Prevalence of non-fatal injuries, associated factors and health seeking behaviours of the injured in Mbarara municipality

Abstract

Introduction: Injuries are an increasing global public health problem with about 4.8 million deaths occurring each year. In sub-Saharan Africa, injuries contribute to over 7% of all Disability Adjusted Life Years (DALYs) lost. In Uganda, injuries are the 10th leading cause of DALYs and in Mbarara district alone; 4066 injury cases were reported in 2015 contributing 1% to the total burden in the country. Current statistics on injuries in Mbarara municipality are facility based; from health facilities and the police, hence limited. Also little is known about health seeking behaviours of people with injuries. There is therefore a dearth of community based information regarding all injuries and the health seeking behaviours of the injured in the municipality. Aim: To estimate the prevalence of injuries in the past six months, factors associated and health seeking behaviours among the injured community members of Mbarara municipality so as to provide data to guide planning for injury prevention and control. Methods: It was a quantitative cross-sectional study on 212 households with 966 individuals conducted between May and June, 2017. Multi-stage sampling was used and either the female head of the household or spouse or eldest person (>18 years of age) at the time of the visit was interviewed by a trained research assistant on information of all household members after obtaining consent from them. This was dependent on who was available at the time of the visit. A structured questionnaire was used to collect information on prevalence, factors associated and health seeking behaviors of the injured. Data was entered using EpiInfo V7 and analysed using STATAV14. Chi square tests were done at bivariate analysis and Modified Poisson at multivariable analysis. Prevalence ratios (PR) were the measure of association, with corresponding 95% confidence intervals. Results: A total of 212 households were visited with 966 persons in Kakoba and Nyakayojo divisions of Mbarara Municipality. Most participants, 240 (24.8%) were between 16 and 25 years of age with a mean age of 21years (SD±16.40). More than half of the participants were females 517 (53.5%). The prevalence of injuries among community members in the past six months before the study leading to the loss of at least one day from normal activity was 18.2% with 92% of the injuries being unintentional. Falls (27.3%) were the common cause of injury followed by road traffic crashes (26.7%). The month of March had the highest number of injuries at 21%. Age (16- 25 years) (Adj.PR=0.60 95% CI: 0.37, 0.99), urban residency (Adj.PR= 1.50, 95% CI: 1.13, 1.99), Muganda tribe Adj.PR=1.83 95% CI: 1.27, 2.62), tribe other than the dominant tribe (Adj.PR=2.35, 95% CI: 1.60, 3.46), self-employment xi (Adj.PR=2.09 95% CI: 1.13, 3.88) and being a casual laborer (Adj.PR=2.10, 95% CI: 1.17, 3.77) were independently associated with injury. Sixty seven percent of the study participants sought health care outside the home. Clinics 56 (47.5%) were the most utilized place of treatment following injury. More than fifty percent of the injured female participants did not seek health care outside the home. Conclusion: The prevalence of injuries in the past six months before the study leading to the loss of at least one day from normal activity was 18.2% in Mbarara Municipality. Most of the injuries were unintentional, occurred at home and were mostly as result of falls and road traffic crashes. Age, occupation, tribe, and urban residency were the major predictors of injury. Majority of the injured participants sought health care outside the home following an injury. Most female participants did not seek health care outside the home. Clinics were the most utilized place of health care following an injury. This calls for strengthening of injury prevention measures in place and eliminating barriers to health care seeking especially for women.