Jurnal internasional Afrika vol.11 issue 4 2021
African Journal of Emergency Medicine
Injury burdens and care delivery in relation to the COVID-19 pandemic in Kigali, Rwanda: A prospective interrupted cross-sectional study

Jurnal internasional Afrika vol.11 issue 4 2021
African Journal of Emergency Medicine
Injury burdens and care delivery in relation to the COVID-19 pandemic in Kigali, Rwanda: A prospective interrupted cross-sectional study

Rwanda
Injury care
COVID-19
Coronavirus
Global health
Lockdown

Introduction: Injuries cause significant burdens in sub-Saharan Africa. In Rwanda, national regulations to reduce
COVID-19 altered population mobility and resource allocations. This study evaluated epidemiological trends and

care among injured patients preceding and during the COVID-19 pandemic at the Centre Hospitalier Uni-
versitaire de Kigali (CHUK) in Kigali, Rwanda.

Methods: This prospective interrupted cross-sectional study enrolled injured adult patients (≥15 years) presenting

to the CHUK emergency department (ED) from January 27th-March 21st (pre-COVID-19 period) and June 1st-
28th (intra-COVID-19 period). Trained study personnel continuously collected standardized data on enrolled

participants through the first six-hours of ED care. The Kampala Trauma Score (KTS) was calculated as a metric
of injury severity. Case characteristics prior to and during the pandemic were compared, statistical differences
were assessed using χ2 or Fisher's exact tests.
Results: Data were collected from 409 pre-COVID-19 and 194 intra-COVID-19 cases. Median age was 32, with a
male predominance (74.3%). Road traffic injuries (RTI) were the most common injury mechanism pre-COVID-19
(47.8%) and intra-COVID-19 (53.6%) (p = 0.27). There was a significant increase in the number of transfer cases
during the intra-COVID-19 period (52.1%) versus pre-COVID-19 (41.3%) (p = 0.01). KTS was significantly lower
among intra-COVID-19 patients (p = 0.04), indicating higher severity of presentation. In the intra-COVID-19
period, there was a significant increase in the number of surgery consultations (40.7%) versus pre-COVID-19

(26.7%) (p < 0.001). The number of hospital admissions increased from 35.5% pre-COVID-19 to 46.4% intra-
COVID-19 (p = 0.01). There was no significant mortality difference pre-COVID-19 as compared to the intra-
COVID-19 period among injured patients (p = 0.76).

Conclusion: Emergency injury care showed increased injury burden, inpatient admission and resource re-
quirements during the pandemic period. This suggests the spectrum of disease may be more severe and that

greater resources for injury management may continue to be needed during the ongoing COVID-19 pandemic in
Rwanda and other similar settings.

Chantal Uwamahoro , Catalina Gonzalez Marques , Aly Beeman , Zeta Mutabazi , Francois Regis Twagirumukiza , Ling Jing , Vincent Ndebwanimana , Doris Uwamahoro , Menelas Nkeshimana , Oliver Y. Tang , Sonya Naganathan , Spandana Jarmale , Andrew Stephen , Adam R. Aluisio

https://doi.org/10.1016/j.afjem.2021.06.007

26 June 2021

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