title: Hospitalised and fatal head injuries in Viti Levu, Fiji: findings from an island-wide trauma registry (TRIP 4).
abstract: BACKGROUND
  Globally, head injury is a substantial cause of mortality and morbidity. A disproportionately greater burden is borne by low- and middle-income countries. The incidence and characteristics of fatal and hospitalised head injuries in Fiji are unknown.
  
  
  METHODS
  Using prospective data from the Fiji Injury Surveillance in Hospital system, the epidemiology of fatal and hospitalised head injuries was investigated (2004-2005).
  
  
  RESULTS
  In total, 226 hospital admissions and 50 fatalities (66% died prior to admission) with a principal diagnosis of head injury were identified (crude annual rates of 34.7 and 7.7/100,000, respectively). Males were more likely to die and be hospitalised as a result of head injury than females. The highest fatality rate was among those in the 30-44-year age group. Road traffic crashes were the leading causes of injuries resulting in death (70%), followed by 'hit by person or object' and falls (14% each). Among people admitted to hospital, road traffic crashes (34.5%) and falls (33.2%) were the leading causes of injury. The leading cause of head injuries in children was falls, in 15-29-year-olds road traffic crashes, and in adults aged 30-44 years or 45 years and older 'hit by person or object'. Among the two major ethnic groups, Fijians had higher rates of falls and 'hit by person or object' and Indians higher rates for road traffic crashes. There were no statistically significant differences between the overall rates of head injuries or the fatal and non-fatal rates among Fijians or Indians by gender following age standardisation to the total Fijian national population.
  
  
  CONCLUSIONS
  Despite underestimating the overall burden, this study identified head injury to be a major cause of death and hospitalisation in Fiji. The predominance of males and road traffic-related injuries is consistent with studies on head injuries conducted in other low- and middle-income countries. The high fatality rate among those aged 30-44 years in this study has not been noted previously. The high case fatality rate prior to admission to the hospital requires urgent attention.
authors.affiliation: Section of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand. b.kool @ auckland.ac.nz
authors.forename: Bridget
authors.initials: B
authors.lastname: Kool
authors.forename: Naina
authors.initials: N
authors.lastname: Raj
authors.forename: Iris
authors.initials: I
authors.lastname: Wainiqolo
authors.forename: Berlin
authors.initials: B
authors.lastname: Kafoa
authors.forename: Eddie
authors.initials: E
authors.lastname: McCaig
authors.forename: Shanthi
authors.initials: S
authors.lastname: Ameratunga
mesh_terms: D000058:Accidental Falls / Q000401:mortality / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015984:Causality; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D006259:Craniocerebral Trauma / Q000453:epidemiology*; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011159:Population Surveillance; D012042:Registries; D017678:Sex Distribution; D015996:Survival Rate; D055815:Young Adult