Injury caseload, pattern and time of presentation to emergency services in Mozambique: A pragmatic, multicentre, observational study

Background

Rapid population growth and urbanisation raise a critical need to better understand the burden of injuries in sub-Saharan Africa. We assessed the pattern of service demand for injuries at emergency department (ED) in urban areas of Mozambique.

Methods

This prospective, multi-centric, observational study was conducted in EDs in southern (Maputo), central (Beira) and northern (Nampula) of Mozambique. We randomly selected 7809 cases (age ≥1 years) during the seasonally distinct months of April/2016–2017 and October/2017. Data on patients’ demographics, nature of injury and clinical outcomes were collected.

Results

Overall, 1881/7809 (26.2 %) emergency cases comprising 518 children (58.5 % male, aged 4.6 ± 2.5 years), 324 adolescents (64.8 % male, 14.7 ± 3.0 years) and 10,39 adults (60.8 % male, 34.5 ± 13.0 years) presented with injury. The arms, legs and head were most affected in both children (518 with 795 injuries) and adults (1039 with 1496 injuries). The diversity of injuries increased with older age. Injury cases predominantly presented during daylight hours (from 0900 to 1900) with age-differentials evident. There were proportionately more injury presentations in the hotter and wetter October than in colder and drier April. The most common mechanisms of injury were falls, physical violence and road traffic injuries. Overall, 9.1 % of injury cases were admitted to hospital and 0.2 % died.

Conclusions

Injuries corresponded to around one-quarter of all emergency admissions in urban Mozambique, and were predominantly caused by falls, physical violence, and road traffic injuries. Understanding distinctive variations in the pattern and timing of these presentations according to the age, location and season will assist in future planning for more efficient injury prevention and health care services in Mozambique.