title: Disparities in injury mortality between Uganda and the United States: comparative analysis of a neglected disease.
abstract: BACKGROUND
  The burden of global injury-related deaths predominantly affects developing countries, which have little infrastructure to evaluate these disparities. We describe injury-related mortality patterns in Kampala, Uganda and compare them with data from the United States and San Francisco (SF), California.
  
  
  METHODS
  We created a database in Kampala of deaths recorded by the City Mortuary, the Mulago Hospital Mortuary, and the Uganda Ministry of Health from July to December 2007. We analyzed the rate and odds ratios and compared them to data from the U.S. Centers for Disease Control and Prevention and the California Department of Public Health.
  
  
  RESULTS
  In Kampala, 25% of all deaths were due to injuries (812/3303) versus 6% in SF and 7% in the United States. The odds of dying of injury in Kampala were 5.0 times higher than in SF and 4.2 times higher than in the United States. Age-standardized death rates indicate a 93% greater risk of dying from injury in Kampala than in SF. The mean age was lower in Kampala than in SF (29 vs. 44 years). The adult injury death rate (rate ratio, or RR) was higher in Kampala than in SF (2.3) or the United States (1.5). Head/neck injury was reported in 65% of injury deaths in Kampala compared to 34% in SF [odds ratio (OR) 3.7] and 28% in the US (OR 4.8).
  
  
  CONCLUSIONS
  Urban injury-related mortality is significantly higher in Uganda than in the United States. Injury preferentially affects adults in the prime of their economically productive years. These findings serve as a call for stronger injury prevention and control policies in Uganda.
authors.affiliation: Department of Surgery, University of California San Francisco, 513 Parnassus Avenue, S321, San Francisco, CA 94118, USA. sudhapjay@gmail.com
authors.forename: Sudha
authors.initials: S
authors.lastname: Jayaraman
authors.forename: Doruk
authors.initials: D
authors.lastname: Ozgediz
authors.forename: Justin
authors.initials: J
authors.lastname: Miyamoto
authors.forename: Nolan
authors.initials: N
authors.lastname: Caldwell
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lipnick
authors.forename: Cephas
authors.initials: C
authors.lastname: Mijumbi
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Mabweijano
authors.forename: Renee
authors.initials: R
authors.lastname: Hsia
authors.forename: Rochelle
authors.initials: R
authors.lastname: Dicker
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D002648:Child; D016208:Databases, Factual; D003906:Developing Countries; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D058069:Neglected Diseases / Q000453:epidemiology*; D018570:Risk Assessment; D012495:San Francisco; D012737:Sex Factors; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014454:Uganda; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D055815:Young Adult