study sought to determine the magnitude and risk factors for injuries in Kenya and to identify where the largest burden lies. A national population-based household survey was conducted from April–June 2015 among adults age 18–69 years. A three-stage cluster sample design was used to select clusters, households and eligible individuals based on WHO guidelines. We estimated the prevalence of injuries, identified factors associated with injuries and the use of protective devices/practices among road users. Multivariate logistic regression was used to identify potential factors associated with injuries. A total of 4484 adults were included in the study. Approximately 15% had injuries from the past 12 months, 60.3% were males. Four percent of the respondents had been injured in a road traffic crash, 10.9% had experienced unintentional injuries other than road traffic injuries while 3.7% had been injured in violent incidents. Among drivers and passengers 12.5% reported always using a seatbelt and 8.1% of the drivers reported driving while drunk. The leading causes of injuries other than road traffic crashes were falls (47.6%) and cuts (34.0%). Males (p = 0.001), age 18–29 (p < 0.05) and smokers (p = 0.001) were significantly more likely to be injured in a road traffic crash. A higher social economic status (p = 0.001) was protective against other unintentional injuries while students had higher odds for such types of injuries. Heavy episodic drinking (p = 0.001) and smoking (p < 0.05) were associated with increased likelihood of occurrence of a violent injury. Our study found that male, heavy episodic drinkers, current smokers and students were associated with various injury types. Our study findings highlight the need to scale up interventions for injury prevention for specific injury mechanisms and target groups. There is need for sustained road safety mass media campaigns and strengthened enforcement on helmet wearing, seatbelt use and drink driving.
Tài liệu tham khảo
World Health Organization (WHO). Injuries and Violence: The facts. 2014.
World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. World Heal Organ. 2013:102.
World Health Organisation - Afro Region. The Brazzaville Declaration on Noncommunicable Diseases Prevention and Control in the Who African Region. 2010. http://www.who.int/nmh/events/2011/ncds_brazzaville_declaration.pdf. Accessed Mar 2017.
Haagsma JA, Graetz N, Bolliger I, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the global burden of disease study 2013. Inj Prev. 2016;22:3–18.
Nantulya VM, Reich MR. Equity dimensions of road traffic injuries in low- and middle-income countries. Inj Control Saf Promot. 2003;10:13–20.
Lopez AD, Mathers CD, Ezzati M, et al. E. Global Burden of Disease and Risk Factors https://www.ncbi.nlm.nih.gov/books/NBK11812/ co-published by Oxford University press, New York. (2006).
United Nations. The Sustainable Development Goals Report 2016. 2016; 56.
Nordberg E. Injuries as a public health problem in sub-Saharan Africa: epidemiology and prospects for control. East Afr Med J. 2000;77:S1–43.
Gathecha GK, Githinji WM, Maina AK. Demographic profile and pattern of fatal injuries in Nairobi , Kenya , January – June 2014. BMC Public Health. 2017:1–7.
Mberu B, Wamukoya M, Oti S, et al. Trends in causes of adult deaths among the urban poor: evidence from Nairobi urban health and demographic surveillance system, 2003–2012. J Urban Heal. 2015;92:422–45.
Saidi H, Oduor J. Trauma deaths outside the hospital: uncovering the typology in Kenyan capital. J Forensic Legal Med. 2013;20:570–4.
Odhiambo FO, Beynon CM, Ogwang S, et al. Trauma-related mortality among adults in rural western Kenya: Characterising deaths using data from a health and demographic surveillance system. PLoS One; 8. Epub ahead of print 2013. DOI: https://doi.org/10.1371/journal.pone.0079840.
Masi AT. Potential uses and limitations of hospital data in epidemiologic research. Am J Public Heal Nations Heal. 1965;55:658–67.
NTSA. Final 2015 Road Safety Status Report. 2015. http://www.ntsa.go.ke/index.php?option=com_content&view=article&id=203&Itemid=551. Accessed Mar 2017.
Njihia BN, Saidi HOJ. Preliminary data from a de novo trauma registry. Ann African Surg. 2016;13:7–11.
Ghaffar A, Hyder AA, Masud TI. The burden of road traffic injuries in developing countries: the 1st national injury survey of Pakistan. Public Health. 2004;118:211–7.
Azetsop J. Social justice approach to road safety in Kenya: addressing the uneven distribution of road traffic injuries and deaths across population groups. Public Health Ethics. 2010;3:115–27.
Schuurman N, Cinnamon J, Walker BB, et al. Intentional injury and violence in Cape Town, South Africa: an epidemiological analysis of trauma admissions data. Glob Health Action. 2015;8:1–9.
Liu BC, Ivers R, Norton R, et al. Helmets for preventing injury in motorcycle riders. In: Liu BC (ed) Cochrane Database Syst Rev Chichester: John Wiley & Sons, Ltd. Epub ahead of print 23 January 2008. DOI: https://doi.org/10.1002/14651858.CD004333.pub3.
