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Epidemiology of Traumatic Injuries in the Northeast Region of Haiti: A Cross-sectional Study

  • Adam R. Aluisio (a1) (a2), Annelies De Wulf (a3), Ambert Louis (a4) and Christina Bloem (a1)

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.


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.


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).


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.

Aluisio AR , De Wulf A , Louis A , Bloem C . Epidemiology of Traumatic Injuries in the Northeast Region of Haiti: A Cross-sectional Study. Prehosp Disaster Med. 2015;30(6):599605.

Corresponding author
Correspondence: Adam R. Aluisio, MD, MSc Department of Emergency Medicine SUNY Downstate Medical Center 450 Clarkson Ave Brooklyn, New York 11203 USA E-mail:
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1. World Health Organization. Injuries and Violence: The Facts. WHO Web site. Accessed July 13, 2015.
2. Lozano, R, Naghavi, M, Foreman, K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095-2128.
3. Chandran, A, Hyder, AA, Peek-Asa, C. The global burden of unintentional injuries and an agenda for progress. Epidemiol Rev. 2010;32:110-120.
4. Hofman, K, Primack, A, Keusch, G, Hrynkow, S. Addressing the growing burden of trauma and injury in low- and middle-income countries. Am J Public Health. 2005;95(1):13-17.
5. Mock, C, Joshipura, M, Arreola-Risa, C, Quansah, R. An estimate of the number of lives that could be saved through improvements in trauma care globally. World J Surg. 2012;36(5):959-963.
6. Gabbe, BJ, Simpson, PM, Sutherland, AM, et al. Improved functional outcomes for major trauma patients in a regionalized, inclusive trauma system. Ann Surg. 2012;255(6):1009-1015.
7. Cameron, PA, Gabbe, BJ, Cooper, DJ, Walker, T, Judson, R, McNeil, J. A statewide system of trauma care in Victoria: effect on patient survival. Med J Aust. 2008;189(10):546-550.
8. O'Reilly, GM, Joshipura, M, Cameron, PA, Gruen, R. Trauma registries in developing countries: a review of the published experience. Injury. 2013;44(6):713-721.
9. Mock, C, Juillard, C, Brundage, S, Goosen, J, Joshipura, M. Guidelines for trauma quality improvement programs. Geneva, Switzerland: World Health Organization Web site. Accessed July 13, 2015.
10. World Health Organization. Global plan for the decade of action for road safety 2011–2020. Geneva, Switzerland:World Health Organization Web site. Accessed July 13, 2015.
11. CIA. The World Factbook. Accessed March 23, 2014.
12. World Health Organization. Haiti: Health profile: 2015. WHO Web site. Accessed July 13, 2015.
13. Pan American Health Organization. Health Situation in the Americas Basic Indicators, 2014. Accessed July 13, 2015.
14. McIntyre, T, Hughes, CD, Pauyo, T, et al. Emergency surgical care delivery in post-earthquake Haiti: Partners in Health and Zanmi Lasante experience. World J Surg. 2011;35(4):745-750.
15. World Health Organization. Haiti: WHO statistical profile. WHO Web site. Accessed July 13, 2015.
16. Sletten, P, Egset, W. Poverty in Haiti. FAFO Paper; 2004:31. ISSN 0804-5135.
17. Dewberry, L, McCullough, C, Goss, J, Hugar, LA, Dente, CJ, Sharma, J. Trauma capacity in the central plateau department of Haiti. The Journal of Surgical Research. 2014;192(1):34-40.
18. Aluisio, AR, Gore, R, Decome, I, De Wulf, A, Bloem, C. Prehospital characteristics in the North East Department of Haiti: a cross-sectional study from a low-income setting without prehospital systems. Prehosp Disaster Med. 2014;29(3):230-236.
19. Centers for Disease Control and Prevention. Traumatic Injury. CDC Web site. Accessed July 13, 2015.
20. Aluisio, A, De Wulf, A, Pierre, P, Bloem, C. Emergency care resources and services in the North East Department of Haiti: a cross-sectional survey. Presentation at 18th World Congress on Disaster and Emergency Medicine; May 28-31, 2013: Manchester, United Kingdom.
