Nathan N O'Hara1, Rodney Mugarura2, Jeffrey Potter3, Trina Stephens4, M Marit Rehavi5, Patrick Francois5, Piotr A Blachut3, Peter J O'Brien3, Bababunmi K Fashola6, Alex Mezei7, Tito Beyeza2, Gerard P Slobogean8. 1. Department of Orthopaedics, University of British Columbia, Vancouver, Canada. Electronic address: nohara@umoa.umm.edu. 2. Department of Orthopaedics, Makerere University, Kampala, Uganda. 3. Department of Orthopaedics, University of British Columbia, Vancouver, Canada. 4. Centre for Clinical Epidemiology & Evaluation, University of British Columbia, Vancouver, Canada. 5. Vancouver School of Economics, University of British Columbia, Vancouver, Canada; Canadian Institute for Advanced Research, Toronto, Canada. 6. School of Population and Public Health, University of British Columbia, Vancouver, Canada. 7. Vancouver School of Economics, University of British Columbia, Vancouver, Canada. 8. Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, USA.
Abstract
INTRODUCTION: Traumatic injury is a growing public health concern globally, and is a major cause of death and disability worldwide. The purpose of this study was to quantify the socioeconomic impact of lower extremity fractures in Uganda. METHODS: All adult patients presenting acutely to Uganda's national referral hospital with a single long bone lower extremity fracture in October 2013 were recruited. Consenting patients were surveyed at admission and again at six-months and 12-months post-injury. The primary outcome was the cumulative 12-month post-injury loss in income. Secondary outcome measures included the change in health-related quality of life (HRQoL) and the injury's effect on school attendance for the patients' dependents. RESULTS: Seventy-four patients were recruited during the study period. Sixty-four (86%) of the patients were available for 12-months of follow-up. Compared to pre-injury earnings, patients lost 88.4% ($1822 USD) of their annual income in the 12-months following their injury. To offset this loss in income, patients borrowed an average of 28% of their pre-injury annual income. Using the EuroQol-5D instrument, the mean HRQoL decreased from 0.91 prior to the injury to 0.39 (p<0.0001) at 12-months post-injury. Ninety-three percent of school-aged dependents missed at least one month of school during their guardian's recovery and only 61% had returned to school by 12-months post-injury. CONCLUSION: This study demonstrates that lower extremity fractures in Uganda had a profound impact on the socioeconomic status of the individuals in our sample population, as well as the socioeconomic health of the family unit.
INTRODUCTION:Traumatic injury is a growing public health concern globally, and is a major cause of death and disability worldwide. The purpose of this study was to quantify the socioeconomic impact of lower extremity fractures in Uganda. METHODS: All adult patients presenting acutely to Uganda's national referral hospital with a single long bone lower extremity fracture in October 2013 were recruited. Consenting patients were surveyed at admission and again at six-months and 12-months post-injury. The primary outcome was the cumulative 12-month post-injury loss in income. Secondary outcome measures included the change in health-related quality of life (HRQoL) and the injury's effect on school attendance for the patients' dependents. RESULTS: Seventy-four patients were recruited during the study period. Sixty-four (86%) of the patients were available for 12-months of follow-up. Compared to pre-injury earnings, patients lost 88.4% ($1822 USD) of their annual income in the 12-months following their injury. To offset this loss in income, patients borrowed an average of 28% of their pre-injury annual income. Using the EuroQol-5D instrument, the mean HRQoL decreased from 0.91 prior to the injury to 0.39 (p<0.0001) at 12-months post-injury. Ninety-three percent of school-aged dependents missed at least one month of school during their guardian's recovery and only 61% had returned to school by 12-months post-injury. CONCLUSION: This study demonstrates that lower extremity fractures in Uganda had a profound impact on the socioeconomic status of the individuals in our sample population, as well as the socioeconomic health of the family unit.
Authors: Trina Stephens; Alexander Mezei; Nathan N O'Hara; Jeffrey Potter; Rodney Mugarura; Piotr A Blachut; Peter J O'Brien; Tito Beyeza; Gerard P Slobogean Journal: World J Surg Date: 2017-06 Impact factor: 3.352
Authors: Daniel K Kisitu; Nathan N O'Hara; Gerard P Slobogean; Andrea L Howe; Piotr A Blachut; Peter J O'Brien; David J Stockton Journal: J Orthop Trauma Date: 2022-09-01 Impact factor: 2.884
Authors: Alexander Thomas Schade; Nohakhelha Nyamulani; Leonard Ngoe Banza; Andrew John Metcalfe; Andrew Leather; Jason J Madan; David G Lallloo; Williams James Harrison; Peter MacPherson Journal: Wellcome Open Res Date: 2021-09-13
Authors: Ericka P von Kaeppler; Erik J Kramer; Claire A Donnelley; Hao-Hua Wu; Elliot Marseille; Edmund Eliezer; Heather J Roberts; David Shearer; Saam Morshed Journal: Malawi Med J Date: 2021-06 Impact factor: 0.875