Injury to presentation delays among musculoskeletal trauma patients in Uganda

Abstract

Background: Injuries are a common cause of morbidity and mortality in the developing world with road traffic crashes being especially prevalent. Kampala has no organised pre hospital rescue service and this causes delays in presentation to hospital with possible adverse outcomes. Objective: The study sought determine the time it took patients to arrive in the hospitals and document the various factors associated with delays in presentation to hospital. Design: Prospective study. Setting: Accident and Emergency Department, Mulago Hospital , Kampala, Uganda Methods: All musculoskeletal injury patients presenting to Mulago Hospital were prospectively enrolled and details of the injury including times of injury and presentation to hospital recorded. Data analysis was done and the Man-Whitney U test and chi square tests used for statistical tests. Results: The median delay in presentation was 3.5 hours. Factors associated with delayed presentation included being managed as an outpatient, having an upper limb injury, being less than 18 years of age and being involved in a road traffic crashes RTC. Conclusion: The delay in presenting to hospital was comparable to other sites in East Africa though significantly longer than in the developed world. The prevalence of traditional bone setters and the lack of an organised pre hospital rescue service may be influencing the delay in presentation to hospital.