21. MacLeod, J, Kobusingye, O, Frost, C, Lett, R, Kirya, F, Shulman, C. A comparison of the Kampala Trauma Score (KTS) with the Revised Trauma Score (RTS), Injury Severity Score (ISS), and the TRISS Method in a Ugandan trauma registry. European Journal of Trauma. 2003;29(6):392-398.
22. Clarkson, C, Clarkson, C, Rubiano, A, Borgaonkar, M. A comparison of the Kampala Trauma Score with the Revised Trauma Score in a cohort of Colombian trauma patients. Panamerican Journal of Trauma, Critical Care & Emergency Surgery. 2012;1(3):146-149.
23. Champion, HR, Sacco, WJ, Copes, WS, Gann, DS, Gennarelli, TA, Flanagan, ME. A revision of the Trauma Score. J Trauma. 1989;29(5):623-629.
24. Baker, SP, O'Neill, B, Haddon, W Jr., Long, WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187-196.
25. Copes, WS, Champion, HR, Sacco, WJ, Lawnick, MM, Keast, SL, Bain, LW. The Injury Severity Score revisited. J Trauma. 1988;28(1):69-77.
26. Mtonga, RE, Zavala, DE. Implementing a hospital-based injury surveillance system in Zambia: a preliminary report. Med Confl Surviv. 2008;24(4):280-284.
27. Hyder, AA, Sugerman, DE, Puvanachandra, P, et al. Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study. Bull World Health Organ. 2009;87(5):345-352.
28. Omoke, NI, Chukwu, CO, Madubueze, CC, Oyakhiolme, OP. Outcome of road traffic injuries received in the emergency room of a teaching hospital, Southeast Nigeria. Trop Doct. 2012;42(1):18-22.
29. Nievergelt, Y. Total least squares: state-of-the-art regression in numerical analysis. SIAM Review. 1994;36(2):258-264.
30. Mathers, CD, Boerma, T, Ma Fat, D. Global and regional causes of death. Br Med Bull. 2009;92:7-32.
31. Patton, GC, Coffey, C, Sawyer, SM, et al. Global patterns of mortality in young people: a systematic analysis of population health data. Lancet. 2009;374(9693):881-892.
32. Norton, R, Kobusingye, O. Injuries. N Engl J Med. 2013;368(18):1723-1730.
33. Mutasingwa, DR, Aaro, LE. Injury registration in a developing country. A study based on patients' records from four hospitals in Dar es Salaam, Tanzania. Cent Afr J Med. 2001;47(8):203-209.
34. Kobusingye, OC, Guwatudde, D, Owor, G, Lett, RR. Citywide trauma experience in Kampala, Uganda: a call for intervention. Inj Prev. 2002;8(2):133-136.
35. World Health Organization: The global burden of disease: 2004 update. WHO Web site. Accessed July 13, 2015.
36. Hyder, AA, Wunderlich, CA, Puvanachandra, P, Gururaj, G, Kobusingye, OC. The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation. 2007;22(5):341-353.
37. Soreide, K. Epidemiology of major trauma. Br J Surg. 2009;96(7):697-698.
38. Mock, CN, Jurkovich, GJ, nii-Amon-Kotei, D, Arreola-Risa, C, Maier, RV. Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma. 1998;44(5):804-812; discussion 812-804.
39. Wisborg, T, Murad, MK, Edvardsen, O, Husum, H. Prehospital trauma system in a low-income country: system maturation and adaptation during eight years. J Trauma. 2008;64(5):1342-1348.
40. Henry, JA, Reingold, AL. Prehospital trauma systems reduce mortality in developing countries: a systematic review and meta-analysis. J Trauma Acute Care Surg. 2012;73(1):261-268.
41. Zavalaa, DE, Bokongo, S, John, IA, et al. Implementing a hospital based injury surveillance system in Africa: lessons learned. Med Confl Surviv. 2008;24(4):260-272.
42. Sklaver, BA, Clavel-Arcas, C, Fandino-Losada, A, et al. The establishment of injury surveillance systems in Colombia, El Salvador, and Nicaragua (2000-2006). Rev Panam Salud Publica. 2008;24(6):379-389.
43. Sakran, JV, Greer, SE, Werlin, E, McCunn, M. Care of the injured worldwide: trauma still the neglected disease of modern society. Scand J Trauma Resusc Emerg Med. 2012;20:64.
44. John, IA, Mohammed, AZ, Lawoko, S, et al. Implementing a hospital based injury surveillance system: a case study in Nigeria. Med Confl Surviv. 2008;24(4):273-279.
45. Friede, KA, Osborne, MC, Erickson, DJ, et al. Predicting trauma admissions: the effect of weather, weekday, and other variables. Minn Med. 2009;92(11):47-49.
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