title: Epidemiology of Traumatic Injuries in the Northeast Region of Haiti: A Cross-sectional Study.
abstract: BACKGROUND
  More than 90% of traumatic morbidity and mortality occurs in low- and middle-income countries (LMIC). Haiti is the poorest country in the Western Hemisphere and lacks contemporary statistics on the epidemiology of traumatic injuries. This study aimed to characterize the burden of traumatic injuries among emergency department patients in the Northeast region of Haiti.
  
  
  METHODS
  Data were collected from the emergency departments of all public hospitals in the Northeast region of Haiti, which included the Fort Liberté, Ouanaminthe, and Trou du Nord sites. All patients presenting for emergent care of traumatic injuries were included. Data were obtained via review of emergency department registries and patient records from October 1, 2013 through November 30, 2013. Data on demographics, mechanisms of trauma, and anatomical regions of injury were gathered using a standardized tool and analyzed using descriptive statistics. Temporal analysis of injury frequency was explored using regression modeling.
  
  
  RESULTS
  Data from 383 patient encounters were accrued. Ouanaminthe Hospital treated the majority of emergent injuries (59.3%), followed by Fort Liberté (30.3%) and Trou du Nord (10.4%). The median age in years was 23 with 23.1% of patients being less than 15 years of age. Road traffic accidents (RTAs) and interpersonal violence accounted for 65.8% and 30.1% of all traumatic mechanisms, respectively. Extremity trauma was the most frequently observed anatomical region of injury (38.9%), followed by head and neck (30.3%) and facial (19.1%) injuries. Trauma due to RTA resulted in a single injury (83.8%) to either an extremity or the head and neck regions most frequently. A minority of patients had medical record documentation (37.9%). Blood pressure, respiratory rate, and mental status were documented in 19.3%, 4.1%, and 0.0% of records, respectively. There were 6.3 injuries/day during the data collection period with no correlation between the frequency of emergent trauma cases and day of the week (R(^2)=0.01).
  
  
  CONCLUSIONS
  Traumatic injuries are a common emergent presentation in the Northeast region of Haiti with characteristics similar to other LMIC. Documentation and associated data to adequately characterize the burden of disease in this region are lacking. Road traffic accidents are the predominate mechanism of injury, suggesting that interventions addressing prevention and treatment of this common occurrence may provide public health benefits in this setting.
authors.affiliation: 1Department of Emergency Medicine,Division of International Emergency Medicine,SUNY Downstate Medical Center,Brooklyn,New YorkUSA.
authors.forename: Adam R
authors.initials: AR
authors.lastname: Aluisio
authors.affiliation: 3Section of Emergency Medicine,Division of International Emergency Medicine,Louisiana State University Health Sciences Center,New Orleans,LouisianaUSA.
authors.forename: Annelies
authors.initials: A
authors.lastname: De Wulf
authors.affiliation: 4Department of Emergency Medicine,Queens Hospital Center,Queens,New YorkUSA.
authors.forename: Ambert
authors.initials: A
authors.lastname: Louis
authors.affiliation: 1Department of Emergency Medicine,Division of International Emergency Medicine,SUNY Downstate Medical Center,Brooklyn,New YorkUSA.
authors.forename: Christina
authors.initials: C
authors.lastname: Bloem
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult
keywords: Haiti; KTS Kampla Trauma Score; LMIC low- and middle-income countries; MSPP Ministère de la Santé Publique et de la Population (Ministry of Public Health and Population); RTA road traffic accident; RTS Revised Trauma Score; WHO World Health Organization; emergency care; injury; road traffic accidents; trauma