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- Talk
- 21/09/2021
- UK
Epidemiology of Fractures and Their Treatment in Malawi: Results of a Multicentre Prospective Registry Study to Guide Orthopaedic Care Planning
Description
This presentation, delivered by William Harrison on behalf of Alex, who is currently pursuing his PhD in Malawi, outlines a significant study addressing trauma care in Malawi. The study is spearheaded by Linda Chokotho, a Malawian expert, aiming to enhance trauma learning and systems in the context of a stark contrast between the UK and Malawi's trauma data and research capabilities.
Malawi faces a serious trauma epidemic, ranking fourth worldwide in trauma mortality, much of which is preventable through improved road safety and better trauma systems. The study was part of the AO Alliance Initiative aimed at improving fracture care over five years and began with an initiative in 2016 involving major hospitals in Blantyre and Lilongwe, as well as district hospitals.
Data collected from over 23,700 participants focused on significant fractures rather than general trauma, establishing a unique fracture care registry in Malawi. The demographic analysis reveals a male-dominant population with a large number of children, predominantly presenting with minor injuries. Falls and road accidents are identified as the leading causes of injuries. The study reported over 1,000 cases of open fractures mainly treated at central hospitals, while district hospitals primarily dealt with debridements due to a lack of surgical staff.
Notably, the findings discuss varied treatment rates and outcomes based on demographics, injury type, and healthcare provider qualifications, indicating that patients treated by orthopedic consultants had a higher chance of surgical intervention than those treated by less experienced staff. The analysis also highlights that most fractures are treated nonoperatively in Malawi, primarily by orthopedic clinical officers.
Though the study lacked patient outcome data, it lays an important foundation for future research aimed at improving trauma care and understanding the effectiveness of the interventions applied, particularly around open tibial shaft fractures. The presentation concludes by acknowledging ongoing studies, including the author's PhD work, which aims to delve deeper into outcome analysis and further enhance trauma care capacity in Malawi.