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Johns Hopkins International Injury Research Unit

A World Health Organization Collaborating Center for Injuries, Violence and Accident Prevention

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Keyword: adnan hyder

Road traffic injuries (RTIs) are a leading cause of death and disability in Africa. With a rate of 28.3 fatalities per 100,000 population, it’s the highest in the world. What’s more, the economic cost of RTIs on the continent is estimated to be 1-2% of the gross national product. Despite these high numbers, there is little data available on prevention and treatment strategies.  This is true for the central African country of Cameroon, where the number of road traffic deaths has been steadily increasing since the 1970s.

Recently, in an effort to examine road traffic injuries JH-IIRU team members published “Road Traffic Injuries in Yaoundé, Cameroon: A hospital-based pilot surveillance study,” in the journal Injury. The paper looked at patients injured in RTIs who sought care at the main referral hospital in Yaoundé to determine not only the characteristics of those injured but also to identify the associations between these characteristics and outcomes which could be used to improve treatment in Cameroon as well as  other low- and middle-income countries (LMICs). The study provides valuable information about RTIs which the team hopes can be used to improve emergency care in Cameroon and other LMICs and highlights the importance of RTI prevention.

The team included JH-IIRU associate director, Kent Stevens and director Adnan Hyder, and colleagues from WHO Africa, the Ministry of Public Health in Yaoundé, as well as the Department of Surgery at the University of California, San Francisco.  Catherine Juillard, currently in the Department of Surgery at Johns Hopkins Hospital, was a post-doctoral fellow in JH-IIRU when this study was conducted.

This study is part of the unit’s ongoing global work on trauma care.

Read more here

Each year, the Global Emergency Medicine Literature Review (GEMLR) searches peer-reviewed and grey literature on emergency medicine to find the most important and upcoming research in the field.

This year, of the several thousand articles reviewed, “The cost of injury and trauma care in low- and middle-income countries: a review of economic evidence,” published in the journal Health Policy and Planning, was selected as one of the top global emergency medicine articles of 2013.

Written by JH-IIRU team members Hadley Wesson, associate director Abdul Bachani and director Adnan Hyder, as well as colleagues Nonkululeko Boikhutso and Karen J. Hofman, the paper suggests that while there is an urgent need to push injury prevention to the forefront of public health initiatives and to understand the costs associated with injury, there is a lack of injury-related economic evidence from LMICs. The paper goes on to summarize the body of economic evidence on injury in LMICs; assess the quality of cost-effectiveness studies using standard methods to highlight the role of economic data as a tool for injury-prevention advocacy; and provide recommendations regarding economic evaluations in LMICs.

“We are delighted to have one of our publications selected by GEMLR this year,” said Hyder. “Emergency medicine, especially in low-income settings, is vitally important and we hope this distinction will help guide policy makers when prioritizing public health funding and initiatives.

Formed in 2005, GEMLR seeks encourage the development of the field of emergency medicine globally by providing clear and accessible scientific literature. The review searches thousands of peer-reviewed and grey literature, and selects those of the highest quality to illustrate best practices and encourage additional research in the field of global emergency medicine.

On June 25 – 26, 2014, Johns Hopkins International Injury Research Unit (JH-IIRU) director, Adnan Hyder, and associate director, Abdul Bachani, participated in the Research Week 2014 Summit at the Universiti Putra (UPM) in Putrajaya, Malaysia. The two-day summit, organized by the Faculty of Medicine and Health Sciences at the university, featured discussions ranging from clinical trials to responsible conduct of research. 

Dr. Hyder gave a plenary talk, “Global Road Safety: Evaluation Strategies in 10 Countries,” in which he discussed the work of the Bloomberg Philanthropies Global Road Safety Program.

Drs. Hyder and Bachani met with UPM leadership, including vice chancellor Dr. Mohd Ramlan, deputy vice chancellor Professor M. Nasir Shamdsudin and deputy dean of research, Dr. Zamberi Sekawi to discuss collaborations on projects such as child injuries in the home. They also met with longtime collaborator, Dr. Kulanthayan KC Mani from the Road Safety Research Center at UPM to discuss mutual collaborations.

