title: Rwanda's Model Prehospital Emergency Care Service: A Two-year Review of Patient Demographics and Injury Patterns in Kigali.
abstract: Introduction Injury is responsible for nearly five million annual deaths worldwide, and nearly 90% of these deaths occur in low- and middle-income countries (LMICs). Reliable clinical data detailing the epidemiology of injury are necessary for improved care delivery, but they are lacking in these regions.
  
  
  METHODS
  A retrospective review of the Service d'Aide Medicale Urgente (SAMU; Kigali, Rwanda) prehospital database for patients with traumatic injury-related conditions from December 2012 through November 2014 was conducted. Chi-squared analysis, binomial probability test, and student's t-test were used, where appropriate, to describe patient demographics, injury patterns, and temporal and geographic trends of injuries.
  
  
  RESULTS
  In the two-year period, 3,357 patients were managed by SAMU for traumatic injuries. Males were 76.5% of the study population, and the median age of all injured patients was 29 years (IQR=23-35). The most common causes of injury were road traffic crashes (RTCs; 73.4%), stabbings/cuts (11.1%), and falls (9.4%), and the most common anatomic regions injured were the head (55.7%), lower (45.0%) extremities, and upper (27.0%) extremities. Almost one-fourth of injured patients suffered a fracture (24.9%). The most common mechanism of injury for adults was motorcycle-related RTCs (61.4%), whereas children were more commonly injured as pedestrians (59.8%). Centrally located sectors within Kigali represented common areas for RTCs.
  
  
  CONCLUSIONS
  These data support the call for focused injury prevention strategies, some of which already are underway in Rwanda. Further research on care processes and clinical outcomes for injured patients may help identify avenues for improved care delivery. Enumah S , Scott JW , Maine R , Uwitonze E , Nyinawankusi JD , Riviello R , Byiringiro JC , Kabagema I , Jayaraman S . Rwanda's model prehospital emergency care service: a two-year review of patient demographics and injury patterns in Kigali. Prehosp Disaster Med. 2016;31(6):614-620.
authors.affiliation: 1Johns Hopkins University School of Medicine,Baltimore,MarylandUSA.
authors.forename: Samuel
authors.identifier: http://orcid.org/0000-0001-7055-3231
authors.initials: S
authors.lastname: Enumah
authors.affiliation: 2Department of Surgery,Brigham and Women's Hospital,Boston,MassachusettsUSA.
authors.forename: John W
authors.identifier: http://orcid.org/0000-0002-9916-6523
authors.initials: JW
authors.lastname: Scott
authors.affiliation: 3University of California-San Francisco,Department of Surgery,San Francisco General Hospital,San Francisco,CaliforniaUSA.
authors.forename: Rebecca
authors.identifier: http://orcid.org/0000-0003-4327-8742
authors.initials: R
authors.lastname: Maine
authors.affiliation: 4Service d'Aide Medicale Urgente,Ministry of Health,Kigali,Rwanda.
authors.forename: Eric
authors.initials: E
authors.lastname: Uwitonze
authors.affiliation: 4Service d'Aide Medicale Urgente,Ministry of Health,Kigali,Rwanda.
authors.forename: Jeanne
authors.initials: J
authors.lastname: D'Arc Nyinawankusi
authors.affiliation: 2Department of Surgery,Brigham and Women's Hospital,Boston,MassachusettsUSA.
authors.forename: Robert
authors.identifier: http://orcid.org/0000-0003-3783-153X
authors.initials: R
authors.lastname: Riviello
authors.affiliation: 6Centre Hospitalier Universitaire de Kigali,Kigali,Rwanda.
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Byiringiro
authors.affiliation: 4Service d'Aide Medicale Urgente,Ministry of Health,Kigali,Rwanda.
authors.forename: Ignace
authors.initials: I
authors.lastname: Kabagema
authors.affiliation: 7Division of Trauma,Emergency Surgery, and Critical Care,Virginia Commonwealth University,Richmond,VirginiaUSA.
authors.forename: Sudha
authors.initials: S
authors.lastname: Jayaraman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003710:Demography / Q000639:trends*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012432:Rwanda / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification* / Q000453:epidemiology; D055815:Young Adult
keywords:  GCS Glasgow Coma Score;  LMIC low- and middle-income country;  RTC road traffic crash;  RTS Revised Trauma Score;  SAMU Service d’Aide Medicale Urgente; Rwanda; epidemiology; injury; prehospital; trauma