title: Head injury--a neglected public health problem: a four-month prospective study at Jimma University Specialized Hospital, Ethiopia.
abstract: BACKGROUND
  Trauma, especially head trauma, is an expanding major public health problem and the leading cause of death of the young and productive part of the world's population. Research is mainly done in high-income countries where only a small proportion of the worldwide fatalities occur. The intention of this study was to analyze head injury in a setting where most patients in low- and middle-income countries receive treatment, a referral hospital with general but no neurosurgical service like Jimma University Specialized Hospital. The study aims to provide surgeons, hospital managers and health planners working in similar set-ups with baseline information for further investigation and prevention programs intending to reduce the burden of head injury.
  
  
  METHODS
  All head injury patients presented to Jimma University Specialized Hospital between March and June 2010 were included in this prospective research. Epidemiological, clinical and management data were collected for the study.
  
  
  RESULTS
  Out of 52 patients, 47 were males. The median age was 20.0 years (SD=13.3). Fights (n=20, 38.5%) and road traffic accidents (n=19, 36.5%) were the most common causes of head injury. Half of the patients sustained mild and 36.5% sustained severe head injury. The initial GCS had a significant correlation with the outcome. The mortality rate was 21.2%. Of all patients 76.9% were managed conservatively.
  
  
  CONCLUSIONS
  Prevention of road traffic accidents and improvement of conservative care were identified as major methods to reduce the burden of head injury in a set-up similar to Jimma. Further studies on head injury patients in low-income countries should be done.
authors.affiliation: Department of Surgery, Ludwig Maximilian University, Munich, Germany.
authors.forename: Isabel
authors.initials: I
authors.lastname: Aenderl
authors.affiliation: Department of Surgery, College of Public Health and Medical Science, Jimma University, Ethiopia.
authors.forename: Teshager
authors.initials: T
authors.lastname: Gashaw
authors.affiliation: Department of Surgery, Ludwig Maximilian University, Munich, Germany ; Center for International Health, Ludwig Maximilian University, Munich, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Siebeck
authors.affiliation: Department of Surgery, Ludwig Maximilian University, Munich, Germany.
authors.forename: Wolf
authors.initials: W
authors.lastname: Mutschler
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000209:etiology; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D014754:Violence / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Head injury; Low; Traffic accidents; Violence