Tahir Malaysia
Dr. Hyder (right) with Dr. Tahir (left), Director for the Institute for Public Health in Malaysia
Hyder UPM
Dr. Adnan Hyder speaks at the plenary session, Global Road Safety: Evaluation Strategies in 10 Countries

Injury severity scores are important and necessary tools for both evaluating care of the injured patient and establishing institutional quality and research practices. In high-income countries (HICs), several injury severity scores have been used to evaluate and study trauma patients; however, despite the fact that more than 90% of the estimated 5.8 million deaths each year caused by injury worldwide occur in low- and middle-income countries (LMICs), few scores have been validated for use in these countries.  The Kampala Trauma Score (KTS) is an injury severity score that was developed specifically for use in low-resource settings.

In the recently published paper, “Is the Kampala Trauma Score an Effective Predictor of Mortality in Low-Resource Settings? A Comparison of Multiple Trauma Severity Scores,” a group of researchers, including Johns Hopkins International Injury Research Unit’s (JH-IIRU) associate director, Kent Stevens and director, Adnan Hyder, compared five trauma severity scores against the ability of KTS to predict mortality of trauma patients in the Central Hospital of Yaounde, Cameroon.

The results suggest that there is potential for the adoption of KTS for injury surveillance and triage in resource-limited settings and that KTS is as effective as other scoring systems in predicting patient mortality. Because the system is simple to administer and record, this makes KTS a potentially valuable tool for low-resource settings, where many hospitals are understaffed and basic record-keeping and data collection is unreliable or incomplete.

To read more about the study, click here.

On May 21 and 22, 2014, the Johns Hopkins International Injury Research Unit (JH-IIRU), along with the Institute for International Programs (IIP) and USAID co-hosted a meeting on child injury at the Johns Hopkins Bloomberg School of Public Health. The meeting brought together members of the injury prevention field in an effort to reduce the global burden on childhood injuries, with a focus on low- and-middle-income countries (LMICs), where more than 95% of both intentional and unintentional child deaths occur.

International Health professor and director of IIP, Bob Black opened the meeting, which was conducted as part of the Health Research Challenge for Impact Program, funded by the United States Agency for International Development with JH-IIRU director, Adnan Hyder discussing the prospects and challenges of child injuries. Olakunle Alonge, JH-IIRU faculty member who is leading the Unit’s work on Saving of Lives from Drowning in Bangladesh (SoLiD) project, discussed effective interventions for child injury and quality of data sources, as well as provided a summary and next steps for the meeting. Also participating from JH-IIRU was Dr. Ricardo Pérez-Núñez, currently a postdoctoral fellow with the Unit.

Child injury group
JH-IIRU, IIP and USAID child injury meeting participants

Other presenters included Dr. Neal Brandes from USAID and Torine Creppy from SafeKids. Several JH-IIRU collaborators participated in the meeting, including Dr. Junaid Razzak from Aga Khan University, Dr. Olive Kobusingye from Makerere University, Dr. Dr. Shams El Arifeen, from icddr,b as well as current and past Global Road Safety Program collaborators, Martha Hijar, former director of Entornos Foundaçion, Mexico and Marieannette Otero, from the Association for Safe International Road Travel (ASIRT).

The World Health Organization (WHO) reports that the five most common unintentional injuries among children are from road traffic injuries, falls, burns, drowning and poisoning.

JH-IIRU is committed to reducing the global burden of childhood unintentional injuries. From our assessment of the potential of child injury prevention in "Saving 1000 children a day: The potential of child and adolescent injury prevention" (accessed here) to our Global Road Safety Program work in low- and middle-income countries that focuses on interventions like seatbelts and child restraints, JH-IIRU is dedicated to using reliable data to assess risks and introduce effective interventions. We have analyzed hospital data on pediatric burn injuries in South Africa, examined child road safety education programs in Malaysia and done extensive home injury risk assessment work in Pakistan.

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