Open AccessDisparities in Injury Mortality Between Uganda and the United States: Comparative Analysis of a Neglected Disease
Author(s) -
Jayaraman Sudha,
Ozgediz Doruk,
Miyamoto Justin,
Caldwell Nolan,
Lipnick Michael S.,
Mijumbi Cephas,
Mabweijano Jacqueline,
Hsia Renee,
Dicker Rochelle
Publication year - 2011
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-010-0871-z
Subject(s) - medicine , odds ratio , mortality rate , public health , demography , injury prevention , christian ministry , environmental health , poison control , surgery , sociology , nursing , philosophy , theology
Background The burden of global injury‐related deaths predominantly affects developing countries, which have little infrastructure to evaluate these disparities. We describe injury‐related mortality patterns in Kampala, Uganda and compare them with data from the United States and San Francisco (SF), California. Methods We created a database in Kampala of deaths recorded by the City Mortuary, the Mulago Hospital Mortuary, and the Uganda Ministry of Health from July to December 2007. We analyzed the rate and odds ratios and compared them to data from the U.S. Centers for Disease Control and Prevention and the California Department of Public Health. Results In Kampala, 25% of all deaths were due to injuries (812/3303) versus 6% in SF and 7% in the United States. The odds of dying of injury in Kampala were 5.0 times higher than in SF and 4.2 times higher than in the United States. Age‐standardized death rates indicate a 93% greater risk of dying from injury in Kampala than in SF. The mean age was lower in Kampala than in SF (29 vs. 44 years). The adult injury death rate (rate ratio, or RR) was higher in Kampala than in SF (2.3) or the United States (1.5). Head/neck injury was reported in 65% of injury deaths in Kampala compared to 34% in SF [odds ratio (OR) 3.7] and 28% in the US (OR 4.8). Conclusions Urban injury‐related mortality is significantly higher in Uganda than in the United States. Injury preferentially affects adults in the prime of their economically productive years. These findings serve as a call for stronger injury prevention and control policies in Uganda.