title: Analysis of Prehospital Transport Use for Trauma Patients in Lusaka, Zambia.
abstract: Despite an increasing burden of injuries, prehospital transport systems remain underdeveloped in many low- and middle-income countries. Little information exists on the use of prehospital services for trauma patients in Zambia.
  
  
  
  A prospective, observational study of trauma presentations was undertaken for 6 months in Lusaka, Zambia, to establish the epidemiology and outcomes of injury in the region. In addition to demographics and mechanism of injury, data were collected on prehospital transport as well as inpatient resources utilization. Trained study personnel gathered data on trauma presentations 24 h a day. Statistical analysis was conducted using SAS 9.3 from a Microsoft®Access database.
  
  
  
  3498 trauma patients were enrolled in the study on arrival to University Teaching Hospital (UTH). 3264 patients had a transport means recorded (95.3 %). Two-thirds (66 %) arrived within 6 h of injury, and 23 % arrived within the first hour after injury. A majority arrived by private vehicle (53.4 %) or public transport (37.7 %); only 5.9 % were transported by public or private ambulance. Of those arriving within the first hour after injury, 69.1 % came by private car, 24.6 % by public transport and 3.1 % by ambulance. There was a small statistical increase in Kampala Trauma Score II among ambulance arrivals.
  
  
  
  Trauma patient use a variety of transport methods to get to UTH. A majority of patients use no formal ambulance transport. Despite this fact, a majority arrives within 6 h of injury but receive no formal prehospital care. An integrated, multilayered prehospital care and transport system may be the most effective approach for Zambia.
authors.affiliation: Department of Emergency Medicine, Yale School of Medicine, 464 Congress Ave, Suite 260, New Haven, CT, 06510, USA. hani.mowafi@yale.edu.
authors.forename: Hani
authors.identifier: http://orcid.org/0000-0001-6225-8048
authors.initials: H
authors.lastname: Mowafi
authors.affiliation: University of Zambia School of Medicine, Lusaka, Zambia.
authors.forename: Rae
authors.initials: R
authors.lastname: Oranmore-Brown
authors.affiliation: Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Hopkins
authors.affiliation: Last Mile Health, Boston, USA.
authors.forename: Emily E
authors.initials: EE
authors.lastname: White
authors.affiliation: University Teaching Hospital, University of Zambia, Lusaka, Zambia.
authors.forename: Yacob F
authors.initials: YF
authors.lastname: Mulla
authors.affiliation: Department of Emergency Medicine, University of New Mexico, Albuquerque, USA.
authors.forename: Phil
authors.initials: P
authors.lastname: Seidenberg
mesh_terms: D000552:Ambulances; D004632:Emergency Medical Services; D006785:Hospitals, University; D006801:Humans; D011446:Prospective Studies; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000628:therapy*; D015024:Zambia