Non-fatal injuries in rural Burkina Faso amongst older adults, disease burden and health system responsiveness: a cross-sectional household survey.

Journal: BMJ open

Volume: 11

Issue: 5

Year of Publication: 2021

Affiliated Institutions:  Institute of Applied Health Research, University of Birmingham, Birmingham, UK john.k.whitaker@kcl.ac.uk. Institute for Global Health, University College London, London, UK. Centre de Recherche en Sante de Nouna, Nouna, Burkina Faso. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. Africa Health Research Institute, KwaZulu-Natal, South Africa. Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Abstract summary 

This study aimed to evaluate the epidemiology of injury as well as patient-reported health system responsiveness following injury and how this compares with non-injured patient experience, in older individuals in rural Burkina Faso.Cross-sectional household survey. Secondary analysis of the CRSN Heidelberg Ageing Study dataset.Rural Burkina Faso.3028 adults, over 40, from multiple ethnic groups, were randomly sampled from the 2015 Nouna Health and Demographic Surveillance Site census.Primary outcome was incidence of injury. Secondary outcomes were incidence of injury related disability and patient-reported health system responsiveness following injury.7.7% (232/3028) of the population reported injury in the preceding 12 months. In multivariable analyses, younger age, male sex, highest wealth quintile, an abnormal Generalised Anxiety Disorder score and lower Quality of Life score were all associated with injury. The most common mechanism of injury was being struck or hit by an object, 32.8%. In multivariable analysis, only education was significantly negatively associated with odds of disability (OR 0.407, 95% CI 0.17 to 0.997). Across all survey participants, 3.9% (119/3028) reported their most recent care seeking episode was following injury, rather than for another condition. Positive experience and satisfaction with care were reported following injury, with shorter median wait times (10 vs 20 min, p=0.002) and longer consultation times (20 vs 15 min, p=0.002) than care for another reason. Injured patients were also asked to return to health facilities more often than those seeking care for another reason, 81.4% (95% CI 73.1% to 87.9%) vs 54.8% (95% CI 49.9% to 53.6%).Injury is an important disease burden in this older adult rural low-income and middle-income country population. Further research could inform preventative strategies, including safer rural farming methods, explore the association between adverse mental health and injury, and strengthen health system readiness to provide quality care.

Authors & Co-authors:  Whitaker John J Harling Guy G Sie Ali A Bountogo Mamadou M Hirschhorn Lisa R LR Manne-Goehler Jennifer J Bärnighausen Till T Davies Justine J

Study Outcome 

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Statistics
Citations :  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. 10.1136/injuryprev-2015-041616
Authors :  8
Identifiers
Doi : e045621
SSN : 2044-6055
Study Population
Male
Mesh Terms
Aged
Other Terms
epidemiology;health services administration & management;trauma management;tropical medicine
Study Design
Cross Sectional Study
Study Approach
Country of Study
Burkina faso
Publication Country
England