The burden and management of self-inflicted injuries at a tertiary care hospital in Mwanza, Tanzania

Abstract

Background: Self-inflicted injuries are a serious but neglected public health problem in developing countries and contribute significantly to the global injury burden. There is a paucity of published data regarding self-inflicted injuries in Tanzania.  This study describes the aetiology, patterns and treatment outcome of these injuries in Mwanza, Tanzania.

Methods: This was a combined retrospective and prospective study of self-inflicted injury patients who were managed at Bugando Medical Centre in Mwanza between February 2007 and April 2014. Data were collected using a pretested and coded questionnaire and analysed using SPSS computer software version 17.0

Results: A total of 136 patients (M: F = 3.3: 1) were enrolled into the study. The median age was 30 years. Psychiatric illness (30.9%) was the most common risk factor for self-inflicted injuries. Self-poisoning (35.3%) was the most frequent mechanism of self-inflicted injuries. This was followed by cutting/stabbing and jumping from heights in 23.5% and 20.6% of patients, respectively. The trunk was the most frequent (31.9%) body region affected. Open wounds were the most (4.2%) common type of injuries sustained. The majority (72.1%) of patients were treated surgically. The complication rate was 50.7% and it was significantly associated with delayed presentation (p= 0.012). The median hospital stay was 12 days. Patients with long bone fractures and those who had surgical site infection stayed longer in the hospital (p < 0.001). The mortality rate was 22.8%. Late presentation (>24 hour), severe injuries (KTS II ≤ 6) and presence of surgical site infections were the main predictors of mortality (p<0.001).

Conclusion: Self-inflicted injuries are an emerging but neglected public health problem in Mwanza, Tanzania and contribute to unacceptably high morbidity and mortality. Addressing the root causes of self-inflicted injuries may reduce the incidence of these injuries in our environment.