Factors Associated with Interpersonal Violence Injuries as Seen at Kigali and Butare University Teaching Hospitals In Rwanda

Abstract

Background: Interpersonal conflicts often result into physical injuries of different magnitudes. Every year, a significant portion of patients admitted with injuries to the Accident and Emergency units of the hospitals in Rwanda, like in other African countries, are victims of intentional interpersonal violence. Globally, studies indicate that the problem of interpersonal violence related-injuries is a significant contributor to surgical morbidity and mortality. The aim of this study was to analyze and document the patterns and risk factors associated with interpersonal violence injuries in two referral hospitals in Rwanda (University Teaching Hospitals – Butare (CHUB) and Kigali (CHUK). Methods: This was a prospective observational study. All patients with interpersonal violence injuries (physical injuries) willing to participate in the study were included. Each participant was assessed using the abbreviated injury sore (AIS), by which we categorized their injuries as minor, moderate, and serious or severe, according to the anatomical distribution and severity of the injuries. The variables studied included types of injuries, weapons used, relationship between assailant and victim, and factors leading to the violence. The study population consisted of 138 patients seen from August 2015 to January 2016. Results: Among the 138 participants (victims) the risk factors identified were: Alcohol abuse (31%); Land conflicts (17%); Robbery (14.3%); Business-related / money issues (12.3%); Domestic violence, including child abuse (5.8%); others (2%). Outcome: 119 patients improved well, 17 died and 2 were left with permanent injuries. The total number of trauma cases admitted in the two referral hospitals in this period was 1004, and the trauma mortality for the two hospitals in the same period was 156. This meant a morbidity of 14%, and a mortality of 10% due to interpersonal violence. Conclusion: The predisposing factors for interpersonal violence in Rwanda, as indicated by this study, included land conflicts, alcohol abuse, robbery, unemployment, domestic violence, and low levels of education. Interpersonal violence injuries contributed significantly to trauma related surgical morbidity and mortality.

Key words: Interpersonal violence, Physical injuries, predisposing factors