Intentional injuries: The Experience from Dodoma Regional Hospital, Central Tanzania

Abstract

Background: Worldwide intentional injuries cause about 9 deaths for every 100,000 persons; in Africa the contribution is estimated to be twice as much (25 out of 100000 persons).The true incidence of intentional injuries in Tanzania is unknown. There are very few hospital based studies which have characterized patients with intentional injuries. This study shares the experience obtained in management of patients with intentional injuries at Dodoma Regional Hospital for a period of about 9 months.

Methods: A hospital based prospective descriptive study was carried out, in which all patients admitted with history of intentional injury were conveniently recruited into the study. Demographic data, injury causes and pattern were recorded; treatment was given according to hospital standard protocol. Consent was obtained from all patients.

Results: Two hundred and fifty two patients were studied, the age ranged from 10 to 60 years with a mean age of 30.54 (standard deviation = 9.6). Males outnumbered females by
1.6. The commonest assailants were persons not related to victims (80%). The majority of injuries occurred outside home environment (70%), with marital status having a significant contribution. Most injuries took place at night. Sexual violence was a leading overall cause (27%), in men robbery or theft was the commonest cause (82%). Knives/machetes in 42% were among the commonest weapons used, followed by wooden sticks 26%. Head and neck were the most common body parts injured (79%), followed by chest and abdomen (19%), with significant difference between men and women (p value = 0.0001). Non-penetrating stabs or cuts wounds were the commonest injuries (70%), followed by penetrating chest and abdominal injuries (12%). Surgical debridement and primary suture was performed in 77% of cases, followed by thoracotomy and or laporatomy. Men needed more radical forms of surgical intervention than women (p value
< 0.0001). The wound complication rate was 37%. The mean hospital stay was 4.7 days, with standard deviation of 7.7 and a range of 1 to 64 days.

Conclusion: Intentional injuries in Dodoma are probably very high, and there is possibility that domestic violence may be higher in this area, if findings from this study are to be extrapolated into the community. There is no doubt that this may significantly contribute to family poverty through morbidity, hospital expenses and lost hours of productivity. Further community based studies and community advocacy through health education are recommended.

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