Profie and Economic Impact of Motorcycle Injuries Treated at a University Referral Hospital in Kigali, Rwanda

Background: Motorcycle injuries constitute a major public health problem in developing countries, leading to significant disability and straining healthcare resources. We aim to present the basic epidemiology of motorcycle injuries presenting to an urban referral hospital in Rwanda and to evaluate patient outcomes and associated costs arising from injuries sustained on motorcycles.
Methods: We conducted a retrospective cross-sectional study of motorcycle injury patients presenting to Kigali Teaching University Hospital from January-December, 2011. Patients were identified through review of ward registers and trauma registries and stratified into 3 groups based upon length of stay. A representative sample of 269 patients was randomly selected from each group for financial analysis. Data were collected from patient medical, police, and financial records as well as patient interviews. Cost analysis was based upon the standard road accident cost conceptual framework. Data were collected using Epi data 3.1, Excel and analyzed using SPSS 16.
Results: A total of 269 motorcycle accident files were examined. Males were more affected than females with sex ratio F:M;1:6.72.Youths were more involved in motorcycle accident (53.2%) than other age group(16-30 years) .The majority of Motorcycles victims were motorcyclists, (30.86%), businessmen (20.45%) and students (11.53%). Motorcycle-vehicle (41.61%) was the fist cause of motorcycle injuries then motorcycle-pedestrian (30.86%). Helmet use was 92.75%. Head injuries and fractures were the predominant diagnoses (82.15%). About 46.7% had pre-hospital care. The mean hospital stay was 15.43 days, and 38.3% spent more than 15 days in hospitalization. Permanent disability was confirmed in 11.5% (n=31), and mortality was 10.4% (n=28). The total economic cost was estimated at US$1,236,207.31 with 39.40% (US$487,030.30) due to loss of labor and 21.76% due to direct medical costs (US$269,000.84).
Conclusions: Motorcycle injuries create a substantial disability and cost burden in Kigali, Rwanda. Prevention and early treatment should be promoted to decrease the morbidity and financial burden.

Keywords
Motorcycle injuries; prevalence; management; outcome; injury pattern; Helmet; accident; related cost; casualty; Rwanda