Browsing by Author "Calland, JF"

Now showing 1 - 4 of 4

Can Focused Trauma Education Initiatives Reduce Mortality OR Improve Resource Utilization in A Low-Resource Setting?
(Academic Press Inc Elsevier Science , 525 B St, Ste 1900, San Diego, Usa, Ca, 92101-4495, 2013) Petroze, RT; Byiringiro, JC; Ntakiyiruta, G; Riviello, R; Briggs, SM; Razek, T; Deckelbaum, D; Sawyer, RG; Kyamanywa, Patrick; Calland, JF
Advanced Trauma Life Support (ATLS) teaches a systematic approach to the initial management of injured patients in over 60 countries. Limited data exists on the impact of ATLS or similar team-based courses on patient outcomes, particularly in low and middle-income countries (LMIC). We hypothesized that implementation of a focused trauma education initiative in a low-income country would result in measurable differences in injury-related outcomes and resource utilization.
Epidemiology of Paediatric Injuries in Rwanda Using a Prospective Trauma Registry
(Oxford Univ Press , Great Clarendon St, Oxford, England, Ox2 6dp, 2020) Petroze, RT; Martin, AN; Ntaganda, E; Kyamanywa, Patrick; St-Louis, E; Rasmussen, SK; Calland, JF; Byiringiro, JC
Background: Child survival initiatives historically prioritized efforts to reduce child morbidity and mortality from infectious diseases and maternal conditions. Little attention has been devoted to paediatric injuries in resource-limited settings. This study aimed to evaluate the demographics and outcomes of paediatric injury in a sub-Saharan African country in an effort to improve prevention and treatment. Methods: A prospective trauma registry was established at the two university teaching campuses of the University of Rwanda to record systematically patient demographics, prehospital care, initial physiology and patient outcomes from May 2011 to July 2015. Univariable analysis was performed for demographic characteristics, injury mechanisms, geographical location and outcomes. Multivariable analysis was performed for mortality estimates. Results: Of 11 036 patients in the registry, 3010 (27⋅3 per cent) were under 18 years of age. Paediatric patients were predominantly boys (69⋅9 per cent) and the median age was 8 years. The mortality rate was 4⋅8 per cent. Falls were the most common injury (45⋅3 per cent), followed by road traffic accidents (30⋅9 percent), burns (10⋅7 per cent) and blunt force/assault (7⋅5 per cent). Patients treated in the capital city, Kigali, had a higher incidence of head injury (7⋅6 per cent versus 2⋅0 per cent in a rural town, P < 0⋅001; odds ratio (OR) 4⋅08, 95 per cent c.i. 2⋅61 to 6⋅38) and a higher overall injury-related mortality rate (adjustedOR 3⋅00, 1⋅50 to 6⋅01; P = 0⋅019). Pedestrians had higher overall injury-related mortality compared withother road users (adjusted OR 3⋅26, 1⋅37 to 7⋅73; P = 0⋅007). Conclusion: Paediatric injury is a significant contributor to morbidity and mortality. Delineating trauma demographics is important when planning resource utilization and capacity-building efforts to address paediatric injury in low-resource settings and identify vulnerable populations.
Patterns of Injury at Two University Teaching Hospitals in Rwanda: Baseline Injury Epidemiology Using the Rwanda Injury Registry
(RBC / Rwanda Health Communication Centre, 2014) Petroze, RT; Mumararungu, A; Ndayiragije, V; Ntakiyiruta, G; Kyamanywa, Patrick; Reid, J; Calland, JF; Byiringiro, JC
Introduction: Globally, more worldwide deaths in 2010 could be attributed to injuries than the total number of deaths from infection with AIDS, tuberculosis, and malaria combined, with a disproportionate number of these deaths occurring in low- and middle-income countries. Yet, worldwide research and plans for prevention of injuries are far below other world health problems, especially in developing countries. Methods: A 31-item, 2-page registry form was adapted from regional trauma registries for use in Rwanda to collect data at the two main university referral hospitals in Kigali and Butare. Beginning in 2011, registrars recorded demographics, pre-hospital care, initial physiology, early interventions, and disposition of injured patients who met our selection criteria. Inpatient 30-day discharge status, mortality, and complications were abstracted from patient charts, ward reports and operating room logs. Descriptive analysis was used to evaluate patterns of injury and basic injury epidemiology at the two study hospitals from August 1, 2011-January 31, 2013. Results: A total of 3599 patients were registered from August 1, 2011 to January 31, 2013. Patients were predominantly male, and road traffic crashes were the leading cause of injury overall, contributing to a greater proportion of injuries in the more urban capital than the smaller city of Butare. The majority of patients were admitted to the hospital. All variables evaluated except for the percentage of injuries acquired via a penetrating mechanism showed statistically significant differences at an alpha significance level of 0.05, illustrating that the trauma population presenting at the two hospitals may be quite different. Conclusion: The Rwanda Injury Registry indicates a high burden of road traffic injuries in a predominantly working age male population over an eighteen-month period. This information can be useful in expanding injury surveillance programs and hopefully implementing population-based prevention programs.
Physician Brain Drain in Sub-Saharan Africa: The Career Plans of Rwanda's Future Doctors
(RBC / Rwanda Health Communication Centre, P.O.Box 4586 / Kigali Rwanda., 2016) Rubagumya, F; Hrdy, Michael; Uwase, MA; Kamanzi, B; Kyamanywa, Patrick; Petroze, R; Calland, JF
Introduction: Brain drain is defined as the migration of health personnel in search of the better standard of living and quality of life, higher salaries, access to advanced technology and more stable political conditions. Methods: A novel survey was created and distributed to 97 sixth year medical students in Rwanda. The survey queried respondents regarding their likelihood to work abroad or to seek opportunities within NGO’s to evaluate the impact of internal and external brain drain. The data were tabulated and analyzed using Microsoft Excel. Results: More than half of students reported a strong desire to study or work abroad. When asked about employment and training after medical school, 29% answered that they will seek opportunities outside Rwanda. When asked on the will to work for NGOs/Public health oriented organization, 64.9% responded that they would do it collaboratively but still practice medicine. Respondents reported financial opportunity as the fifth motivations for their potential desire to depart from clinical care of patients if such opportunities emerged. Conclusion: Our findings suggest that internal brain drain (work for NGO’s) may potentially coexist alongside and external or international brain drain as an important contributing factor in the shortage of medical doctors in Rwanda and Sub-Saharan Africa.