Trauma admissions among victims of domestic violence at a tertiary care hospital in north-western Tanzania: an urgent call to action

Abstract

Background: Despite the growing recognition of domestic violence as a public health and human rights concern, it remains rampant in developing countries and has a negative impact on the victim’s health. This study describes the injury characteristics and treatment outcome of trauma associated with domestic violence in north-western Tanzania.

Methods: This was a descriptive prospective study of patients who were managed for domestic violence related trauma at Bugando Medical Centre in Mwanza, Tanzania from April 2009 to March 2014.

Results: A total of 324 patients (M: F = 1: 10.6) were studied. Majority of the patients were in the second and third decades of life. The perpetrators were mainly husbands and ex-partners (55.5%). Suspecting sexual partner being unfaithful was the most common reason given by victims for domestic violence in 63.4% of cases. Blunt and sharp objects (56.8%) were the most common weapons used. Gunshot injuries were recorded in 0.6% of cases. The head/neck was commonly affected in 68.5%. Soft tissue injuries (77.8%) were the most frequent type of injuries. The majority of patients (65.4%) sustained mild injuries. Twenty-three (7.1%) patients were HIV positive. Surgical treatment was performed in only 34.6% of cases.  Complication rate was 26.8%. The median hospital stay was 12 days. Mortality rate was 6.5%. The main predictors of mortality were advanced age (> 60 years),  late presentation,  severity of injury, severe head injury, HIV seropositivity, low CD 4 count (<200 cells), surgical site infection (p<0.001). More than two-thirds of patients were lost to follow up.

Conclusion: Domestic violence related trauma remains rampant in northwestern Tanzania and contributes significantly to high morbidity and mortality. Urgent preventive measures targeting at reducing the occurrence of domestic physical violence is necessary to reduce the morbidity and mortality resulting from these injuries.