Cummings P. Association of seat belt use with death: a comparison of estimates based on data from police and estimates based on data from trained crash investigators. Inj Prev. 2002;8:338–41.
Abbas AK, Hefny AF, Abu-Zidan FM. Seatbelts and road traffic collision injuries. World J Emerg Surg. 2011;6:18.
Forjuoh SN. Traffic-related injury prevention interventions for low-income countries. Inj Control Saf Promot. 2003;10:109–18.
Ministry of Health. Kenya National Violence and Injury Prevention and Control Action Plan 2018–2022.
Ministry of Health, Kenyan National Bureau of statistics WHO. Kenya STEPwise Survey for Non Communicable Diseases Risk Factors 2015 Report 2015; 5.
Sass A-C, Stang A. Population-based incidences of non-fatal injuries - results of the German-wide telephone survey 2004. BMC Public Health. 2013;13:376.
Stewart K-A, Groen RS, Kamara TB, et al. T. Traumatic injuries in developing countries: report from a Nationwide cross-sectional survey of Sierra Leone. Biophys Chem. 2005;257:2432–7.
Lett RR, Kobusingye OC, Ekwaru P. Burden of injury during the complex political emergency in northern Uganda. Can J Surg. 2006;49:51–7.
El Tayeb S, Abdalla S, Mørkve O, et al. Injuries in Khartoum state, the Sudan: a household survey of incidence and risk factors. Int J Inj Control Saf Promot. 2013;7300:37–41.
Moshiro C, Heuch I, Åstrøm AN, et al. Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey. BMC Public Health. 2005;5:11.
Sorenson SB. Gender disparities in injury mortality: consistent, persistent, and larger than you’d think. Am J Public Health. 2011;101:353–8.
Granié M-A. Effects of gender, sex-stereotype conformity, age and internalization on risk-taking among adolescent pedestrians. Saf Sci. 2009;47:1277–83.
Levant RF PW. A new psychology of men. New York, 2003.
Moshiro C, Heuch I, Åstrøm AN, et al. Effect of recall on estimation of non-fatal injury rates: a community based study in Tanzania. Inj Prev. 2005;11:48–52.
Tiesman H, Zwerling C, Peek-Asa C, et al. Non-fatal injuries among urban and rural residents: the National Health Interview Survey, 1997-2001. Inj Prev. 2007;13:115–9.
Halawa EF, Barakat A, Rizk HII, et al. Epidemiology of non-fatal injuries among Egyptian children: a community-based cross-sectional survey. BMC Public Health. 2015;15:1248.
World Bank. The High Toll of Traffic Injuries : Unacceptable and Preventable. 2017. https://openknowledge.worldbank.org/handle/10986/29129?show=full. Accessed Apr 2017.
Cherpitel C, Ye Y. Alcohol and violence-related injuries among emergency room patients in an international perspective. J Am Psychiatr Nurses Assoc. 2010;16:227–35.
Buccola NG, Rosedale M, Bryan T. A clinical translation of the research article titled, ‘alcohol and violence-related injuries among emergency room patients in an international perspective’. J Am Psychiatr Nurses Assoc. 2010;16:236–8.
Kreitman N. Alcohol consumption and the preventive paradox. Br J Addict. 1986;81:353–63.
World Health Organization. Globbal strategy to reduce the harmful use of alcohol: World Heal Organ; 2010. p. 44. http://www.who.int/substance_abuse/msbalcstragegy.pdf.
Sacks JJ, Nelson DE. Smoking and Injuries: An Overview. Prev Med (Baltim). 1994;23:515–20.
Wen CP, Tsai SP, Cheng TY, et al. Excess injury mortality among smokers: a neglected tobacco hazard. Tob Control. 2005;14:i28 LP–i32.
W O, Khayesi M, Heda PM. Road traffic injuries in Kenya: magnitude, causes and status of intervention. Inj Control Saf Promot. 2003;10:53–61.
Starkey P. The benefits and challenges of increasing motorcycle use for rural access.
Bachani AM, Hung YW, Mogere S, et al. Helmet wearing in Kenya: prevalence, knowledge, attitude, practice and implications. Public Health. 2017;144:s23–31.
Hossain M, Zimmerman C, Kiss L, et al. Men’s and women’s experiences of violence and traumatic events in rural Côte d ‘Ivoire before, during and after a period of armed conflict. BMJ Open; 4. Epub ahead of print 2014. DOI: https://doi.org/10.1136/bmjopen-2013-003644.
Lyons RA, Kendrick D, Towner EM, et al. Measuring the population burden of injuries-implications for global and national estimates: a multi-Centre prospective UK longitudinal study. PLoS Med; 8. Epub ahead of print 2011. DOI: https://doi.org/10.1371/journal.pmed.1001140.
Frenk J, Gomez-Dantes O. The triple burden. Disease in developing nations 2011.